AETNA TRAVELING PPO

Nov 30, 2018

  1. margostl
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    margostl Expert

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    I have a question regarding this.I recall being told by an Aetna Field Director during a presentation on new
    extras coming in 2019, that now at least in Georgia PPOs and HMOS clients can travel outside their local network, even to another state.I have'nt found it written maybe I overlooked it.I want to use it as a markerting tool since so many clients travel to see Grandchildren out of state.I know UHC has the travel passport for MA
    but it is not included in all plans or for that matter all states.
     
    margostl, Nov 30, 2018
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  2. StephanieCJ
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    StephanieCJ Super Genius

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    That is specifically mentioned on the SOB for the Aetna PPO in our area. It is listed as “Explorer” in the summary of benefits and states that you can “see an Aetna Medicare participating provider anywhere in the United States and pay in-network cost sharing.” You just call customer service while traveling and they can hook you up with a doctor/pharmacy where you are.
     
  3. margostl
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    margostl Expert

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    Thanks for your help, this is a game changer for some clients that are resistant to changing
    their MA.IMHO I hadn't seen anything any other carriers offered that was significant enough to warrant a change.unless it was a change in formulary.
     
    margostl, Nov 30, 2018
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  4. Hopes
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    Hopes Super Genius

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    I know don't know what plans may be in your area but it's my understanding the national network applies to specifically to Aetna only, not Coventry.
     
    Hopes, Dec 1, 2018
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  5. Chazm
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    Chazm Guru

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    Coventry is only an hmo and never has a big network that I’ve seen
     
    Chazm, Dec 1, 2018
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  6. Devin01
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    Devin01 Guru

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    Aetna has a seamless network all over the country gives then an advantage over many other mapds
     
    Devin01, Dec 1, 2018
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  7. StephanieCJ
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    StephanieCJ Super Genius

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    Just make sure you check the SOB for your location. Aetna is pretty consistent from area to area, but the one time you don’t check and tell somebody something is in there will be the one time it isn’t. Definitely a selling point vs. other MA plans. One of the other things I do when determining whether or not to move someone is the drug cost look up. That can make a huge difference for people sometimes and it may be worth it from an RX cost standpoint to move companies.
     
  8. Hopes
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    Hopes Super Genius

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    Thanks Chazm. I wish I'd seen this when you first posted it.

    I almost put a woman in a Coventry plan but questioned myself because I couldn't find her out of state specialist "in network" so I ended up calling the local Aetna/Coventry broker manager to find out.
     
    Hopes, Dec 8, 2018 at 2:11 AM
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