Expanding CVS Health Medicare Advantage Plans in West Virginia
Through its Aetna subsidiary, CVS Health, a leading health solutions company, serves nearly 3.5 million people with Medicare Advantage plans.
Expanding into West Virginia, it promises personalized care and disease state management for home health services, thanks to the collaboration with myNEXUS.
However, it’s essential to note that the availability of these plans varies by ZIP code. This means that while some counties in West Virginia might have access to these expanded plan options, others might not.
But no matter where you are, the promise of a comprehensive healthcare plan that caters to your unique needs is worth exploring.
Aetna Medicare Advantage Plans
Aetna Medicare Advantage plans stand out from Original Medicare, offering:
- HMO and PPO plans with a Medicare contract
- Serving as a comprehensive substitute with potential additional benefits
- These potential additional benefits focus on total health, going beyond what Original Medicare provides and offering a holistic approach to healthcare.
Imagine having access to a concierge service that helps you find local resources. Think about 24-hour access to a registered nurse.
Medicare Advantage Prescription Drug Coverage
Medicare Advantage plans in West Virginia may come with prescription drug coverage. These plans combine hospital, medical, and medication coverage under one plan. And that’s not all.
Moreover, Aetna is moving nearly 300 medications to lower-cost tiers. This includes a cap of $35 for a one-month supply of insulin.
With prescription mail-order delivery and an updated formulary offering increased coverage and lower copays, Aetna Medicare Advantage plans are making a strong case for being one of the popular providers of Medicare Advantage Prescription Drug plans in West Virginia.
Participating Health Care Providers and Aetna Medicare Pharmacy Network
One of the significant advantages of the Aetna Medicare Advantage plans is the vast network of pharmacies it provides access to. With nearly 66,000 network pharmacies in West Virginia, including 24,000 preferred locations offering additional savings, members have a range of choices when it comes to healthcare providers.
Adding to this convenience is myNEXUS, a care management company engaged by Aetna Medicare Advantage to handle the network and claims payment for home health services among its members in West Virginia.
From July 1, 2022, myNEXUS has been responsible for processing all claims for approved home health services, requiring pre-authorization for all home health-related services for Medicare Advantage members.
In-Network vs. Out-of-Network Services
When it comes to selecting healthcare providers, understanding the difference between in-network and out-of-network services is crucial. Here’s what you need to know:
- An in-network provider has a contracted agreement with Aetna to offer services at reduced rates to members.
- In contrast, out-of-network providers do not have such agreements, typically resulting in higher costs for members.
- Members using out-of-network services can face higher out-of-pocket expenses, as certain Aetna plans may not offer out-of-network benefits outside of emergencies.
Hence, choosing in-network services is a financially prudent decision, helping members avoid balance billing and higher deductibles.
