Discount programs - Aetna Medicare

Aetna Medicare Open SMPlan (PFFS)The freedom tochoose, plus benefitsthat go beyondOriginal MedicareMedical and prescriptiondrug coverage – and addedbenefits – with your choiceof doctors and hospitalsH5736_7F_80612 (09/2008)

Medicare benefits that put you in controlof whom you see – and so much moreNow you can receive your Medicare benefitsfrom doctors and hospitals of your choice alongwith some important extras that go beyondOriginal Medicare coverage. With the AetnaMedicare Open Plan, a Medicare Advantageprivate fee-for-service plan (PFFS), you can go toany licensed doctor or hospital eligible to receivepayment from Medicare who is willing to treatyou and accepts the Aetna Medicare Open PlanTerms and Conditions.*The Aetna Medicare Open Plan can also saveyou money from Original Medicare by settingpredictable copays for doctor visits and hospitalstays. And when you add prescription drugcoverage, you may save even more. If youpreviously enrolled in a stand-alone MedicarePrescription Drug (Part D) plan, you canchange to one of our Medicare Advantage plansthat provides coverage to both prescriptiondrugs and medical care, usually at a lower totalpremium cost to you.Plans are available withor without prescriptiondrug coverage. You choosethe plan that best meetsyour needs.The advantage of addingprescription drug coverageWhen you add prescription drug coverage toAetna Medicare Open Plan, you’ll have access to: More than 59,000 network pharmaciesnationwide, including national chains A prescription formulary that covers allMedicare-approved drugs (pharmacy clinicalprograms may apply) Mail order prescription drug program formaintenance drugs – a great way to save timeand money Aetna Specialty Pharmacy, for expensiveand hard-to-find medications.* A Medicare Advantage private fee-for-service planworks differently than a Medicare supplement plan.Your doctor or hospital is not required to agree toaccept the plan’s terms and conditions, and thusmay choose not to treat you, with the exception ofemergencies. If your doctor or hospital does notagree to accept our payment terms and conditions,they may choose not to provide health care servicesto you, except in emergencies. Providers can findAetna’s terms and conditions on our website at:http://www.aetna.com/members/medicare/data/terms_conditions.pdf2|Contact us 1-800-832-2640

Enroll nowOur Aetna Medicare representativesare ready to help you enroll or answerany questions.Call us at 1-800-832-26408 am to 6 pm, Monday through Friday.TTY/TDD users call 1-800-628-3323.Or visit us atwww.aetnamedicare.com.Extra help for drug costsFederal “extra help” with Medicare Part D costsapplies to your Aetna Medicare Advantage planprescription drug benefits. The extra help canlower your Part D-related monthly premiumsand cost-share amounts.To see if you qualify for extra help, call: 1-800-MEDICARE (1-800-633-4227)24 hours a day, 7 days a week(TTY/TDD users should call 1-877-486-2048) The Social Security Administrationat 1-800-772-1213(TTY/TDD 1-800-325-0778)7 am – 7 pm, Monday – Friday Your state Medicaid office.Visit us www.aetnamedicare.com | 3

Extra benefits and savings areincluded in your planWhat really sets Aetna apart is what it includesin its PFFS plan. The Aetna Medicare Open Plan(PFFS) includes benefits for: Annual physicals. For $0 copay, you receive anannual physical exam. Hearing. Reimbursement for the cost ofhearing aids every three years, up to a specifiedamount, plus an annual hearing evaluation atno extra charge. Vision. Reimbursement for the cost of glassesand contact lenses every two years, up to aspecified amount, plus an annual routine eyeexam at no extra charge.And it includes these value-addedAetna Extras SM at no extra cost:*SM Aetna Vision discount program. Up to40% off the retail prices of eyeglass frames,savings on all types of lenses and up to15% off Lasik procedures.SM Aetna Weight Management discountprogram. Save on weight-loss programs andproducts from one of the world’s largest weightmanagement firms – Jenny Craig ® .When it comes toMedicare Advantage plans,experience countsAetna has been in businessfor more than 150 years andhas served individuals eligiblefor Medicare for more than40 years. In 2008, Aetna wasnamed the most admiredhealth care insurancecompany byFortune Magazine.Fortune Magazine, March 17, 2008* The discounted products and services described above are neither offered nor guaranteed under our contractwith the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputesregarding these products and services may be subject to the Aetna Medicare grievance process.4|Contact us 1-800-832-2640

A world of informationat your fingertipsFor need-to-know information 24 hours a day, look no furtherthan www.aetnamedicare.com. It is your easy-access portal to: Aetna Navigator ®. Our secure member website can answer questionsabout your health care, types of treatment, cost of services and more. Personal Health Record. An online tool where you can securelymanage your personal health information online and accessthe information you and your doctor need to make informeddecisions about your health. Aetna InteliHealth ®. Interactive education and information fromHarvard Medical School, Columbia Dental School and others. Informed Health ®Line. A toll-free 24-hour telephone servicethat puts you in touch with experienced registered nurses andan audio health library. DocFind ®. Updated three times a week, your online sourcefor locating network pharmacies (for plans with prescriptiondrug coverage) and vision services professionals in your area.DocFind ® Zip City CountyGeographic InformationProvider Category Select a Provider CategoryProvider Type Select a Provider TypePlanSelect a PlanSearch byspecialty,name, andother optionsComplete AboveStart SearchNarrow your search by specialty, name, hospital,affiliation, languages spoken, and/or other criteria.View search results now for all providersin your selected geographic area.Visit us www.aetnamedicare.com | 5

Built-in features to helpmanage your healthIn helping people make the best of unforeseencircumstances and certain conditions, Aetna haslong been an innovator. Your plan also includes: National Medical Excellence Program ®.For those with a complex illness or injurywho qualify, access to our national networkof respected doctors and facilities.SM Aetna Health Connections – DiseaseManagement. This program providesindividualized clinical programs for more than30 chronic conditions. It can help you learnabout how to manage your chronic healthconditions and achieve your optimal stateof health. Case Management Services. A medicalcondition may qualify you for an individuallyassigned nurse case manager, who will coordinatewith your physicians to help so you can get welland stay healthy. Cancer screening reminders. For breast,colorectal and cervical cancer, timely remindersfor regular screenings. Annual preventive reminders. Regular mailersthat help you to remember to get your flu shotsand other vaccinations.6 |Contact us 1-800-832-2640

Exclusions and LimitationsThe following is a partial listing. Please refer to applicable plan documents for a complete description ofbenefits, exclusions, limitations and conditions of coverage. Drug List for details (applies to plans with prescription drug coverage). with a Medicare contract, and benefits, limitations, service areas and premiums are subject to change onJanuary 1 of each year.This material is for informational purposes only. See plan documents for a complete description ofbenefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary bylocation and are subject to change.Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna’s prescriptions. Pharmacy clinical programs such as precertification, step therapy, and quantity limits mayapply to your prescription drug coverage.Providers are independent contractors and are not agents of Aetna. Provider participation may changewithout notice. Aetna does not provide care or guarantee access to health services.Health information programs provide general health information and are not a substitute for diagnosisor treatment by a physician or other health care professional. Discount programs provide access todiscounted prices and are not insured benefits.You must be entitled to Medicare Part A and continue to pay your Part B premium and Part A, ifapplicable. This product does not require a contracted network and providers are not required to acceptMedicare private fee-for-service plans.Translation of this material into another language may be available. For assistance, please call MemberServices at 1-800-832-2640 (TDD: 1-800-628-3323).Puede estar disponible la traducción de este material en otro idioma. Para ayuda, por favor llame aServicios al Miembro al 1-800-832-2640 (TDD: 1-800-628-3323).Visit us www.aetnamedicare.com | 7

It’s easy to enroll.Select the plan that meetsyour needs – and enroll.Enroll nowOur Aetna Medicare representativesare ready to help you enroll or answerany questions.Call us at 1-800-832-26408 am to 6 pm, Monday through Friday.TTY/TDD users call 1-800-628-3323.Or visit us atwww.aetnamedicare.com.You can also enroll by calling Medicareat 1-800-MEDICARE (1-800-633-4227),24 hours a day, 7 days a week.TTY/TDD users can call 1-877-486-2048.You may also enroll in an Aetna Medicareplan through the Centers for Medicareand Medicaid Services Online EnrollmentCenter, at www.medicare.gov.© 2008 Aetna Inc.18.02.400.1 B (10/08)