CVS Aetna Medicare Advantage Plans New Jersey 2025

If you’re sifting through Medicare Advantage plans in New Jersey, you might wonder what sets CVS Aetna plans apart.

We cut through the clutter to highlight the advantages, cost-savings, and comprehensive coverage options unique to CVS Aetna Medicare Advantage Plans New Jersey, aiding your decision with straightforward facts and comparisons.

 

Key Takeaways

 

  • Eligibility for these plans requires being enrolled in Medicare Parts A and B and residing within the service area, with New Jersey beneficiaries having access to a broad provider and pharmacy network within the Aetna system, including 24/7 virtual care and walk-in clinics.

 

  • Individuals can enroll in CVS Aetna Medicare Advantage Plans during the Annual Enrollment Period from October 15 to December 7, and enjoy added perks such as disease management programs and behavioral health services, with the plans offering more inclusive benefits and potential financial savings compared to traditional Medicare.

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Understanding CVS Medicare Advantage Plans in New Jersey

 

CVS Aetna Medicare Advantage Plans New Jersey 2025, Understanding CVS Medicare Advantage Plans in New Jersey

 

Aetna, a CVS Health company, has widened its Medicare Advantage Plan offerings, allowing Medicare-eligible beneficiaries to access a more comprehensive range of services in New Jersey. Serving Medicare beneficiaries with robust prescription drug coverage, the plans are designed to cater to the diverse healthcare needs of nearly all Medicare members nationwide.

Whether you’re looking for a plan that offers prescription drug coverage or one that provides access to a broad network of health care providers, CVS Health’s Aetna Medicare Advantage Plans are a recommended health plan resource.

The CVS Health family has designed a suite of plans with different eligibility requirements to ensure that all Medicare-eligible beneficiaries can access the benefits they need.

These plans include Aetna Medicare SmartFit plans, and new preferred provider organization (PPO) plans, all tailored to meet the unique healthcare needs of the Medicare population.

 

Plan Types

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

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

Another popular option is the Aetna SmartFit plans, which are designed to provide convenient, affordable benefits to Medicare beneficiaries. These plans offer $0 monthly premium options, making them an accessible choice for those considering a switch to Medicare Advantage.

In fact, 84% of Medicare-eligible beneficiaries in the U.S. have access to a $0 monthly premium Aetna Medicare Advantage plan, emphasizing the broad reach and affordability of these plans.

 

Eligibility Requirements

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

For individuals with disabilities, eligibility extends 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 access the benefits of 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.

Exclusive Benefits of CVS Medicare Advantage Plans

 

CVS Aetna Medicare Advantage Plans New Jersey 2025, Exclusive Benefits of CVS Medicare Advantage

 

CVS Aetna Medicare Advantage plans offer a complete package of health care services, including:

  • Coverage for hospital stays

 

  • Medical services

 

  • Prescription drugs

 

  • Dental, vision, and hearing needs

 

The all-inclusive approach of the leading health solutions company ensures that members receive comprehensive care, including life insurance coverage, covering a wide spectrum of health needs.

Apart from the standard services, CVS Aetna Medicare Advantage plans also offer unique benefits, including:

  • Exclusive post-discharge meal delivery service for members after leaving an inpatient hospital or skilled nursing facility, fostering effective recovery

 

  • Behavioral health services via virtual means with qualified professionals

 

  • Additional financial savings through enriched Extra Benefits Cards and over-the-counter (OTC) benefits.

 

Comprehensive Health Risk Assessment

An integral part of the CVS Medicare Advantage plan is the Comprehensive Health Risk Assessment (HRA). These assessments capture essential self-reported data reflecting individual lifestyle choices and social factors, which are critical in identifying specific health risk factors and addressing care disparities.

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

This information forms the foundation for creating personalized care management programs, tailored to meet the unique needs of each patient.

 

Expanded Money-Saving Benefits

 

CVS Aetna Medicare Advantage Plans New Jersey 2025

 

CVS Medicare Advantage Plans have expanded their money-saving benefits to enhance member savings and well-being. The Aetna Medicare Extra Benefits Card, for instance, offers flexible allowances for members to spend on healthy foods, over-the-counter items, and even rent or mortgage payments. This feature provides greater financial flexibility for members.

In addition, members can now enjoy an expanded range of fitness benefits at no additional cost, including the fitness reimbursement benefit. These benefits encompass a SilverSneakers membership and reimbursements for activities such as pickleball, golf, swimming, and national and state park fees.

To further support cost savings, CVS Aetna Medicare Advantage plans have implemented strategies to reduce prescription drug costs for their members.

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Access to an Extensive Provider Network

 

CVS Aetna Medicare Advantage Plans New Jersey 2025, Access to an Extensive Provider Network

 

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

The plan ensures comprehensive coverage, giving members the peace of mind they need when it comes to their health care.

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

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

 

Participating Health Care Providers

To make the process of finding healthcare providers as easy as possible, Aetna offers an online tool for members to conveniently locate in-network healthcare providers in New Jersey.

The Aetna provider network in New Jersey includes a wide range of participating healthcare providers, offering members diverse options for their medical care. The network is designed to ensure that members 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 have access to a comprehensive network of pharmacy locations, including:

  • CVS Pharmacy®

 

  • Costco® Pharmacy

 

  • Walmart

 

  • Albertsons®

 

  • Publix Super Markets

 

  • Kroger®

 

  • Safeway

 

This extensive network ensures that members can conveniently access their medications, providing convenient and affordable benefits.

The Aetna Medicare pharmacy network has reduced prescription drug costs for prescription drug plan customers within the Medicare Advantage Prescription Drug (MAPD) plan portfolio. This includes offering $0 deductibles on Tier 1 and Tier 2 drugs and $0 copays at preferred network pharmacies for Tier 1 drugs.

Preferred network pharmacies offer members the possibility to save more on prescription medications compared to standard network pharmacies.


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Extra Services and Programs

 

CVS Aetna Medicare Advantage Plans New Jersey 2025, Extra Services and Programs

 

CVS Aetna Medicare Advantage plans offer a range of extra services and programs to support members’ health and well-being. These include:

  • Assistance in understanding care and plan benefits

 

  • Access to registered nurses for health questions

 

  • Support in caring for loved ones through available resources at all times

 

In addition, members can enjoy a webcast series focused on maintaining a healthy lifestyle, including in the New Jersey Aetna Medicare Advantage plans at no extra cost. These additional services and programs further emphasize the comprehensive nature of CVS Medicare Advantage plans.

 

Disease State Management Program

CVS Medicare Advantage plans include a Disease State Management Program designed to empower patients to manage their health proactively. Regularly conducted Health Risk Assessments (HRAs) help identify risk factors and prevent future health problems, thereby reducing healthcare costs. Additionally, certain management support services are provided to ensure the effectiveness of the program.

Personalized health plans for disease management are created based on identified risk factors from comprehensive HRAs, helping prevent functional decline.

As a health maintenance organization, our Healthy Home Visits granted to all Medicare Advantage plan members include comprehensive health risk assessments and a non-invasive physical exam.

 

Behavioral Health Plans

CVS Medicare Advantage Plans in New Jersey encompass a behavioral health component to effectively address the mental health and substance abuse needs of the members. The provider network of CVS Medicare Advantage Plans includes licensed mental health professionals, ensuring members have access to the care they need.

Behavioral health benefits emphasize early treatment and regular assessments to help avoid emergencies and maintain continuous support for the member’s mental health. Members of CVS Medicare Advantage Plans can also benefit from additional support such as health coaching and online wellness resources tailored to behavioral health.

Enrolling in a CVS Medicare Advantage Plan

 

CVS Aetna Medicare Advantage Plans New Jersey 2025

 

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.

Prior to 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 begins 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 ensures 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 are 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 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.

Comparing CVS Medicare Advantage Plans with Traditional Medicare

 

CVS Aetna Medicare Advantage Plans New Jersey 2025, Comparing CVS Medicare Advantage Plans with Traditional Medicare

 

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

Traditional Medicare allows beneficiaries to use any provider that contracts with Medicare, offering a broad choice without network restrictions.

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

A significant advantage of Medicare Advantage plans is the out-of-pocket maximum, which is capped at $8,000, providing a safety net for beneficiaries’ healthcare expenses.

Original Medicare has no out-of-pocket maximum unless a beneficiary opts for additional coverage through Medigap policies, which are incompatible with Medicare Advantage plans.

 

Coverage Differences

Coverage differences between CVS Medicare Advantage plans and traditional Medicare are significant. CVS Health’s Aetna Medicare Advantage plans in New Jersey offer a comprehensive package including:

  • Hospital coverage

 

  • Medical coverage

 

  • Prescription drug coverage

 

  • Additional benefits not typically covered by traditional Medicare

 

Through CVS Health, Aetna provides Medicare Supplement Insurance plans that cater to healthcare costs not covered by original Medicare, ensuring comprehensive coverage for enrollees. This expansive coverage is a significant factor to consider when comparing CVS Medicare Advantage plans with traditional Medicare.

 

Cost Differences

Cost is a critical factor when choosing a healthcare plan. Here are some key points 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, which stands at $174.70.

 

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

 

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

 

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

Medigap policies, used to supplement Original Medicare, offer standardized benefits but can have varying premiums that are often higher if purchased outside of the initial open enrollment period.

Summary

In conclusion, CVS Medicare Advantage plans offer New Jersey residents a comprehensive healthcare package that goes beyond traditional Medicare. With a wide range of plan types, a broad provider network, exclusive benefits, and additional services and programs, these plans are tailored to meet the diverse healthcare needs of Medicare-eligible individuals.

Whether you’re looking for a plan with robust prescription drug coverage, behavioral health plans, or one that offers expanded fitness benefits, CVS Health’s Medicare Advantage plans are 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 for 2025 is Humana, known for its good coverage, affordable costs, and highly rated member experience and drug plans.

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

 

How much does Medicare Advantage cost in NJ?

The average cost of a Medicare Advantage plan in New Jersey is around $14.98 to $22 per month.

 

What does Medicare Part B not cover?

Medicare Part B does not usually cover prescription drugs at retail pharmacies like CVS or Walgreens. Part B is the medical insurance portion of Original Medicare, 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.

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