CVS Aetna Medicare Advantage Plans 2025

Integrated Health Services Through CVS Aetna Medicare Advantage

Aetna Medicare plans, part of CVS Health and under the umbrella of Aetna Insurance Company, emphasize a comprehensive approach to health care that focuses on resources, support, and affordable care options, including behavioral health plans.

The wellness-centric design of Aetna Medicare Advantage plans connects members to health coverage across a wide spectrum of care needs. By blending medical, pharmacy, and retail capabilities, the plan strives toward a more connected, convenient, and budget-friendly healthcare model.

Personalized Pharmacy Support

As part of this integrated healthcare approach, members with chronic conditions like diabetes can benefit from Aetna’s plan. The option of 90-day refills facilitates continuous medication adherence, an essential factor in managing chronic conditions.

Furthermore, members have comprehensive access to the Aetna Managed Pharmacy Network, including specialty pharmacies like CVS Specialty and home infusion providers such as Coram. This broad network enhances personalized care for complex health needs, ensuring that members receive the best possible support.

Empowering Members with Data-Driven Health Solutions

In the modern health landscape, data-driven solutions are key to delivering personalized and proactive health care. As a leading health solutions company, CVS Health and Aetna understand this, deploying advanced health information technology to deliver tailored health messages to members.

By analyzing data and using it to inform health communications, these companies can empower members to take control of their health.

Tailored Health Communications

CVS Health leverages data analytics to deliver tailored health communications to patients. Using technologies such as Databricks and Microsoft Azure, CVS Health can analyze large databases to enhance personalized customer strategies.

This personalized approach extends even to campaign planning.

Enhanced Medical Management Capabilities

To enhance medical management capabilities, CVS Health employs advanced analytics tools and machine learning. Programs like Transform Diabetes Care develop personalized, predictive models for diabetes prevention, enabling members to stay one step ahead of their health.

Personalized data informs CVS Health’s methods to manage and support individual Medicare Advantage member health needs, offering more choices and greater flexibility.

This was exemplified by fixing malfunctioning glucometers for diabetic patients.

Excellence in Medicare Services Recognized

Aetna Medicare Advantage plans’ dedication to quality care and member satisfaction is not just a claim—it’s a recognized fact. The CMS Star Rating system evaluates Medicare Advantage plans based on multiple performance measures.

Aetna Medicare Advantage plans have consistently achieved ratings of 4 stars or above, a testament to their effective and comprehensive services for members.

Understanding CMS Medicare Star Ratings

The Medicare Star Ratings published by CMS serve as a benchmark for consumers to compare the quality of different Medicare plans. These ratings employ up to:

• 40 unique quality and performance measures for plans with prescription drug coverage

• 30 measures for Medicare Advantage-only plans

• 12 measures for standalone Prescription Drug Plans.

Star ratings encapsulate a variety of performance indicators that benefit member health outcomes, including member health outcomes improvement in areas such as:

• healthcare effectiveness

• member satisfaction

• responsiveness of the plan

• customer service

The methodology for these ratings is continually refined to enhance the stability and reliability of scores. For instance, the 2024 Star Ratings introduced the Tukey outlier deletion technique to remove extreme outliers from the calculation process.

Notably, Medicare Advantage contracts that have been part of the program longer tend to score higher on the Star Ratings, generally achieving 4 stars or more.

The Impact of High Star Ratings on Members

High Star Ratings have a profound positive impact on members. Members enrolled in higher-rated Medicare Advantage plans typically receive:

• Higher quality care

• Superior customer service

• Access to a wider network of healthcare providers

Enrolling in a 5-star plan outside the Annual Enrollment Period is possible, allowing members to access high-quality services sooner and potentially reducing health plan member complaints.

Strengthening Member Support with Coordinated Care

CVS Aetna Medicare Advantage plans recognize that healthcare is not a one-size-fits-all service. Their approach to member support is coordinated and personalized, strengthening the member experience through a team-based approach to healthcare and a holistic view of health and wellness needs.

The entire Aetna Medicare team plays a crucial role in delivering this exceptional service.

Team-Based Approach to Health Care

The team-based approach to healthcare involves collaboration between clinical pharmacists, healthcare providers, and personal care teams. Clinical pharmacists and health care providers collaborate within the Aetna national PPO contract, focusing on comprehensive care for individual MA members.

This collaborative approach not only ensures a comprehensive view of each member’s health status but also facilitates optimal medication management.

Summary

From integrated health services to personalized pharmacy support and data-driven health solutions to simplified access to OTC benefits, CVS Aetna Medicare Advantage plans offer a comprehensive approach to healthcare. The high CMS Star Ratings achieved by these plans demonstrate their dedication to quality care and member satisfaction.

By addressing individual health and wellness needs and offering coordinated care, these plans underscore the importance of a personalized approach to healthcare. With CVS Aetna Medicare Advantage, members can navigate their health journey with confidence, knowing they have a committed team at their side.