CVS Aetna Medicare Advantage Plans 2025

If you’re sifting through Medicare Advantage options, you might wonder how CVS Aetna Medicare Advantage plans measure up. From pharmacy services to MinuteClinic accessibility and a noted track record with CMS Star Ratings, our comprehensive guide lays out the pivotal details.

Read on to discover the nuanced care and value provided by CVS Aetna Medicare Advantage plans to see if they fit your needs.

 

Key Takeaways

  • CVS Aetna Medicare Advantage plans provide a comprehensive approach to health care with an emphasis on integrated services, including medical, pharmacy, and retail aspects, to ensure convenient and cost-effective care for members.

 

  • Advanced data analytics and health information technology underpin CVS Health’s strategies to personalize patient care, delivering tailored health communications and sophisticated medical management capabilities for predictive and proactive health solutions.

 


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Integrated Health Services Through CVS Aetna Medicare Advantage

 

CVS Aetna Medicare Advantage Plans 2,025 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.

The prescription drug plans under CVS Health ensure that members receive coverage for critical healthcare expenditures such as outpatient medication, important vaccines, and necessary medical supplies. Pharmacists provide targeted interventions for issues like correcting pharmacy coding errors related to medical supplies, which directly supports members in effectively managing their health conditions.

 

MinuteClinic® Accessibility

CVS Health offers an additional layer of convenience and accessibility through its MinuteClinic locations. Members of the Aetna Connected Plan with CVS Health can utilize these clinics to manage chronic conditions and fulfill their routine health screenings.

The effectiveness of MinuteClinic in managing member health is evident in achieving 5 stars for Breast Cancer Screening and controlling Blood Pressure for Medicare Advantage members.

What’s more, patients benefit from $0 copays for clinic services at MinuteClinic locations. This ensures easy and affordable access to necessary health services, further demonstrating CVS Health’s commitment to accessing affordable health care.

 

Empowering Members with Data-Driven Health Solutions

 

CVS Aetna Medicare Advantage Plans 2025 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. For instance, a personalized mobile messaging campaign by CVS Health, in partnership with IBM Watson Advertising, effectively engaged customers in areas with high flu activity.

By combining data, claims, and clinical literature, CVS Health creates a more personalized approach to managing patient therapy. Such data-driven initiatives not only enhance the patient experience but also drive improved health outcomes. The CVS Health President plays a crucial role in implementing these strategies.

 

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.

Clinical pharmacists at CVS Health conduct retrospective drug utilization reviews, promoting the appropriate use of medications for Medicare members. This proactive approach to patient management extends to Aetna D-SNP’s care teams, which deliver comprehensive support to members, such as rapidly resolving equipment issues and addressing drug plan member complaints.

This was exemplified by fixing malfunctioning glucometers for diabetic patients.

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Excellence in Medicare Services Recognized

 

CVS Aetna Medicare Advantage Plans 2025 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 benefits 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. For instance, 87% of CVS Aetna Medicare Advantage members are enrolled in plans rated 4 stars or higher by CMS for 2024. A 5-star rating in Care Coordination further underscores Aetna’s commitment to quality medical management and member satisfaction.

Members enrolled in higher-rated Medicare Advantage plans typically receive:

  • Higher quality care

 

  • Superior customer service

 

  • Access to a wider network of healthcare providers

 

  • Value-added services like the SilverSneakers fitness program

 

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.

 

Simplified Access to Over-the-Counter (OTC) Benefits

 

CVS Aetna Medicare Advantage Plans 2025 Simplified Access to Over-the-Counter (OTC) Benefits

 

In addition to comprehensive healthcare services, CVS Aetna Medicare Advantage members enjoy the following Over-the-Counter (OTC) benefits:

  • Simplified access to OTC items

 

  • Option to order items online or shop in person at select locations

 

  • Ability to manage minor health issues and support self-care initiatives conveniently

 

Hassle-Free Online Ordering

Hassle-free online ordering is a significant aspect of OTC benefits. Members can log in to the online OTC ordering system to see their specific OTC benefit amount and the items available for order. This system provides members with the flexibility to manage their OTC needs at their own pace and convenience.

For assistance with OTC orders, members also have the option to call a dedicated number to place their orders through an agent or use an automated system. This ensures that members, regardless of their comfort level with technology, can easily access their OTC benefits.

 

In-Person Shopping Experience

While online ordering offers comfort and convenience, there’s a unique value in the in-person shopping experience. CVS Aetna Medicare Advantage members can shop for OTC benefits at select CVS and Navarro locations.

This allows members to see products firsthand, ask staff for advice, and make informed decisions about their health needs.

Moreover, being able to walk out of the store with the necessary items offers immediate satisfaction and eliminates the wait for delivery. This in-person shopping experience is just another way CVS Aetna Medicare Advantage plans cater to the diverse needs and preferences of their members.

Strengthening Member Support with Coordinated Care

 

CVS Aetna Medicare Advantage Plans 2025 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.

The information from MinuteClinic visits can be shared with members’ primary care providers, improving coordinated care. Beyond medical assistance, Aetna’s team-based care includes consistent contact and emotional support for their members, emphasizing the importance of mental and emotional well-being in overall health.

 

Addressing Member Health and Wellness Needs

CVS Aetna Medicare Advantage plans offer comprehensive support to address member health and wellness needs, including Medicaid services. Specialized services like the Transform Oncology Care program and coverage for essential health needs such as oral, vision, and hearing care are designed to manage complex conditions and maintain overall health.

In addition to workers’ compensation administrative services, the Resources for Living® program connects members to local community programs and support groups, as well as personal healthcare resources. This program emphasizes the importance of social and community support in maintaining health and wellness.

Furthermore, the integration of hospital, medical, and additional coverage reinforces access to care, mirroring Aetna’s comprehensive approach to member health and wellness.

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.


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Frequently Asked Questions

 

What is the difference between Aetna Medicare and Aetna Medicare Advantage?

The main difference between Aetna Medicare and Aetna Medicare Advantage is that Medicare Advantage plans (Part C) are offered by private insurance companies like Aetna®, and they can include extra benefits that Original Medicare doesn’t offer.

 

Is Aetna CVS different from Aetna?

Yes, Aetna is now officially part of CVS Health after the $69 billion deal closed, making one of the largest healthcare giants even bigger.

 

How does CVS Aetna Medicare Advantage Plan use data analytics?

CVS Aetna Medicare Advantage Plan uses data analytics to deliver tailored health communications and enhance medical management capabilities, allowing them to inform health communications and manage individual health needs effectively.

 

What are CMS Star Ratings, and why are they important?

CMS Star Ratings provide a benchmark to compare the quality of Medicare Advantage and Prescription Drug Plans. Aetna Medicare Advantage plans have consistently achieved ratings of 4 stars or above, showing their dedication to quality care and member satisfaction.

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