CVS Aetna Medicare Advantage Plans New York 2025

Navigating Medicare Advantage plans in New York can be overwhelming. CVS Health, through its partner Aetna, simplifies the process with tailored options that suit everyone’s healthcare needs and financial circumstances.

In this guide, we’ll cover the essentials of CVS Medicare Advantage plans in New York for 2025: the benefits, enrollment steps, and what each plan type means for you. Get ready to make an informed decision on securing the right healthcare coverage.


Key Takeaways

  • CVS Health, through Aetna, offers various Medicare Advantage plans in New York that integrate medical and prescription coverage with additional benefits such as dental, vision, and hearing, ensuring a comprehensive approach to health care.


  • Medicare Advantage plans by CVS Health include $0 premium options, extensive provider networks, and benefits like Extra Benefits Card, SilverSneakers fitness membership, and prescription drug coverage with convenient features like mail-order pharmacy services.


  • Enrollment in a CVS Health Medicare Advantage Plan requires Medicare Parts A and B and residency in the service area, with enrollment periods including the seven-month Initial Enrollment Period around one’s 65th birthday, and other windows such as General, Special, and Open Enrollment Periods.

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Understanding CVS Health’s Medicare Advantage Plans in New York


CVS Aetna Medicare Advantage Plans New York 2025, Understanding CVS Health's Medicare Advantage Plans in New York


CVS Health, through Aetna, offers Medicare Advantage plans to residents of New York. These plans ensure comprehensive healthcare coverage, making it easier for New Yorkers to manage their health and well-being.

CVS Health’s Medicare Advantage Plans are not merely an alternative to Original Medicare; they offer a total approach to healthcare, seamlessly integrating hospital and medical services with prescription coverage, and even adding enhanced benefits like dental, vision, and hearing care.

To cater to various health and budget needs, CVS Health offers several types of Medicare Advantage plans, including:

  • HMO (Health Maintenance Organization)


  • PPO (Preferred Provider Organization)



  • MA-only (Medicare Advantage Only) plans


Each type of plan offers a unique blend of services and cost-sharing, allowing you to choose a plan that best suits your needs and stand ready for any situation.


Types of Medicare Advantage Plans Offered by CVS Health

The HMO plans work with a specific network of healthcare providers to offer coordinated care. You’ll need to choose a primary care physician who will guide your healthcare and refer you to specialists within the network.

This type of plan is ideally suited for individuals who prefer to have their care coordinated through a single doctor.

On the other hand, PPO plans offer more flexibility. With a PPO, you can visit any healthcare provider, in or out of the network, without a referral. However, using providers in the plan’s network will cost less out-of-pocket.

D-SNP plans are designed for individuals who qualify for both Medicare and Medicaid, providing additional benefits to cater to their specific needs.

Finally, MA-only plans provide all the benefits of Original Medicare but do not include prescription drug coverage. These varying plan options ensure that CVS Health can cater to a wide range of healthcare needs and preferences.


Key Features of CVS Health Medicare Advantage Plans

The hallmark of CVS Health’s Medicare Advantage plans is their comprehensive care package. In addition to hospital and medical services, these plans include prescription coverage and enhanced benefits such as dental, vision, and hearing care – all in a single plan.

This all-encompassing approach to healthcare ensures that plan members have access to a wide range of services that cater to their overall health and well-being.

Another key feature of these plans is their affordability. Several Aetna Medicare Advantage plans are available with $0 premium options. This promotes cost-effectiveness while offering expanded benefits for dental, vision, and hearing on every plan.

Additionally, plan members benefit from features geared towards overall health and well-being, including an Extra Benefits Card, which may further enhance the advantageous nature of CVS Health’s Medicare Advantage plans.

Maximizing Your Health Care Coverage with CVS Health


CVS Aetna Medicare Advantage Plans New York 2025, Maximizing Your Health Care Coverage with CVS Health


CVS Health provides a range of Medicare Advantage plans, offering different cost and coverage options to suit varying needs and preferences. By choosing the appropriate CVS Health Medicare Advantage plan, you can ensure you have coverage that aligns with your healthcare needs and budget.

Whether you’re looking for low premiums or comprehensive benefits, CVS Health has a Medicare Advantage plan designed with you in mind.

Maximizing your health benefits involves more than just selecting a plan. It’s about taking full advantage of the benefits your plan offers. CVS Health’s Medicare Advantage plans include:

  • Prescription drug coverage, helps you save on medications


  • CVS Pharmacy’s extensive network offers significant savings on prescription medications under these plans


  • CVS Caremark Mail Service Pharmacy feature, which allows convenient delivery of medications, further enhancing the prescription drug benefits.


Access to a Wide Network of Providers


CVS Aetna Medicare Advantage Plans New York 2025, Maximizing Your Health Care Coverage with CVS Health


One of the key advantages of CVS Health’s Medicare Advantage plans is access to a wide network of healthcare providers. This includes primary care doctors, specialists, and hospitals, ensuring that you can get the care you need when you need it.

The strong provider network that integrates medical care with prescription drug coverage is one of the reasons why Aetna’s Medicare Advantage plans, partnering with CVS Health, are preferred by many New Yorkers.

Having a wide network of providers is not just about having choices; it’s about having the right choices. By choosing a provider within the network, you can ensure coordinated, high-quality care. This means less hassle for you and better health outcomes.


Prescription Drug Benefits


CVS Aetna Medicare Advantage Plans New York 2025, Maximizing Your Health Care Coverage with CVS Health


Prescription drug coverage is a crucial aspect of any healthcare plan. CVS Health’s Medicare Advantage plans include Medicare Part D prescription drug coverage, eliminating the need for a separate Part D plan.

This coverage extends to a variety of medications, including outpatient drugs, vaccines, and certain medical supplies, providing cost savings and convenience for members.

For individuals who qualify for both Medicare and Medicaid, the Dual Eligible Special Needs Plan (D-SNP) by Aetna offers $0 Part D drugs and an Extra Supports Wallet for additional allowances. This comprehensive coverage ensures that your prescription needs are well catered for, providing and financial savings.


OTC Allowance and Wellness Resources

In addition to the standard benefits, Aetna’s Medicare Advantage plans include allowances for essential needs, adding flexibility and value to member benefits. These plans go beyond traditional health coverage to ensure that members have access to resources that support their overall well-being.

Members also have access to wellness resources like the SilverSneakers fitness membership and meal delivery services following hospital stays for patients.

These resources promote healthy living and help members maintain their well-being, demonstrating CVS Health’s commitment to comprehensive healthcare.

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Navigating City Retirees’ Medicare Contract Options

City retirees have the unique option to choose between different Medicare contracts, such as Original Medicare or Medicare Advantage plans. This decision can have a considerable impact on your healthcare coverage, making it essential to understand the differences between these options.

When comparing Medicare Advantage to Original Medicare, retirees should consider factors like plan costs, network restrictions, and benefits coverage.

Medicare Advantage plans, such as those offered by CVS Health, may offer additional benefits like fitness programs, wellness services, vision, hearing, and dental benefits not typically covered by Original Medicare.

This makes Medicare Advantage plans an attractive option for city retirees looking for comprehensive healthcare coverage.


Comparing Medicare Supplement Plans and Medicare Advantage Plans

Medicare Supplement plans, also known as Medigap, complement Original Medicare by paying remaining out-of-pocket costs such as the 20% coinsurance. These plans can help manage out-of-pocket expenses but do not provide additional benefits like Medicare Advantage plans do.

On the other hand, Medicare Advantage plans cap out-of-pocket expenses annually, potentially reducing financial risk.

While Medicare Advantage plans typically require using a network of doctors, limiting member choice to within-network providers for non-emergency care, Original Medicare allows seeing any doctor that accepts Medicare.

Moreover, Medicare Supplement plans may provide emergency medical care coverage when traveling outside the U.S., a feature generally not available through Medicare Advantage plans, although some may offer this as a supplemental benefit.


How CVS Health Supports City Retirees


CVS Aetna Medicare Advantage Plans New York 2025, Navigating City Retirees' Medicare Contract Options


CVS Health, through Aetna, was awarded a significant Medicare Advantage contract for City of New York retirees. This contract, which potentially serves over 250,000 retirees, aims to:

  • Save the city approximately $600 million annually


  • Provide high-quality, affordable, and convenient healthcare services


  • Utilize Aetna’s extensive network of healthcare providers


The Medicare Advantage plan, one of the available Medicare plans, offered to city retirees is designed to improve healthcare access and affordability.

To ensure a smooth transition to the Medicare Advantage plan, CVS Health has been working closely with the City of New York and the Municipal Labor Committee on educational initiatives for retirees, focusing on labor relations.

The contract commences on September 1, 2023, with an initial period ending December 31, 2028, and includes options for extension.

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How to Enroll in a CVS Health Medicare Advantage Plan

Enrolling in a CVS Health Medicare Advantage Plan is a simple and straightforward process. To enroll, you must be enrolled in Medicare Parts A and B, live in the plan’s service area, and not be enrolled in a Medigap plan.

Enrollment can be accomplished through various methods, including online via the provider’s website, by mail with a completed enrollment form, or by phone through the insurance company or Medicare directly.

As you consider enrolling, it’s essential to understand the eligibility requirements and enrollment periods.


Eligibility Requirements

Medicare is generally available to individuals when they turn 65 years old. However, people under 65 may also qualify for Medicare under specific conditions.

For instance, if they receive disability benefits from Social Security or the Railroad Retirement Board, or if they have been diagnosed with end-stage renal disease or Lou Gehrig’s disease, they may be eligible for Medicare.

It’s important to note that eligibility requirements for specific Medicare Advantage plans might vary. For instance, D-SNP plans are designed for individuals who qualify for both Medicare and Medicaid. Therefore, it’s always a good idea to check the specific eligibility requirements for the plan you’re interested in.


Enrollment Periods

Enrollment periods for Medicare Advantage plans are defined by Medicare. There are several enrollment periods to be aware of:

  • Initial enrollment period: This is the seven-month window around your 65th birthday, from three months before to three months after the birth month.


  • General enrollment period: If you miss the initial enrollment period, you can enroll during the general enrollment for Medicare Parts A and B, which is from January 1st to March 31st.


  • Special enrollment period: This period is from April 1st to June 30th and is specifically for enrolling in a Medicare Advantage plan.


It’s important to understand these enrollment periods to ensure you can enroll in a Medicare Advantage plan at the right time.

Additionally, the annual open enrollment period for Medicare Advantage plans occurs each year from October 15th to December 7th. Current Medicare Advantage members also have an additional Open Enrollment Period from January 1st to March 31st, during which they can change or drop their plans.

These periods provide ample opportunities for you to enroll in or make changes to your Medicare Advantage plan.


Assistance and Customer Service


CVS Aetna Medicare Advantage Plans New York 2025


If you need assistance with enrollment or have questions about CVS Health’s Medicare Advantage plans, rest assured that help is readily available.

CVS Health provides dedicated customer service for assistance with enrollment and any questions you may have about their Medicare Advantage plans. You can access this assistance by simply choosing to please call our customer service phone line at 1-800-SHOP CVS (1-800-746-7287).

For personalized assistance, you can find guidance on Medicare Advantage plans at your local CVS Pharmacy. Whether you prefer to find information online, over the phone, or in person, CVS Health is committed to providing you with the support you need to make informed health coverage decisions.


In conclusion, CVS Health’s Medicare Advantage Plans offer comprehensive and affordable healthcare coverage for New Yorkers. With various plan types, a wide network of providers, prescription drug benefits, and additional wellness resources, CVS Health ensures a holistic approach to healthcare.

City retirees have the advantage of choosing between different Medicare contracts, and CVS Health provides the necessary support for a smooth transition.

With a clear understanding of eligibility requirements and enrollment periods, you can navigate your way to optimal healthcare coverage with CVS Health. Remember, your health is your wealth, and making the right healthcare choice is a significant step towards a healthy and fulfilling life.


Frequently Asked Questions


What is the most highly rated Medicare Advantage plan?

The most highly rated Medicare Advantage plan companies are Humana, AARP/UnitedHealthcare, Blue Cross Blue Shield, Aetna, and UnitedHealthcare, offering good coverage, affordable costs, and a broad array of options.

UnitedHealthcare is the largest provider of Medicare Advantage plans.


Is Medicare Advantage cheaper than Medicare?

Yes, Medicare Advantage plans often offer affordable or $0 monthly plan premiums, making them potentially cheaper than Original Medicare. Plans, benefits, and costs vary by plan, company, and region. Call us today for help on 1-844-350-0776.


What is the alternative to a Medicare Advantage plan?

The alternative to a Medicare Advantage plan is a Medigap plan, which supplements original Medicare and provides flexibility and choice in network selection.


Does New York have Medicare Advantage?

Yes, New York does have Medicare Advantage plans, with over 50% of Medicare beneficiaries in the state enrolled in such plans. Up to 7 insurers provide Medigap plans in New York, and there are various Medicare plan options available.


What are the different types of Medicare Advantage Plans offered by CVS Health?

CVS Health offers HMO, PPO, D-SNP, and MA-only Medicare Advantage plans. These plans cater to different healthcare needs and preferences.

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