Understanding CVS Medicare Advantage Plans in New Jersey

Aetna, a CVS Health company, will likely widen some of its Medicare Advantage Plan offerings, possibly allowing Medicare-eligible beneficiaries to access a more comprehensive range of services in New Jersey. Potentially serving Medicare beneficiaries with robust prescription drug coverage, the plans may be designed to cater to the diverse healthcare needs of nearly all Medicare members nationwide.

Whether you’re looking for a plan that could potentially offer prescription drug coverage or one that may provide access to a broad network of health care providers, some of CVS Health’s Aetna Medicare Advantage Plans may be a recommended health plan resource.

The CVS Health family will likely design a suite of plans that may have different eligibility requirements that could ensure that all Medicare-eligible beneficiaries may access the benefits they need.

These plans will likely include new preferred provider organization (PPO) plans, which may be tailored to meet the unique healthcare needs of the Medicare population.

Plan Types

Some of the CVS Medicare Advantage plans in New Jersey may offer a variety of plan types that could meet some of the diverse health needs of the population. One of these may be the Dual Eligible Special Needs Plan (D-SNP), tailor-made for individuals who qualify for both Medicare and Medicaid services.

This plan will likely ensure that dual-eligible beneficiaries receive comprehensive coverage for their unique health needs.

Eligibility Requirements

Eligibility for most of CVS Medicare Advantage plans in New Jersey will likely be based on specific criteria. To qualify, you must be at least 65 years old or have a qualifying disability.

For individuals with disabilities, eligibility may extend to those who have received 24 months of Social Security Disability Insurance (SSDI) or have been diagnosed with ALS or end-stage renal disease. By meeting these criteria, Medicare-eligible beneficiaries could potentially access some of the benefits of certain CVS Medicare Advantage plans in New Jersey.

It’s important to note that the Initial Enrollment Period for Medicare Advantage Plans corresponds with the time when an individual first becomes eligible for Medicare. This includes the three months before they start receiving Medicare and extends to three months after.

Potential Exclusive Benefits of CVS Medicare Advantage Plans

Some of the CVS Aetna Medicare Advantage plans may offer a complete package of health care services, which may include:

• Coverage for hospital stays

• Medical services

• Prescription drugs

• Dental, vision, and hearing needs

The potential all-inclusive approach of the leading health solutions company will likely ensure that members may receive comprehensive care.

Comprehensive Health Risk Assessment

One of the potential integrated parts of some of the CVS Medicare Advantage plans may be the Comprehensive Health Risk Assessment (HRA). These assessments will likely capture essential self-reported data that may reflect individual lifestyle choices and social factors, which could be critical in identifying specific health risk factors and addressing care disparities.

During an Annual Wellness Visit (AWV), HRAs may enrich biometric data with patient-reported insights, possibly offering a comprehensive perspective on a patient’s overall health condition.

This information could form the foundation for creating personalized care management programs, which may be tailored to meet the unique needs of each patient.

Possible Expanded Money-Saving Benefits

Some CVS Medicare Advantage Plans may offer to expand some of their money-saving benefits to potentially include member savings and well-being. For instance, some of the CVS Aetna Medicare Advantage plans may have implemented strategies that could potentially reduce prescription drug costs for their members.

Access to an Extensive Provider Network

CVS Medicare Advantage plan members in New Jersey will likely have access to an extensive provider network. This network may include a wide range of healthcare providers, that may range from local doctors and specialists to hospitals.

These plans could potentially ensure comprehensive coverage, possibly giving members the peace of mind they need when it comes to their health care.

Plan members may also benefit from 24/7 virtual care services, which may be accessed through phone, video, or mobile app. In addition, in-person walk-in visits may be available at over 1,000 MinuteClinic locations.

Aetna’s provider network in New Jersey will likely include both national chains and local health care providers, possibly ensuring members could have coverage options across the state.

Participating Health Care Providers

To make the process of finding healthcare providers as easy as possible, Aetna will likely offer an online tool for members that could help them conveniently locate in-network healthcare providers in New Jersey.

The Aetna provider network in New Jersey may include a wide range of participating healthcare providers, possibly offering members diverse options for their medical care. The network is designed to ensure that members may have access to the care they need, when they need it, from providers they trust.

Aetna Medicare Pharmacy Network

Members of the CVS Aetna Medicare Advantage plan in New Jersey will likely have access to a comprehensive network of pharmacy locations, which may include:

• CVS Pharmacy®

• Costco® Pharmacy

• Walmart

• Albertsons®

• Publix Super Markets

• Kroger®

• Safeway

This extensive network could potentially ensure that members might be able to conveniently access their medications, possibly providing convenient and affordable benefits.

The Aetna Medicare pharmacy network may also reduce some of the prescription drug costs for certain prescription drug plan customers within the Medicare Advantage Prescription Drug (MAPD) plan portfolio.

Some preferred network pharmacies might offer members the possibility to save more on prescription medications compared to standard network pharmacies.

Enrolling in a CVS Medicare Advantage Plan

Enrolling in a CVS Medicare Advantage plan in New Jersey requires meeting specific eligibility criteria. To qualify, individuals must be enrolled in Medicare Part A and B and reside in the plan’s service area.

Before enrolling, beneficiaries should review their current healthcare needs to determine if a CVS Medicare Advantage Plan is suitable for them.

During the Annual Enrollment Period, beneficiaries can switch from another Medicare Advantage plan to a CVS plan. Beneficiaries interested in enrolling should contact CVS to begin the application process and receive help with any questions.

The Medicare Annual Enrollment Period runs from October 15 to December 7 each year, during which time changes can be made to Medicare Advantage plans.

Steps to Enroll

To be eligible for a Medicare Advantage Plan, individuals need to be enrolled in both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Once enrolled, Medicare Advantage Plan coverage begins the same day as Medicare if enrollment occurs before Medicare starts.

Otherwise, coverage may begin on the first of the month following receipt of the enrollment request by the plan.

Individuals who get Part B after Part A can join a Medicare Advantage Plan during the three months before their Part B coverage begins. This provision could potentially ensure that there’s an adequate window for enrollment in the plan.

Important Dates

Noting important dates is critical when it comes to enrolling in a CVS Medicare Advantage Plan. Here are some important dates to remember:

• The Annual Open Enrollment Period for Medicare Advantage Plans in New Jersey runs from October 15 to December 7.

• The General Enrollment Period for Medicare, to sign up for Part B and Premium-Part A occurs annually from January 1 to March 31.

• Coverage for Medicare during the General Enrollment Period starts the month after enrollment.

The Medicare Advantage Open Enrollment Period allows current enrollees to switch or revert plans from January 1 to March 31 each year. Moreover, individuals may be eligible to join a Medicare Advantage Plan during their Initial Enrollment Period, which begins 3 months before and ends 3 months after they first receive Medicare.

Special Enrollment Periods could allow for joining or switching plans due to life events like moving or losing coverage, with coverage typically starting the first of the month following the plan’s receipt of the enrollment request.

Our licensed agents can provide comprehensive information, personalized guidance, and ongoing assistance to navigate the enrollment process for private insurance companies, making it easier for beneficiaries to make informed decisions about their healthcare. You can reach them at 1-844-350-0776 (TTY user 711) Mon-Fri 8am-9pm Est.

Comparing Potential CVS Medicare Advantage Plans with Traditional Medicare

Selecting a healthcare plan that suits your needs may be daunting, especially when numerous options abound. When comparing potential CVS Medicare Advantage plans with traditional Medicare, several differences may emerge.

Traditional Medicare will likely allow for beneficiaries to use any provider that contracts with Medicare, possibly offering a broad choice without network restrictions.

However, most Medicare Advantage plans, which may include CVS Health’s Aetna Medicare Advantage plans, could include a provider network that may limit the choice of healthcare providers compared to Traditional Medicare.

Original Medicare could potentially have no out-of-pocket maximum unless a beneficiary opts for additional coverage through Medigap policies, which may be incompatible with Medicare Advantage plans.

Potential Coverage Differences

Some of the possible coverage differences between certain CVS Medicare Advantage plans and traditional Medicare could be significant. Some of CVS Health’s Aetna Medicare Advantage plans in New Jersey may offer a comprehensive package that could include:

• Hospital coverage

• Medical coverage

• Prescription drug coverage

Through CVS Health, Aetna will likely provide Medicare Supplement Insurance plans that could cater to different healthcare costs that may not be covered by original Medicare, possibly ensuring comprehensive coverage for enrollees. The possibility of expansive coverage could be a significant factor to consider when comparing CVS Medicare Advantage plans with traditional Medicare.

Possible Cost Differences

Cost is a critical factor when choosing a healthcare plan. Here are some key points that you may want to consider:

• Traditional Medicare Part A is usually premium-free if the individual or their spouse paid Medicare taxes while employed.

• Medicare Part B has a standard monthly premium.

• Medicare Advantage plans may have an additional monthly premium on top of the standard Part B premium.

• Some Medicare Advantage plans could offer low or no additional premiums and might even offset the Part B premium costs.

Some Medicare Advantage plans may provide lower out-of-pocket costs when compared to Original Medicare, despite both having deductibles and coinsurance obligations.

Certain Medigap policies, which are typically used to supplement Original Medicare, may offer standardized benefits but may also include varying premiums that may be higher if purchased outside of the initial open enrollment period.

Summary

Some CVS Medicare Advantage plans may offer New Jersey residents a comprehensive healthcare package that could potentially go beyond traditional Medicare. With a wide range of plan types, a broad provider network, potential benefits, and possible additional services and programs, these plans may be tailored to meet the diverse healthcare needs of Medicare-eligible individuals.

Whether you’re looking for a plan that might offer robust prescription drug coverage or behavioral health plans, some of CVS Health’s Medicare Advantage plans may be a recommended health plan resource. It’s time to take health into your own hands with CVS Medicare Advantage plans.

Frequently Asked Questions

What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plan will likely be CVS Aetna, known for its good coverage, affordable costs, and highly rated member experience and drug plans.

UnitedHealthcare and Humana might also offer top-rated Medicare Advantage plans for their network size, potential perks, and low-cost plan availability.

What does Medicare Part B not cover?

Medicare Part B usually may not cover prescription drugs at retail pharmacies like CVS or Walgreens. Part B is the medical insurance portion of Original Medicare, and will likely be focused on outpatient care, physician services, preventive care, and medical supplies.

Is Aetna CVS Health different from Aetna?

Yes, Aetna Connected Plan and CVS Health are different entities, with CVS Health being a separate legal entity from Aetna Health Inc.

Who is eligible for CVS Medicare Advantage plans in New Jersey?

New Jersey residents who are at least 65 years old or have a qualifying disability are eligible for CVS Medicare Advantage plans.