Aetna Medicare Medicare Plan Hearing Aid Benefits

3,354,723 Total Members

OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? Enrollees
Aetna Medicare Aetna Medicare Plan (PPO)
H5521-801-0 		Local PPO No $0 No 650,141
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H5521-802-0 		Local PPO No $0 No 523,045
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-272-0 		Local PPO $30 per Month No $0 Yes $3,000 No No Yes No No 43,725
Aetna Medicare Aetna Medicare Advantra Silver (PPO)
H5522-004-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 41,524
Aetna Medicare Aetna Medicare Value (PPO)
H5521-086-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 39,549
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-120-0 		Local PPO No $0 Yes $2,500 No No Yes No No 35,522
Aetna Medicare Aetna Medicare Plan w/Rx $75 Buy-Down (PPO)
H5521-812-0 		Local PPO No $0 No 31,056
Aetna Medicare Aetna Medicare Gold Advantage Prime (HMO)
H2663-005-0 		HMO $120 per Quarter No $480 Yes $4,000 No No Yes No No 30,538
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-270-0 		Local PPO $35 per Month No $0 Yes $2,500 No No Yes No No 29,343
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H1609-001-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 28,967
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-170-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 27,893
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-081-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 27,748
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-091-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 25,967
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-043-0 		HMO $285 per Month No $0 Yes $5,000 No No Yes No No 25,353
Aetna Medicare Aetna Medicare Advantra Cares (HMO D-SNP)
H3959-036-0 		HMO $300 per Month Yes $0 Yes $5,000 No No Yes No No 25,087
Aetna Medicare Aetna Medicare Essential Elite Plan (PPO)
H5521-352-0 		Local PPO $75 per Quarter No $300 Yes No No Yes No No 23,731
Aetna Medicare Aetna Medicare Freedom Plus Plan (PPO)
H2293-008-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 23,711
Aetna Medicare Aetna Medicare Advantra Gold (HMO)
H3959-002-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 22,750
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-157-0 		Local PPO $75 per Quarter No $300 Yes No No Yes No No 21,861
Aetna Medicare Aetna Medicare Advantra Premier (HMO-POS)
H3959-032-0 		HMOPOS $150 per Quarter No $600 Yes $2,500 No No Yes No No 20,950
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H2293-016-0 		Local PPO $165 per Quarter No $660 Yes $2,000 No No Yes No No 20,598
Aetna Medicare Aetna Medicare Signature Plan (PPO)
H5521-360-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 20,373
Aetna Medicare Aetna Medicare Value (PPO)
H7301-007-0 		Local PPO $60 per Quarter No $240 Yes $4,000 No No Yes No No 19,219
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-089-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 18,768
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-273-0 		Local PPO $25 per Month No $0 Yes $2,000 No No Yes No No 18,620
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-005-0 		HMOPOS $150 per Quarter No $600 Yes $2,500 No No Yes No No 18,545
Aetna Medicare Aetna Medicare Advantra Gold (HMO)
H3959-001-0 		HMO $135 per Quarter No $540 Yes $2,500 No No Yes No No 17,477
Aetna Medicare Aetna Medicare Advantra Silver (HMO-POS)
H3959-011-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 17,062
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-088-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 16,868
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-016-0 		Local PPO $120 per Quarter No $480 Yes $3,000 No No Yes No No 16,818
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-140-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No No No No 16,401
Aetna Medicare Aetna Medicare Advantra Cares (HMO D-SNP)
H3959-035-0 		HMO $300 per Month Yes $0 Yes $5,000 No No Yes No No 16,162
Aetna Medicare Aetna Medicare Value Plus Plan (HMO)
H3146-006-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 15,371
Aetna Medicare Aetna Medicare Explorer Plan (PPO)
H5521-159-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 15,070
Aetna Medicare Aetna Medicare Premier (PPO)
H1608-001-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 15,040
Aetna Medicare Aetna Medicare Premier Advantra (PPO)
H7301-002-0 		Local PPO $105 per Quarter No $420 Yes $3,000 No No Yes No No 14,361
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-077-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 14,050
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-269-0 		Local PPO $25 per Month No $0 Yes $2,500 No No Yes No No 13,821
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3312-069-0 		HMO $215 per Month No $0 Yes $2,500 No No Yes No No 13,521
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3312-048-0 		HMO $45 per Quarter No $180 Yes $2,500 No No Yes No No 13,231
Aetna Medicare Aetna Medicare Premier (HMO)
H2663-026-0 		HMO $120 per Quarter No $480 Yes $3,000 No No Yes No No 12,665
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-319-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 12,511
Aetna Medicare Aetna Medicare Select (HMO)
H1609-018-0 		HMO $80 per Month No $0 Yes $2,500 No No Yes No No 12,324
Aetna Medicare Aetna Medicare Advantra Silver Plus (PPO)
H5522-013-0 		Local PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 11,994
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-003-0 		HMOPOS $90 per Quarter No $360 Yes $1,000 No No Yes No No 11,926
Aetna Medicare Aetna Medicare Plan (HMO)
H3152-801-0 		HMO No $0 No 11,810
Aetna Medicare Aetna Medicare Advantra Gold (HMO-POS)
H3959-037-0 		HMOPOS $150 per Quarter No $600 Yes $2,500 No No Yes No No 11,564
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3146-001-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 11,463
Aetna Medicare Aetna Medicare Assure 1 (HMO D-SNP)
H0628-013-0 		HMO $235 per Month No $0 Yes $4,000 No No Yes No No 11,392
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3597-001-0 		HMO $100 per Quarter No $400 Yes No No Yes No No 11,194
Aetna Medicare Aetna Medicare Value Advantra (PPO)
H7301-006-0 		Local PPO $75 per Quarter No $300 Yes $1,500 No No Yes No No 11,159
Aetna Medicare Aetna Medicare Assure Plan (HMO-POS D-SNP)
H5793-017-0 		HMOPOS $155 per Month Yes $0 Yes $2,500 No No Yes No No 10,770
Aetna Medicare Aetna Medicare Advantra Cares (HMO D-SNP)
H1692-005-0 		HMO $200 per Month No $0 Yes $4,000 No No Yes No No 10,639
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-218-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 10,623
Aetna Medicare Aetna Medicare Part B Only Plan (PPO)
H5521-805-0 		Local PPO No $0 No 10,531
Aetna Medicare Aetna Medicare Advantra Silver (PPO)
H5522-005-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 10,103
Aetna Medicare Aetna Medicare Advantra Value (HMO)
H3959-052-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 10,075
Aetna Medicare Aetna Medicare Value Plus Plan (HMO-POS)
H3748-003-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 10,057
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-293-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 9,748
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3312-070-0 		HMO $180 per Month No $0 Yes $2,500 No No Yes No No 9,683
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H7149-001-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 9,632
Aetna Medicare Aetna Medicare Select (HMO)
H1609-016-0 		HMO $70 per Month No $0 Yes $2,500 No No Yes No No 9,610
Aetna Medicare Aetna Medicare Freedom Plus Plan (PPO)
H2293-007-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 9,543
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H3192-007-0 		HMO $220 per Month No $0 Yes $4,000 No No Yes No No 8,673
Aetna Medicare Aetna Medicare Preferred Plan (PPO)
H5521-380-0 		Local PPO $75 per Quarter No $300 Yes $4,000 No No Yes No No 8,565
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3312-002-0 		HMO No $0 Yes $1,500 No No Yes No No 8,526
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-021-0 		Local PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 8,476
Aetna Medicare Aetna Medicare Premier Plus (HMO-POS)
H2663-023-0 		HMOPOS $180 per Quarter No $720 Yes $3,000 No No Yes No No 8,441
Aetna Medicare Aetna Medicare Premier (PPO)
H7301-009-0 		Local PPO $75 per Quarter No $300 Yes $4,000 No No Yes No No 8,437
Aetna Medicare Aetna Medicare Value (PPO)
H5521-214-0 		Local PPO $90 per Quarter No $360 Yes $1,500 No No Yes No No 8,275
Aetna Medicare Aetna Medicare Explorer Premier Plus (PPO)
H5521-278-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 8,171
Aetna Medicare Aetna Medicare Advantra Credit Value (PPO)
H5522-017-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 8,168
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-033-0 		Local PPO $30 per Month No $0 Yes $3,000 No No Yes No No 8,145
Aetna Medicare Aetna Medicare Advantra Silver (HMO-POS)
H3959-010-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 8,071
Aetna Medicare Aetna Medicare Advantra Premier Plus (PPO)
H5522-001-0 		Local PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 7,834
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-017-0 		Local PPO $120 per Quarter No $480 Yes $3,000 No No Yes No No 7,784
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H3748-009-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 7,603
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-016-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 7,599
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H3931-092-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 7,555
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-169-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 7,509
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-003-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 7,394
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-236-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 7,385
Aetna Medicare Aetna Medicare Advantra Gold (PPO)
H1608-027-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 7,383
Aetna Medicare Aetna Medicare Value (PPO)
H5521-263-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 7,295
Aetna Medicare Aetna Medicare Value Plan (HMO)
H8332-002-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 7,231
Aetna Medicare Aetna Medicare Explorer Plan (PPO)
H5521-374-0 		Local PPO $75 per Quarter No $300 Yes No No Yes No No 7,160
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-168-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 6,999
Aetna Medicare Aetna Medicare Freedom Core Plan (PPO)
H3288-020-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 6,927
Aetna Medicare Aetna Medicare Explorer Plan (PPO)
H5521-160-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 6,832
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-243-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 6,825
Aetna Medicare Aetna Medicare Dual Complete Plan (HMO D-SNP)
H8597-001-0 		HMO $150 per Month No $0 Yes $2,500 No No Yes No No 6,796
Aetna Medicare Aetna Medicare $100 Buy-Down Plan w/Rx (PPO)
H5521-810-0 		Local PPO No $0 No 6,668
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3146-004-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 6,551
Aetna Medicare Aetna Medicare Advantra Silver (PPO)
H1608-029-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 6,389
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H5522-803-0 		Local PPO No $0 No 6,327
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-178-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 6,208
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-245-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 6,156
Aetna Medicare Aetna Medicare Prime Plus Plan (HMO-POS)
H3931-151-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 6,138
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-247-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 6,070
Aetna Medicare Aetna Medicare Advantra Silver (HMO-POS)
H1692-002-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 6,031
Aetna Medicare Aetna Medicare Value (PPO)
H5521-195-0 		Local PPO $105 per Quarter No $420 Yes $1,500 No No Yes No No 5,996
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-048-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 5,858
Aetna Medicare Aetna Medicare Signature Plan (PPO)
H2293-006-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 5,819
Aetna Medicare Aetna Medicare Prime Value (HMO-POS)
H3152-080-0 		HMOPOS $60 per Quarter No $240 Yes $2,500 No No Yes No No 5,689
Aetna Medicare Aetna Medicare Value Plan (PPO)
H3288-047-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 5,666
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-050-0 		Local PPO $75 per Quarter No $300 Yes $4,000 No No Yes No No 5,587
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-087-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 5,587
Aetna Medicare Aetna Medicare Credit Plan (PPO)
H5521-313-0 		Local PPO No $0 Yes $1,500 No No Yes No No 5,581
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-099-0 		HMOPOS $210 per Quarter No $840 Yes $4,000 No No Yes No No 5,571
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-344-0 		Local PPO $90 per Quarter No $360 Yes $3,000 No No Yes No No 5,555
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-044-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 5,473
Aetna Medicare Aetna Medicare Value (PPO)
H5521-099-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 5,433
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-268-0 		Local PPO $30 per Month No $0 Yes $2,000 No No Yes No No 5,418
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-017-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 5,404
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-312-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 5,351
Aetna Medicare Aetna Medicare Value (PPO)
H5521-261-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 5,230
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H9431-001-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 5,207
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-018-0 		Local PPO $90 per Quarter No $360 Yes $3,000 No No Yes No No 5,002
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H2293-013-0 		Local PPO $75 per Quarter No $300 Yes $1,500 No No Yes No No 4,961
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-001-0 		HMO $250 per Month No $0 Yes $5,000 No No Yes No No 4,878
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-001-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 4,870
Aetna Medicare Aetna Medicare Advantra Premier Plus (PPO)
H5522-002-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 4,792
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-001-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 4,782
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-391-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 4,779
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-100-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 4,699
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-008-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 4,646
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-150-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 4,582
Aetna Medicare Aetna Medicare Advantra Eagle (HMO)
H3959-041-0 		HMO $120 per Quarter No $480 Yes $1,500 No No Yes No No 4,508
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-286-0 		Local PPO $120 per Quarter No $480 Yes $3,000 No No Yes No No 4,502
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-002-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 4,452
Aetna Medicare Aetna Medicare Value Plus Plan (PPO)
H5521-326-0 		Local PPO $70 per Month No $0 Yes $1,000 No No Yes No No 4,438
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-328-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 4,352
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-101-0 		HMOPOS $150 per Quarter No $600 Yes $2,000 No No Yes No No 4,276
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-037-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 4,248
Aetna Medicare Aetna Medicare Advantra (HMO-POS)
H8649-003-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 4,208
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H2056-005-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 4,186
Aetna Medicare Aetna Medicare Explorer Premier (PPO)
H5521-037-0 		Local PPO No $0 Yes $2,500 No No Yes No No 4,153
Aetna Medicare Aetna Medicare Explorer Value (HMO)
H3152-082-0 		HMO No $0 Yes $2,000 No No Yes No No 4,105
Aetna Medicare Aetna Medicare Premier Plus 1 (PPO)
H5521-250-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 4,100
Aetna Medicare Aetna Medicare Value (PPO)
H5521-231-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 3,962
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3597-007-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 3,933
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H2293-019-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 3,932
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-271-0 		Local PPO $35 per Month No $0 Yes $2,000 No No Yes No No 3,868
Aetna Medicare Aetna Medicare Advantra Premier (HMO-POS)
H3959-039-0 		HMOPOS $120 per Quarter No $480 Yes $2,500 No No Yes No No 3,851
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H2663-028-0 		HMOPOS $120 per Quarter No $480 Yes $3,000 No No Yes No No 3,841
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-011-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 3,825
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-118-0 		Local PPO No $0 Yes $2,500 No No Yes No No 3,822
Aetna Medicare Aetna Medicare Premier Plan (HMO)
H4523-015-0 		HMO $90 per Quarter No $360 Yes $1,000 No No Yes No No 3,801
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H2663-029-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 3,728
Aetna Medicare Aetna Medicare Plus Plan (PPO)
H3288-045-0 		Local PPO No $0 Yes $1,000 No No Yes No No 3,717
Aetna Medicare Aetna Medicare Advantra Value (HMO-POS)
H3959-055-0 		HMOPOS $120 per Quarter No $480 Yes $2,500 No No Yes No No 3,700
Aetna Medicare Aetna Medicare Advantra Premier Plus (PPO)
H5522-014-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 3,581
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H5593-001-0 		HMO $205 per Month No $0 Yes $4,000 No No Yes No No 3,569
Aetna Medicare Aetna Medicare Prime Plus Plan (HMO-POS)
H4835-001-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 3,517
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-143-0 		HMOPOS $135 per Quarter No $540 Yes $3,000 No No Yes No No 3,459
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-055-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 3,456
Aetna Medicare Aetna Medicare Prime (HMO-POS)
H3192-001-0 		HMOPOS $135 per Quarter No $540 Yes $2,000 No No Yes No No 3,445
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3931-152-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 3,439
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-039-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 3,436
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H2056-003-0 		HMOPOS $45 per Quarter No $180 Yes $4,000 No No Yes No No 3,426
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-005-0 		HMO $200 per Month No $0 Yes $2,500 No No Yes No No 3,335
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-232-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 3,328
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H2293-017-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 3,268
Aetna Medicare Aetna Medicare Duly Prime (PPO)
H5521-314-0 		Local PPO $120 per Quarter No $480 Yes $1,500 No No Yes No No 3,207
Aetna Medicare Aetna Medicare Prime (HMO-POS)
H3192-006-0 		HMOPOS $75 per Quarter No $300 Yes $1,500 No No Yes No No 3,207
Aetna Medicare Aetna Medicare Select Plan (PPO)
H5521-128-0 		Local PPO No $0 Yes $2,500 No No Yes No No 3,197
Aetna Medicare Aetna Medicare Value (PPO)
H5521-262-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 3,191
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-040-0 		Local PPO No $0 Yes $2,500 No No Yes No No 3,188
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-110-0 		Local PPO No $0 Yes $2,500 No No Yes No No 3,110
Aetna Medicare Aetna Medicare Value (PPO)
H5521-223-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 3,106
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H4711-012-0 		HMO $215 per Month No $0 Yes $4,000 No No Yes No No 3,097
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-249-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 3,082
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-004-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 3,081
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-002-0 		HMO $175 per Month No $0 Yes $2,500 No No Yes No No 3,019
Aetna Medicare Aetna Medicare Dual Complete Plan (HMO D-SNP)
H8597-003-0 		HMO $150 per Month No $0 Yes $5,000 No No Yes No No 3,014
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-234-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 3,010
Aetna Medicare Aetna Medicare Dual Prime Plan (HMO D-SNP)
H4711-011-0 		HMO $140 per Month Yes $0 Yes $5,000 No No Yes No No 2,989
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-094-0 		HMOPOS $120 per Quarter No $480 Yes $2,500 No No Yes No No 2,964
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H2663-021-0 		HMOPOS $180 per Quarter No $720 Yes $3,000 No No Yes No No 2,962
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-125-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 2,962
Aetna Medicare Aetna Medicare Assure 1 (HMO D-SNP)
H0628-012-0 		HMO $185 per Month No $0 Yes $4,000 No No Yes No No 2,943
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-001-0 		HMO $235 per Month No $0 Yes $2,500 No No Yes No No 2,926
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H1609-017-0 		HMO $150 per Month No $0 Yes $5,000 No No Yes No No 2,924
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-048-0 		HMO $285 per Month No $0 Yes $5,000 No No Yes No No 2,920
Aetna Medicare Aetna Medicare Prime Plan (HMO)
H4523-024-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 2,903
Aetna Medicare Aetna Medicare Explorer Elite (HMO)
H3152-084-0 		HMO No $0 Yes $2,500 No No Yes No No 2,892
Aetna Medicare Aetna Medicare Advantra Philly Prime (HMO)
H3959-053-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 2,869
Aetna Medicare Aetna Medicare Dual Complete Plan (HMO D-SNP)
H8597-002-0 		HMO $150 per Month No $0 Yes $4,000 No No Yes No No 2,864
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-009-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 2,863
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-215-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 2,852
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H2293-018-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 2,850
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-227-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 2,847
Aetna Medicare Aetna Medicare Advantra Value (PPO)
H1608-041-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 2,827
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-321-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 2,789
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-002-0 		HMO $250 per Month No $0 Yes $5,000 No No Yes No No 2,784
Aetna Medicare Aetna Medicare Elite Plan (HMO)
H5793-010-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 2,757
Aetna Medicare Aetna Medicare Assure Gold Prime (HMO D-SNP)
H5325-005-0 		HMO $275 per Month Yes $0 Yes $5,000 No No Yes No No 2,749
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-194-0 		Local PPO $105 per Quarter No $420 Yes $1,500 No No Yes No No 2,721
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-217-0 		Local PPO $75 per Quarter No $300 Yes $2,000 No No Yes No No 2,708
Aetna Medicare Aetna Medicare Platinum Plan (HMO-POS)
H3931-129-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 2,701
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-141-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 2,695
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-046-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 2,689
Aetna Medicare Aetna Medicare Prime Credit (PPO)
H5521-277-0 		Local PPO No $0 Yes $2,000 No No Yes No No 2,657
Aetna Medicare Aetna Medicare Select Plan (HMO)
H8332-003-0 		HMO $165 per Quarter No $660 Yes $2,500 No No Yes No No 2,599
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-171-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 2,556
Aetna Medicare Aetna Medicare Select (HMO)
H1609-020-0 		HMO $60 per Month No $0 Yes $2,500 No No Yes No No 2,552
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-090-0 		Local PPO $135 per Quarter No $540 Yes $3,000 No No Yes No No 2,509
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-007-0 		HMO $235 per Month No $0 Yes $2,500 No No Yes No No 2,439
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-390-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 2,433
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H2663-810-0 		HMO No $0 No 2,425
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-220-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 2,423
Aetna Medicare Aetna Medicare Advantra Value (PPO)
H1608-040-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 2,420
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H5302-012-0 		HMO $195 per Month No $0 Yes $2,500 No No Yes No No 2,414
Aetna Medicare Aetna Medicare Premier (PPO)
H1608-012-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 2,348
Aetna Medicare Aetna Medicare Advantra Select (HMO-POS)
H8649-008-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 2,332
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-254-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 2,303
Aetna Medicare Aetna Medicare Value (PPO)
H5521-219-0 		Local PPO $75 per Quarter No $300 Yes $1,500 No No Yes No No 2,295
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-222-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 2,272
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-329-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 2,262
Aetna Medicare Aetna Medicare Advantra Premier (HMO)
H3959-033-0 		HMO $135 per Quarter No $540 Yes $2,500 No No Yes No No 2,261
Aetna Medicare Aetna Medicare Advantra Credit Value (PPO)
H1608-031-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 2,244
Aetna Medicare Aetna Medicare Sunrise Plan (HMO-POS)
H3931-146-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 2,243
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-230-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 2,241
Aetna Medicare Aetna Medicare Assure Plan (HMO-POS D-SNP)
H3597-011-0 		HMOPOS $150 per Month Yes $0 Yes $2,500 No No Yes No No 2,241
Aetna Medicare Aetna Medicare Choice II Plan (PPO)
H3288-018-0 		Local PPO $120 per Quarter No $480 Yes $1,000 No No Yes No No 2,237
Aetna Medicare Aetna Medicare Dual Select Plan (HMO D-SNP)
H3239-011-0 		HMO $120 per Month No $0 Yes $1,000 No No Yes No No 2,227
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H2056-004-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 2,223
Aetna Medicare Aetna Medicare Value Plan (HMO)
H8332-001-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 2,206
Aetna Medicare Aetna Medicare Premier Plan (HMO)
H4523-001-0 		HMO $75 per Quarter No $300 Yes $1,000 No No Yes No No 2,201
Aetna Medicare Aetna Medicare Value Plus Plan (PPO)
H2293-001-0 		Local PPO $40 per Month No $0 Yes $2,500 No No Yes No No 2,153
Aetna Medicare Aetna Medicare Premier Plus 2 (PPO)
H1608-024-0 		Local PPO $120 per Quarter No $480 Yes $3,000 No No Yes No No 2,151
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H4711-002-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 2,136
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-045-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 2,128
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-028-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 2,116
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-098-0 		HMOPOS $105 per Quarter No $420 Yes $2,000 No No Yes No No 2,106
Aetna Medicare Aetna Medicare Value (PPO)
H7301-011-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 2,103
Aetna Medicare Aetna Medicare Select (HMO)
H1609-034-0 		HMO $80 per Month No $0 Yes $2,500 No No Yes No No 2,086
Aetna Medicare Aetna Medicare Value (PPO)
H5521-288-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 2,079
Aetna Medicare Aetna Medicare Choice II Plan (PPO)
H3288-002-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 2,077
Aetna Medicare Aetna Medicare Select (HMO)
H1609-021-0 		HMO $65 per Month No $0 Yes $3,000 No No Yes No No 2,047
Aetna Medicare Aetna Medicare Value Plus Plan (HMO)
H3146-011-0 		HMO $105 per Quarter No $420 Yes $4,000 No No Yes No No 2,047
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-348-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 2,038
Aetna Medicare Aetna Medicare Advantra Butler Prime (HMO)
H3959-047-0 		HMO $150 per Quarter No $600 Yes $2,500 No No Yes No No 2,011
Aetna Medicare Aetna Medicare Platinum Plus Plan (HMO-POS)
H3748-004-0 		HMOPOS No $0 Yes $2,500 No No Yes No No 2,007
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-382-0 		Local PPO $45 per Quarter No $180 Yes $2,000 No No Yes No No 1,977
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-003-0 		HMO $195 per Month No $0 Yes $2,500 No No Yes No No 1,970
Aetna Medicare Aetna Medicare SNJ Prime Elite (PPO)
H5521-123-0 		Local PPO No $0 Yes $2,500 No No Yes No No 1,969
Aetna Medicare Aetna Medicare Select (HMO)
H1609-027-0 		HMO $50 per Month No $0 Yes $3,000 No No Yes No No 1,962
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-003-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,957
Aetna Medicare Aetna Medicare Preferred Premium Plan (PPO)
H3288-042-0 		Local PPO $60 per Quarter No $240 Yes $1,500 No No Yes No No 1,952
Aetna Medicare Aetna Medicare Explorer Plan (PPO)
H5521-375-0 		Local PPO $100 per Quarter No $400 Yes No No Yes No No 1,933
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H2056-001-0 		HMOPOS $60 per Quarter No $240 Yes $4,000 No No Yes No No 1,902
Aetna Medicare Aetna Medicare Value (PPO)
H5521-285-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 1,894
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-056-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,880
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-290-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,876
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-341-0 		Local PPO No $0 Yes $1,500 No No Yes No No 1,874
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H5302-013-0 		HMO $190 per Month No $0 Yes $2,500 No No Yes No No 1,865
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-056-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 1,862
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-002-0 		HMO $165 per Month Yes $0 Yes $5,000 No No Yes No No 1,859
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-233-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 1,859
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-033-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 1,846
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H3931-804-0 		HMO No $0 No 1,842
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H3192-009-0 		HMO $80 per Month No $0 Yes $4,000 No No Yes No No 1,831
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-038-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,829
Aetna Medicare Aetna Medicare Explorer Premier (HMO-POS)
H3152-022-0 		HMOPOS $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,816
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-006-0 		Local PPO $165 per Quarter No $660 Yes $1,000 No No Yes No No 1,815
Aetna Medicare Aetna Medicare Freedom Preferred Plan (PPO)
H2293-014-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 1,796
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-003-0 		HMO $250 per Month No $0 Yes $5,000 No No Yes No No 1,788
Aetna Medicare Aetna Medicare Prime Plan (HMO)
H4523-021-0 		HMO $75 per Quarter No $300 Yes $1,000 No No Yes No No 1,770
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-127-0 		Local PPO No $0 Yes $2,500 No No Yes No No 1,737
Aetna Medicare Aetna Medicare Gold Plan (PPO)
H5521-122-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 1,715
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-303-0 		Local PPO $105 per Quarter No $420 Yes $4,000 No No Yes No No 1,714
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-190-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 1,696
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-241-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 1,689
Aetna Medicare Aetna Medicare Explorer Premier Plan (PPO)
H5521-013-0 		Local PPO $45 per Quarter No $180 Yes No No Yes No No 1,689
Aetna Medicare Aetna Medicare Select (HMO)
H1609-042-0 		HMO $50 per Month No $0 Yes $3,000 No No Yes No No 1,688
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-053-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,678
Aetna Medicare Aetna Medicare Advantage Plus Plan (PPO)
H2293-010-0 		Local PPO No $0 Yes $1,000 No No Yes No No 1,678
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-007-0 		HMO $200 per Month No $0 Yes $5,000 No No Yes No No 1,675
Aetna Medicare Aetna Medicare Choice (HMO-POS)
H1609-028-0 		HMOPOS $35 per Month No $0 Yes $2,500 No No Yes No No 1,672
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-119-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,654
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3931-064-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,640
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H1609-019-0 		HMO $100 per Month No $0 Yes $5,000 No No Yes No No 1,636
Aetna Medicare Aetna Medicare Prime II Plan (HMO)
H0523-073-0 		HMO $135 per Quarter No $540 Yes $2,500 No No Yes No No 1,617
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-030-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 1,599
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-224-0 		Local PPO $105 per Quarter No $420 Yes $2,000 No No Yes No No 1,597
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-353-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 1,597
Aetna Medicare Aetna Medicare Prime (HMO-POS)
H3146-007-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,586
Aetna Medicare Aetna Medicare Preferred Plan (HMO D-SNP)
H4982-008-0 		HMO $50 per Month No $0 Yes $5,000 No No Yes No No 1,583
Aetna Medicare Aetna Medicare Eagle Plus Plan (PPO)
H5521-369-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,566
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H3959-804-0 		HMO No $0 No 1,565
Aetna Medicare Aetna Medicare Advantra Cares (HMO D-SNP)
H3959-063-0 		HMO $200 per Month No $0 Yes $2,500 No No Yes No No 1,562
Aetna Medicare Aetna Medicare Select (HMO)
H1609-025-0 		HMO $60 per Month No $0 Yes $2,500 No No Yes No No 1,556
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-095-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,555
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H4711-013-0 		HMO $140 per Month Yes $0 Yes $5,000 No No Yes No No 1,542
Aetna Medicare Aetna Medicare Plan (HMO)
H3931-801-0 		HMO No $0 No 1,536
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-246-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,526
Aetna Medicare Aetna Medicare Premier (PPO)
H1608-013-0 		Local PPO $60 per Quarter No $240 Yes $3,000 No No Yes No No 1,510
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3931-107-0 		HMOPOS $165 per Quarter No $660 Yes $3,000 No No Yes No No 1,506
Aetna Medicare Aetna Medicare Premier 1 (HMO-POS)
H3931-153-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 1,504
Aetna Medicare Aetna Medicare Advantra Gold (PPO)
H1608-026-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 1,504
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H3146-014-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,492
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-121-0 		Local PPO $0 per Month No $0 Yes $2,500 No No Yes No No 1,478
Aetna Medicare Aetna Medicare Explorer Plan (PPO)
H5521-144-0 		Local PPO $45 per Quarter No $180 Yes No No Yes No No 1,456
Aetna Medicare Aetna Medicare The Valley Plan (PPO)
H5521-294-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,444
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-251-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,434
Aetna Medicare Aetna Medicare Premier Plus 2 (PPO)
H5521-207-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,428
Aetna Medicare Aetna Medicare Advantra Preferred Plan (PPO)
H1608-028-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 1,426
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H5793-001-0 		HMOPOS $100 per Quarter No $400 Yes No No Yes No No 1,425
Aetna Medicare Aetna Medicare Select Plan (PPO)
H5521-022-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,420
Aetna Medicare Aetna Medicare Advantra Washington Prime (HMO)
H3959-046-0 		HMO $150 per Quarter No $600 Yes $2,500 No No Yes No No 1,414
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-047-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,409
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-029-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 1,409
Aetna Medicare Aetna Medicare Elite 3 (HMO)
H3152-088-0 		HMO No $0 Yes $2,500 No No Yes No No 1,407
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-008-0 		HMO $185 per Month Yes $0 Yes $5,000 No No Yes No No 1,394
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-117-0 		Local PPO No $0 Yes $2,500 No No Yes No No 1,389
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4711-001-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,387
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-047-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 1,372
Aetna Medicare Aetna Medicare Premier 2 (HMO-POS)
H3931-154-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 1,358
Aetna Medicare Aetna Medicare Signature Plan (PPO)
H5521-365-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 1,325
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-054-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,325
Aetna Medicare Aetna Medicare Value (PPO)
H5521-211-0 		Local PPO $60 per Quarter No $240 Yes $1,500 No No Yes No No 1,316
Aetna Medicare Aetna Medicare Credit (HMO)
H1609-060-0 		HMO $30 per Month No $0 Yes $2,500 No No Yes No No 1,314
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-139-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,301
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-384-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,295
Aetna Medicare Aetna Medicare Select Plan (HMO-POS)
H3931-100-0 		HMOPOS $210 per Quarter No $840 Yes $3,000 No No Yes No No 1,292
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3312-072-0 		HMO No $0 Yes $1,500 No No Yes No No 1,280
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-001-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 1,263
Aetna Medicare Aetna Medicare Prime (HMO-POS)
H3192-005-0 		HMOPOS $90 per Quarter No $360 Yes $1,500 No No Yes No No 1,262
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-002-0 		HMOPOS $90 per Quarter No $360 Yes $1,000 No No Yes No No 1,258
Aetna Medicare Aetna Medicare Beaver Valley Prime (HMO)
H3959-051-0 		HMO $150 per Quarter No $600 Yes $2,500 No No Yes No No 1,243
Aetna Medicare Aetna Medicare Sunrise Plan (HMO-POS)
H3931-147-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,242
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-101-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 1,227
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-070-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,227
Aetna Medicare Aetna Medicare Prime Value (PPO)
H5521-392-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,225
Aetna Medicare Aetna Medicare Explorer Premier Plus (HMO-POS)
H3152-048-0 		HMOPOS $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,218
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-116-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 1,214
Aetna Medicare Aetna Medicare Premier Plan (HMO)
H2663-034-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,212
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-279-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 1,205
Aetna Medicare Aetna Medicare Choice II Plan (PPO)
H3288-048-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 1,195
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H9431-004-0 		Local PPO No $0 Yes $2,500 No No Yes No No 1,188
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H2056-002-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 1,184
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-301-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,178
Aetna Medicare Aetna Medicare Advantra Excela Prime (HMO-POS)
H3959-049-0 		HMOPOS $120 per Quarter No $480 Yes $2,500 No No Yes No No 1,174
Aetna Medicare Aetna Medicare Value (PPO)
H5521-311-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 1,169
Aetna Medicare Aetna Medicare Value (HMO)
H2663-043-0 		HMO $120 per Quarter No $480 Yes $3,000 No No Yes No No 1,167
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H7149-006-0 		HMO $205 per Month No $0 Yes $4,000 No No Yes No No 1,166
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-005-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 1,155
Aetna Medicare Aetna Medicare Dual Select Plan (HMO D-SNP)
H3239-012-0 		HMO $105 per Month No $0 Yes $2,500 No No Yes No No 1,140
Aetna Medicare Aetna Medicare Dual Select Plan (HMO D-SNP)
H3239-010-0 		HMO $125 per Month No $0 Yes $2,500 No No Yes No No 1,136
Aetna Medicare Aetna Medicare Plan (PPO)
H1608-801-0 		Local PPO No $0 No 1,134
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3931-126-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 1,134
Aetna Medicare Aetna Medicare Dual Choice Plus Plan (PPO D-SNP)
H2293-002-0 		Local PPO $190 per Month No $0 Yes $2,500 No No Yes No No 1,129
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4711-005-0 		HMOPOS $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,127
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-053-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,127
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-046-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 1,119
Aetna Medicare Aetna Medicare Premier Plus (HMO-POS)
H3931-004-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 1,108
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-085-0 		Local PPO $165 per Quarter No $660 Yes $2,500 No No Yes No No 1,108
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-333-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 1,099
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-027-0 		Local PPO No $0 Yes $1,000 No No Yes No No 1,097
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-026-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 1,094
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-023-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 1,093
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-226-0 		Local PPO $75 per Quarter No $300 Yes $1,500 No No Yes No No 1,082
Aetna Medicare Aetna Medicare Value Plus Plan (HMO)
H3146-012-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,066
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4835-004-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,064
Aetna Medicare Aetna Medicare Credit (HMO)
H1609-053-0 		HMO $30 per Month No $0 Yes $2,000 No No Yes No No 1,064
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-024-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 1,055
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-003-0 		HMO $230 per Month Yes $0 Yes $5,000 No No Yes No No 1,036
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-330-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 1,035
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-027-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 1,030
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-299-0 		Local PPO $105 per Quarter No $420 Yes $4,000 No No Yes No No 1,028
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3312-062-0 		HMOPOS $45 per Quarter No $180 Yes $2,000 No No Yes No No 1,027
Aetna Medicare Aetna Medicare Premier (Regional PPO)
R6694-006-0 		Regional PPO No $0 Yes $2,500 No No Yes No No 1,019
Aetna Medicare Aetna Medicare Silver Back (PPO)
H5522-022-0 		Local PPO $90 per Quarter No $360 Yes $1,500 No No Yes No No 1,016
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-006-0 		HMO $235 per Month No $0 Yes $2,500 No No Yes No No 1,015
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-069-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 1,002
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-049-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 986
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-305-0 		Local PPO $30 per Month No $0 Yes $3,000 No No Yes No No 983
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-154-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No No No No 976
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-007-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 971
Aetna Medicare Aetna Medicare Dual Choice Plan (PPO D-SNP)
H2293-003-0 		Local PPO $80 per Month No $0 Yes $2,500 No No Yes No No 959
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H3748-008-0 		HMOPOS $45 per Quarter No $180 Yes $4,000 No No Yes No No 955
Aetna Medicare Aetna Medicare Explorer Premier 2 (PPO)
H5521-124-0 		Local PPO No $0 Yes $2,500 No No Yes No No 949
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3312-065-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 942
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-354-0 		Local PPO $75 per Quarter No $300 No 941
Aetna Medicare Aetna Medicare Premier (HMO)
H2663-039-0 		HMO $90 per Quarter No $360 Yes $2,500 No No Yes No No 935
Aetna Medicare Aetna Medicare Value (HMO-POS)
H3931-109-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 930
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-216-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 929
Aetna Medicare Aetna Medicare Preferred Plan (HMO D-SNP)
H4982-016-0 		HMO $50 per Month No $0 Yes $5,000 No No Yes No No 928
Aetna Medicare Aetna Medicare Gold Advantage Value Prime (HMO)
H2663-032-0 		HMO $60 per Quarter No $240 Yes $2,500 No No Yes No No 925
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3748-001-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 919
Aetna Medicare Aetna Medicare Value (PPO)
H7301-012-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 914
Aetna Medicare Aetna Medicare Eagle (HMO)
H3152-045-0 		HMO $45 per Quarter No $180 Yes $2,500 No No Yes No No 913
Aetna Medicare Aetna Medicare Preferred Plan (HMO D-SNP)
H4982-009-0 		HMO $50 per Month No $0 Yes $5,000 No No Yes No No 902
Aetna Medicare Aetna Medicare Philly Suburban Value (HMO-POS)
H3931-105-0 		HMOPOS $60 per Quarter No $240 Yes $2,500 No No Yes No No 902
Aetna Medicare Aetna Medicare PinnacleHealth Prime (HMO)
H3931-091-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 893
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-004-0 		HMO $250 per Month No $0 Yes $5,000 No No Yes No No 893
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3312-018-0 		HMO No $0 Yes $2,500 No No Yes No No 892
Aetna Medicare Aetna Medicare Silver (HMO)
H3931-070-0 		HMO $45 per Quarter No $180 Yes $2,500 No No Yes No No 891
Aetna Medicare Aetna Medicare Value (PPO)
H5521-289-0 		Local PPO $75 per Quarter No $300 Yes $1,500 No No Yes No No 888
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4835-005-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 877
Aetna Medicare Aetna Medicare Platinum Plan (PPO)
H5521-184-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 874
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-332-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 872
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-032-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 849
Aetna Medicare Aetna Medicare Freedom Preferred Plan (PPO)
H3288-019-0 		Local PPO $165 per Quarter No $660 Yes $4,000 No No Yes No No 845
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-009-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 843
Aetna Medicare Aetna Medicare Select Plan (HMO)
H1109-005-0 		HMO $90 per Quarter No $360 Yes $1,000 No No Yes No No 838
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-005-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 822
Aetna Medicare Aetna Medicare Prime Premier (PPO)
H5521-275-0 		Local PPO No $0 Yes $2,500 No No Yes No No 822
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4835-002-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 817
Aetna Medicare Aetna Medicare Dual Select Plan (HMO D-SNP)
H5302-020-0 		HMO $80 per Month No $0 Yes $2,500 No No Yes No No 815
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-010-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 808
Aetna Medicare Aetna Medicare Prime (HMO-POS)
H3192-004-0 		HMOPOS $90 per Quarter No $360 Yes $1,500 No No Yes No No 806
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-008-0 		HMOPOS $150 per Quarter No $600 Yes $2,500 No No Yes No No 801
Aetna Medicare Aetna Medicare Elite Plan 3 (PPO)
H5521-310-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 798
Aetna Medicare Aetna Medicare Premier Plus 1 (Regional PPO)
R6694-003-0 		Regional PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 797
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-068-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 796
Aetna Medicare Aetna Medicare Option 1 (HMO-POS)
H2663-006-0 		HMOPOS $90 per Quarter No $360 Yes $5,000 No No Yes No No 794
Aetna Medicare Aetna Medicare Signature Plan (PPO)
H5521-366-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 787
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-016-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 781
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-284-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 773
Aetna Medicare Aetna Medicare Select (HMO)
H1609-022-0 		HMO $50 per Month No $0 Yes $3,000 No No Yes No No 771
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-302-0 		Local PPO $105 per Quarter No $420 Yes $2,000 No No Yes No No 770
Aetna Medicare Aetna Medicare Elite 1 (HMO-POS)
H4711-006-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 770
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-006-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 767
Aetna Medicare Aetna Medicare Assure Premier (HMO D-SNP)
H3192-008-0 		HMO $80 per Month No $0 Yes $4,000 No No Yes No No 764
Aetna Medicare Aetna Medicare Advantra Plan (HMO)
H3928-001-0 		HMO $120 per Quarter No $480 Yes $1,000 No No Yes No No 757
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-022-0 		HMO No $0 Yes $1,000 No No Yes No No 750
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3931-108-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 749
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-323-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 749
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H9431-005-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 727
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-331-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 721
Aetna Medicare Aetna Medicare UnityPoint Health Prime (HMO)
H2663-017-0 		HMO $90 per Quarter No $360 Yes $4,000 No No Yes No No 706
Aetna Medicare Aetna Medicare Premier 1 (PPO)
H5521-134-0 		Local PPO $165 per Quarter No $660 Yes $2,000 No No Yes No No 701
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-340-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 699
Aetna Medicare Aetna Medicare Value (PPO)
H5521-283-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 699
Aetna Medicare Aetna Medicare Silver (HMO)
H1692-007-0 		HMO $90 per Quarter No $360 Yes $1,000 No No Yes No No 692
Aetna Medicare Aetna Medicare UVA Health System Prime (HMO-POS)
H3931-124-0 		HMOPOS $105 per Quarter No $420 Yes $2,000 No No Yes No No 691
Aetna Medicare Aetna Medicare Premier Plus (HMO)
H3931-102-0 		HMO $90 per Quarter No $360 Yes $2,500 No No Yes No No 686
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-197-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 685
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-351-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 671
Aetna Medicare Aetna Medicare Option 2 (HMO)
H2663-002-0 		HMO $90 per Quarter No $360 Yes $5,000 No No Yes No No 663
Aetna Medicare Aetna Medicare Value Plus Plan (PPO)
H5521-364-0 		Local PPO $45 per Month No $0 Yes $2,500 No No Yes No No 661
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-006-0 		HMO $275 per Month Yes $0 Yes $5,000 No No Yes No No 659
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-007-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 658
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-003-0 		Local PPO $120 per Quarter No $480 Yes $1,000 No No Yes No No 654
Aetna Medicare Aetna Medicare Standard Plan (HMO-POS)
H3931-095-0 		HMOPOS $105 per Quarter No $420 Yes $2,000 No No Yes No No 650
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4835-006-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 647
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H3288-034-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 644
Aetna Medicare Aetna Medicare Premier 2 (PPO)
H5521-020-0 		Local PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 639
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H5302-014-0 		HMO $190 per Month No $0 Yes $2,500 No No Yes No No 637
Aetna Medicare Aetna Medicare Connect Plus (HMO)
H3931-097-0 		HMO No $0 Yes $1,000 No No Yes No No 632
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-281-0 		Local PPO $150 per Quarter No $600 No 624
Aetna Medicare Aetna Medicare Part B Only Plan w/Rx (PPO)
H5521-806-0 		Local PPO No $0 No 620
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H3288-004-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 613
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-017-0 		HMO $135 per Month Yes $0 Yes $4,000 No No Yes No No 611
Aetna Medicare Aetna Medicare PennHighlands Prime (HMO)
H3959-045-0 		HMO $135 per Quarter No $540 Yes $2,500 No No Yes No No 611
Aetna Medicare Aetna Medicare Freedom Preferred Plan (PPO)
H3288-017-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 608
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-235-0 		Local PPO $120 per Quarter No $480 Yes $1,000 No No Yes No No 606
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-013-0 		HMOPOS $90 per Quarter No $360 Yes $1,000 No No Yes No No 605
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-009-0 		HMO $240 per Month Yes $0 Yes $5,000 No No Yes No No 599
Aetna Medicare Aetna Medicare Premier Plan (HMO-POS)
H4835-003-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 596
Aetna Medicare Aetna Medicare Premier (HMO)
H2663-038-0 		HMO $90 per Quarter No $360 Yes $3,000 No No Yes No No 591
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H3239-008-0 		HMO $205 per Month No $0 Yes $2,500 No No Yes No No 589
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H3931-096-0 		HMOPOS $105 per Quarter No $420 Yes $1,000 No No Yes No No 588
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-320-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 585
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H3748-006-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 585
Aetna Medicare Aetna Medicare Eagle 1 (PPO)
H5521-378-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 581
Aetna Medicare Aetna Medicare Sunrise Plan (HMO-POS)
H3931-145-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 570
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-156-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 569
Aetna Medicare Aetna Medicare Dual Plus Plan (HMO D-SNP)
H3239-013-0 		HMO $245 per Month No $0 Yes $2,500 No No Yes No No 569
Aetna Medicare Aetna Medicare Eagle (HMO-POS)
H4711-010-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 568
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-007-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 558
Aetna Medicare Aetna Medicare Value (HMO)
H1609-026-0 		HMO $20 per Month No $0 Yes $2,500 No No Yes No No 552
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H9431-002-0 		Local PPO No $0 Yes $2,500 No No Yes No No 550
Aetna Medicare Aetna Medicare Advantra Elite (HMO-POS)
H1692-003-0 		HMOPOS $90 per Quarter No $360 Yes $1,000 No No Yes No No 545
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-052-0 		Local PPO $90 per Quarter No $360 Yes $3,000 No No Yes No No 543
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H5793-018-0 		HMOPOS $100 per Quarter No $400 Yes No No Yes No No 542
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-318-0 		Local PPO No $0 Yes $2,500 No No Yes No No 538
Aetna Medicare Aetna Medicare Premier 1 (HMO-POS)
H4711-008-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 538
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-260-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 531
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-015-0 		Local PPO No $0 Yes $1,000 No No Yes No No 531
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H5793-014-0 		HMOPOS $100 per Quarter No $400 Yes No No Yes No No 525
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-010-0 		HMOPOS $180 per Quarter No $720 Yes $2,500 No No Yes No No 518
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-055-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 513
Aetna Medicare Aetna Medicare Premier Plan (HMO)
H5302-019-0 		HMO $90 per Quarter No $360 Yes $1,000 No No Yes No No 512
Aetna Medicare Aetna Medicare Longevity Plan (HMO I-SNP)
H3959-066-0 		HMO $210 per Quarter No $840 Yes $2,000 No No Yes No No 511
Aetna Medicare Aetna Medicare Select (HMO)
H1609-041-0 		HMO $60 per Month No $0 Yes $2,500 No No Yes No No 503
Aetna Medicare Aetna Medicare Prime Plan (HMO-POS)
H5793-019-0 		HMOPOS $210 per Quarter No $840 Yes No No Yes No No 503
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-373-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 500
Aetna Medicare Aetna Medicare Elite 2 (HMO-POS)
H4711-007-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 498
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H9431-015-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 498
Aetna Medicare Aetna Medicare Freedom Core Plan (PPO)
H3288-021-0 		Local PPO $105 per Quarter No $420 Yes $1,000 No No Yes No No 494
Aetna Medicare Aetna Medicare Prime Plan (HMO)
H4523-020-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 492
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-025-0 		Local PPO $90 per Quarter No $360 Yes $1,000 No No Yes No No 491
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H5521-177-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 490
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-306-0 		Local PPO $30 per Month No $0 Yes $2,500 No No Yes No No 483
Aetna Medicare Aetna Medicare Freedom Plan (PPO)
H3288-031-0 		Local PPO $75 per Quarter No $300 Yes $1,000 No No Yes No No 482
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-292-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 480
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-229-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 475
Aetna Medicare Aetna Medicare Explorer Elite 2 (HMO)
H3152-092-0 		HMO No $0 Yes $2,500 No No Yes No No 475
Aetna Medicare Aetna Medicare Value Plus Plan (HMO-POS)
H3931-149-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 469
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H9431-006-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 461
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H3152-804-0 		HMO No $0 No 460
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-016-0 		HMO $185 per Month Yes $0 Yes $4,000 No No Yes No No 458
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-307-0 		Local PPO $90 per Quarter No $360 Yes $1,500 No No Yes No No 455
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-076-0 		Local PPO No $0 Yes $2,500 No No Yes No No 455
Aetna Medicare Aetna Medicare Eagle Plus Plan (PPO)
H2293-009-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 450
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-051-0 		Local PPO $45 per Quarter No $180 Yes $4,000 No No Yes No No 446
Aetna Medicare Aetna Medicare Premier Plan (HMO)
H5302-018-0 		HMO $90 per Quarter No $360 No 445
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3597-009-0 		HMO $45 per Quarter No $180 Yes No No Yes No No 438
Aetna Medicare Aetna Medicare Select (HMO)
H1609-059-0 		HMO $50 per Month No $0 Yes $3,000 No No Yes No No 432
Aetna Medicare Aetna Medicare Value Plan (HMO)
H8332-005-0 		HMO $90 per Quarter No $360 Yes $2,500 No No Yes No No 430
Aetna Medicare Aetna Medicare Elite Plan (HMO-POS)
H3748-007-0 		HMOPOS No $0 Yes $4,000 No No Yes No No 429
Aetna Medicare Aetna Medicare Explorer Elite (PPO)
H5521-295-0 		Local PPO No $0 Yes $2,500 No No Yes No No 429
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-015-0 		HMO $170 per Month Yes $0 Yes $5,000 No No Yes No No 417
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-031-0 		HMO No $0 Yes $1,000 No No Yes No No 415
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H5793-016-0 		HMOPOS $75 per Quarter No $300 Yes No No Yes No No 411
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-084-0 		Local PPO $120 per Quarter No $480 Yes $5,000 No No Yes No No 409
Aetna Medicare Aetna Medicare Value Plus Plan (HMO)
H3146-013-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 409
Aetna Medicare Aetna Medicare Sunrise Plan (HMO-POS)
H3931-148-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 402
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H0628-006-0 		HMOPOS $135 per Quarter No $540 Yes $2,500 No No Yes No No 401
Aetna Medicare Aetna Medicare Eagle (HMO-POS)
H1609-058-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 398
Aetna Medicare Aetna Medicare Advantra Eagle (HMO)
H3959-057-0 		HMO $120 per Quarter No $480 Yes $1,500 No No Yes No No 398
Aetna Medicare Aetna Medicare Premier Preferred (HMO)
H2663-041-0 		HMO $75 per Quarter No $300 Yes $4,000 No No Yes No No 396
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-043-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 394
Aetna Medicare Aetna Medicare Platinum Plan (PPO)
H5521-200-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 394
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-324-0 		Local PPO $150 per Quarter No $600 Yes $4,000 No No Yes No No 394
Aetna Medicare Aetna Medicare Select Plan (PPO)
H5521-300-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 387
Aetna Medicare Aetna Medicare Elite Plan (HMO)
H5793-015-0 		HMO $60 per Quarter No $240 Yes No No Yes No No 381
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-052-0 		HMO No $0 Yes $1,000 No No Yes No No 380
Aetna Medicare Aetna Medicare Plan (HMO)
H0523-801-0 		HMO No $0 No 378
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H1608-056-0 		Local PPO No $0 Yes $2,500 No No Yes No No 364
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-012-0 		HMO $75 per Quarter No $300 Yes $2,500 No No Yes No No 354
Aetna Medicare Aetna Medicare Eagle (HMO-POS)
H2663-025-0 		HMOPOS $60 per Quarter No $240 Yes $3,000 No No Yes No No 353
Aetna Medicare Aetna Medicare Elite (HMO-POS)
H3931-104-0 		HMOPOS $75 per Quarter No $300 No 352
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-363-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 339
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-370-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 336
Aetna Medicare Aetna Medicare Eagle Plan (HMO)
H4982-013-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 331
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H9431-017-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 328
Aetna Medicare Aetna Medicare Premier (HMO)
H2663-040-0 		HMO $90 per Quarter No $360 Yes $3,000 No No Yes No No 326
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-002-0 		HMO No $0 Yes $1,000 No No Yes No No 326
Aetna Medicare Aetna Medicare Eagle (HMO)
H0628-015-0 		HMO $180 per Quarter No $720 Yes $2,500 No No Yes No No 325
Aetna Medicare Aetna Medicare Value Plan (HMO)
H3312-064-0 		HMO No $0 Yes $2,500 No No Yes No No 324
Aetna Medicare Aetna Medicare Dual Choice Plus Plan (PPO D-SNP)
H2293-005-0 		Local PPO $190 per Month No $0 Yes $2,500 No No Yes No No 315
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H9431-016-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 311
Aetna Medicare Aetna Medicare Elite (PPO)
H9431-014-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 310
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-082-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 309
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-296-0 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 309
Aetna Medicare Aetna Medicare Advantra Eagle (HMO)
H1692-006-0 		HMO $120 per Quarter No $480 Yes $1,500 No No Yes No No 306
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H4523-802-0 		HMO No $0 No 290
Aetna Medicare Aetna Medicare Assure (HMO D-SNP)
H5325-009-0 		HMO $250 per Month No $0 Yes $5,000 No No Yes No No 286
Aetna Medicare Aetna Medicare Premier 2 (HMO-POS)
H4711-009-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 280
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H1109-802-0 		HMO No $0 No 280
Aetna Medicare Aetna Medicare MyMichigan Prime (HMO-POS)
H3192-017-0 		HMOPOS $60 per Quarter No $240 Yes $1,500 No No Yes No No 280
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3748-010-0 		HMOPOS No $0 Yes $2,500 No No Yes No No 273
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-379-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 272
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-371-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 270
Aetna Medicare Aetna Medicare Eagle (HMO-POS)
H7149-007-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 270
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-280-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 265
Aetna Medicare Aetna Medicare Prime Plan (HMO)
H0523-061-0 		HMO No $0 Yes $1,000 No No Yes No No 259
Aetna Medicare Aetna Medicare Dual Choice Plan (PPO D-SNP)
H2293-004-0 		Local PPO $80 per Month No $0 Yes $2,500 No No Yes No No 258
Aetna Medicare Aetna Medicare Eagle (HMO-POS)
H2663-022-0 		HMOPOS $180 per Quarter No $720 Yes $3,000 No No Yes No No 257
Aetna Medicare Aetna Medicare Elite (PPO)
H1608-059-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 256
Aetna Medicare Aetna Medicare Premier (PPO)
H9431-013-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 256
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-383-0 		Local PPO $60 per Quarter No $240 Yes $2,500 No No Yes No No 251
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-072-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 250
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-347-0 		Local PPO $30 per Month No $0 Yes $2,500 No No Yes No No 248
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-065-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 243
Aetna Medicare Aetna Medicare Explorer Premier (PPO)
H5521-298-0 		Local PPO No $0 Yes $2,500 No No Yes No No 240
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-010-0 		HMOPOS $60 per Quarter No $240 Yes $1,000 No No Yes No No 238
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-345-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 237
Aetna Medicare Aetna Medicare Value Plus (PPO)
H5521-376-0 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 235
Aetna Medicare Aetna Medicare Value Plan (HMO)
H8332-004-0 		HMO $120 per Quarter No $480 Yes $2,500 No No Yes No No 232
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-259-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 228
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-308-0 		Local PPO $30 per Month No $0 Yes $2,500 No No Yes No No 227
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-377-0 		Local PPO $30 per Month No $0 Yes $2,500 No No Yes No No 225
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-350-0 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 223
Aetna Medicare Aetna Medicare Eagle (PPO)
H5521-322-0 		Local PPO $150 per Quarter No $600 Yes $5,000 No No Yes No No 213
Aetna Medicare Aetna Medicare Premier (HMO)
H2663-042-0 		HMO $90 per Quarter No $360 Yes $3,000 No No Yes No No 208
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3748-005-0 		HMOPOS No $0 Yes $2,500 No No Yes No No 207
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-102-0 		Local PPO $90 per Quarter No $360 Yes $2,000 No No Yes No No 187
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H0523-805-0 		HMO No $0 No 186
Aetna Medicare Aetna Medicare Dual Preferred Plan (HMO D-SNP)
H8649-010-0 		HMO $120 per Month No $0 Yes $5,000 No No Yes No No 179
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-012-0 		HMOPOS $60 per Quarter No $240 Yes $1,000 No No Yes No No 179
Aetna Medicare Aetna Medicare Platinum Plan (HMO-POS)
H3931-115-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 178
Aetna Medicare Aetna Medicare Advantra Central Value (PPO)
H5522-020-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 172
Aetna Medicare Aetna Medicare Select (HMO)
H1609-038-0 		HMO $50 per Month No $0 Yes $3,000 No No Yes No No 172
Aetna Medicare Aetna Medicare Premier (PPO)
H1608-035-0 		Local PPO No $0 Yes $2,500 No No Yes No No 166
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-266-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 160
Aetna Medicare Aetna Medicare Select (HMO)
H1609-035-0 		HMO $50 per Month No $0 Yes $2,500 No No Yes No No 157
Aetna Medicare Aetna Medicare Select (HMO)
H1609-063-0 		HMO $55 per Month No $0 Yes $2,500 No No Yes No No 154
Aetna Medicare Aetna Medicare Select Plan (HMO)
H1109-006-0 		HMO $75 per Quarter No $300 Yes $1,000 No No Yes No No 154
Aetna Medicare Aetna Medicare Value Plus (PPO)
H5522-021-0 		Local PPO $120 per Quarter No $480 Yes $2,500 No No Yes No No 147
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-196-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 147
Aetna Medicare Aetna Medicare Advantra Plan (HMO)
H3928-002-0 		HMO $105 per Quarter No $420 Yes $1,000 No No Yes No No 145
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-083-0 		Local PPO $45 per Quarter No $180 Yes $1,000 No No Yes No No 142
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-389-0 		Local PPO $75 per Quarter No $300 Yes $2,000 No No Yes No No 142
Aetna Medicare Aetna Medicare Platinum Plan (HMO-POS)
H3748-011-0 		HMOPOS No $0 Yes $2,500 No No Yes No No 142
Aetna Medicare Aetna Medicare Premier Plus 2 (Regional PPO)
R6694-005-0 		Regional PPO $135 per Quarter No $540 Yes $2,500 No No Yes No No 136
Aetna Medicare Aetna Medicare Assure Premier (PPO D-SNP)
H1608-062-0 		Local PPO $135 per Month No $0 Yes $4,000 No No Yes No No 131
Aetna Medicare Aetna Medicare Premier (HMO)
H0628-011-0 		HMO $150 per Quarter No $600 Yes $2,500 No No Yes No No 131
Aetna Medicare Aetna Medicare Advantra Eagle (HMO-POS)
H3959-056-0 		HMOPOS $120 per Quarter No $480 Yes $1,500 No No Yes No No 125
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-355-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 121
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H3288-049-0 		Local PPO $150 per Quarter No $600 Yes $4,000 No No Yes No No 119
Aetna Medicare Aetna Medicare Elite Plan (PPO)
H5521-372-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 116
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H3288-050-0 		Local PPO $150 per Quarter No $600 Yes $4,000 No No Yes No No 116
Aetna Medicare Aetna Medicare Value Plus Plan (PPO)
H2293-011-0 		Local PPO $45 per Month No $0 Yes $1,000 No No Yes No No 113
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H1608-802-0 		Local PPO No $0 No 112
Aetna Medicare Aetna Medicare Plus Plan (HMO)
H4982-011-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 112
Aetna Medicare Aetna Medicare Choice Plan (PPO)
H5521-393-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 108
Aetna Medicare Aetna Medicare Discover Value Plan (PPO)
H5521-381-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 108
Aetna Medicare Aetna Medicare Plan (HMO)
H1109-801-0 		HMO No $0 No 108
Aetna Medicare Aetna Medicare Eagle II (PPO)
H2293-015-0 		Local PPO $105 per Quarter No $420 Yes $2,500 No No Yes No No 107
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-061-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 106
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H3312-804-0 		HMO No $0 No 90
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-349-0 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 85
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H3288-052-0 		Local PPO $150 per Quarter No $600 Yes $4,000 No No Yes No No 82
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H3288-051-0 		Local PPO $150 per Quarter No $600 Yes $4,000 No No Yes No No 81
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H1609-807-0 		HMO No $0 No 76
Aetna Medicare Aetna Medicare Eagle II Plan (PPO)
H2293-020-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 73
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-071-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 70
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-067-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 68
Aetna Medicare Aetna Medicare Eagle (HMO)
H0628-014-0 		HMO $150 per Quarter No $600 Yes $4,000 No No Yes No No 65
Aetna Medicare Aetna Medicare Assure Plus (HMO D-SNP)
H1609-062-0 		HMO $270 per Month No $0 Yes $5,000 No No Yes No No 61
Aetna Medicare Aetna Medicare Eagle (HMO)
H1609-052-0 		HMO $30 per Month No $0 Yes $2,500 No No Yes No No 59
Aetna Medicare Aetna Medicare Eagle (PPO)
H1608-061-0 		Local PPO $90 per Quarter No $360 Yes $2,500 No No Yes No No 57
Aetna Medicare Aetna Medicare Value (PPO)
H5521-387-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 52
Aetna Medicare Aetna Medicare Plan (HMO)
H4523-801-0 		HMO No $0 No 50
Aetna Medicare Aetna Medicare Select Plan (HMO)
H0523-066-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 50
Aetna Medicare Aetna Medicare Eagle II (PPO)
H2293-012-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 49
Aetna Medicare Aetna Medicare Plan (HMO)
H3312-801-0 		HMO No $0 No 48
Aetna Medicare Aetna Medicare Plan w/Rx (HMO)
H5302-810-0 		HMO No $0 No 34
Aetna Medicare Aetna Medicare Premier (PPO)
H5521-388-0 		Local PPO $75 per Quarter No $300 Yes $2,000 No No Yes No No 33
Aetna Medicare Aetna Medicare Premier (HMO-POS)
H3192-011-0 		HMOPOS $60 per Quarter No $240 Yes $1,000 No No Yes No No 27
Aetna Medicare Aetna Medicare Plan (HMO)
H3597-801-0 		HMO No $0 No 24
Aetna Medicare Aetna Medicare Plan (HMO)
H5793-801-0 		HMO No $0 No 23
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-267-0 		Local PPO $165 per Quarter No $660 Yes $2,500 No No Yes No No 21
Aetna Medicare Aetna Medicare Premier Plus (PPO)
H5521-386-0 		Local PPO $60 per Quarter No $240 Yes $1,000 No No Yes No No 17
Aetna Medicare Aetna Medicare Plan (HMO)
H2663-805-0 		HMO No $0 No 13

Plan Claims Contact Information

Organization Name: Aetna Medicare
Contact Name: Meg Knight
Title: AVP, Medicare Service Operations
Phone: 1-800-282-5366
Email: MKnight@aetna.com
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