Medicare Advantage Plan

Group of seniorsRetirees and Dependents Eligible for Medicare

Plan Documents and Coverage

The Preferred Provider Option ("PPO") plan offers benefits beyond Original Medicare (Parts A & B). Members of the PPO plan must live in the plan service area and be eligible for Medicare Part A at no cost. 

This PPO plan has an Extended Service Area ("ESA"). This means that you may enroll in the plan even if you live outside the Aetna Medicare network service area. Members of this PPO-ESA plan must be eligible for Medicare Part A at no cost. To confirm if you reside in a county that qualifies for this plan, contact Aetna Medicare Member Services at 1-888-267-2637.

If you do not qualify for Medicare Part A at no cost, the plan documents below pertain to your Aetna Medicare Advantage coverage:

Premium Rates

Effective January 1, 2019 through December 31, 2019

Level of Coverage Monthly Pension Deduction* Monthly State Contribution*
Retiree $0 $285.34
Spouse $285.34 $0
Surviving Spouse $285.34 $0

Effective January 1, 2018 through December 31, 2018

Level of Coverage Monthly Pension Deduction* Monthly State Contribution*
Retiree $0 $287.02
Spouse $287.02 $0
Surviving Spouse $287.02 $0

*Note: Premium rates listed above are for retirees and spouses who are eligible for Medicare Part A at no cost.  If you do not qualify for premium-free Medicare Part A, please contact Employee Health & Benefits at 1-800-422-4503.  Note, rates do not reflect retirees who receive a pro-rated contribution.  See governing statutes for more information.

Premium Rates for active employees and retirees not eligible for Medicare