When you sign up for a health insurance plan, you know regular doctor visits will likely be covered. Along with the cost of some prescription drugs and routine vaccinations and screenings. But Aetna Dual Eligible Special Needs Plan, or D-SNP, members get additional benefits and services that make it even easier to support your health needs.  

“It’s really important to know what these are,” says Nicole Wolf, RN, CCM. “They’re all designed to make reaching your health goals even easier. Wolf is a senior clinical leader at Aetna. To find out what’s included in an Aetna D-SNP plan and if one might be right for you, keep reading.

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1. An entire care team on your side  

Trying to figure out your health care can be tricky. That’s especially true if you’re dealing with more than one complex health condition. Aetna D-SNPs take the pressure off by pairing each member with a team of health care professionals called a care team. They can help you:

• Create an overall care plan. They work with you and your doctor to determine the best benefits and services for reaching your health goals.
   
• Understand your state Medicaid benefits and help you get the ones you need.
   
• Schedule medical and dental appointments and possibly even arrange local transportation to approved medical appointments. 
   
• Connect you with local and state programs to help you with meals, local transportation, rent, utilities and more.

Find out if an Aetna care team can help you get the care you need

Aetna Dual Eligible Special Needs Plan, or D-SNP, members get access to a care team to help them stay on top of their health.

Schedule a call with a licensed Aetna agent to learn more about our D-SNP plans.  

2. Help paying for everyday expenses

Depending on your plan and eligibility, you may be able to use your card for certain everyday expenses, like:    

• Healthy foods*
   
• Utilities**
   
• Gas or transportation** 
   
• Personal care products** 

*Members in California, New Jersey and New York FIDE plans must have a qualifying condition to be eligible for this benefit.

**Members in New Jersey and New York FIDE plans must have a qualifying condition to be eligible for this benefit. Members in California plans are not eligible for this benefit.

For members in California, New Jersey and New York FIDE plans: The benefits mentioned are part of special supplemental program for the chronically ill. Eligibility is determined by whether you have a chronic condition associated with this benefit. Standards may vary for each benefit. Conditions include hypertension, hyperlipidemia, diabetes, cardiovascular disorders, cancer. Other eligible conditions may apply. Contact us to confirm your eligibility for these benefits.

If you have questions, call us at 1-833-228-1297 (TTY: 711) 7 days a week, 8 AM to 8 PM.

3. $0 copay

Prescription medications can be expensive. And if you’re taking more than one, the costs can really add up. But Aetna D-SNPs come with a $0-to-low copay on all covered Part D prescription drugs at in-network pharmacies. It’s just one way Aetna helps you get access to the medications you need to feel your best.

4. A 24-Hour Nurse Line 

As an Aetna D-SNP member, you can call a special hotline to speak to a trained nurse and get support within minutes.“It’s available to all Aetna D-SNP members at all hours of the day or night. Which is important if a patient isn’t sure that they have an emergency,” says Wolf.  

A quick discussion with a nurse can tell you whether it’s better to stay in bed and rest — or whether you should make a trip to an urgent care center or the emergency room. Even better, the next day the information from your call will be sent to your case manager. That way, your case manager can follow up with you as needed. 

Want answers to health questions right when you need it?

Become an Aetna Dual Eligible Special Needs Plan, or D-SNP, member, and you can call our 24/7 Nurse Line to speak with a licensed nurse, 24 hours a day, 7 days a week.

To see if an Aetna D-SNP is right for you, call us at 1-833-228-1297 (TTY: 711) between 8 AM and 8 PM, 7 days a week.

5. Telehealth visits  

If you struggle with mobility issues, it can be too hard to get to your provider in person. In some cases, you can opt for telehealth, if your provider offers virtual visits. This is where you see your provider by phone or secure video from the comfort of home. It can also be a good way to do follow-up visits and quick medication checks. Many medical providers offer it, says Wolf. It’s included in the Aetna D-SNP plan.  

6. Meal delivery after a hospital stay

The last thing you want to deal with after you’re discharged from the hospital is cooking. That’s why the Aetna D-SNP program provides freshly prepared meals to members after a qualifying in-patient hospital, in-patient psychiatric hospital or skilled nursing facility stay. They’re easy to heat in the oven or microwave, so you can focus on resting and getting well. 

“When someone gets out of the hospital, there are a lot of things they’re trying to manage,” says Wolf. “We ensure they can eat healthfully and get enough nutrition so they can optimally heal.”

7. A basic fitness membership 

A fitness center is more than just a place to exercise. It’s also a great place to socialize and make friends, says Wolf. Aetna D-SNP members can gain access to one, at no added cost, through the SilverSneakers® fitness program. There are more than 16,000 participating SilverSneakers locations across the country.

If it’s too hard for you to get to the gym, you can exercise at home instead. SilverSneakers also has online videos for yoga, strength training and more. 

8. Healthy home visits  

More than one in four older adults have a fall each year. And 3 million older adults end up in the ER with fall-related injuries.* As an Aetna D-SNP member,  you can request a Healthy Home Visit from your care team.

During a Healthy Home Visit, a licensed medical professional can assess your fall risk. Members also get a $150 annual allowance you can use to help fall-proof your home. Use it to purchase approved home and bathroom safety devices like no-slip bathmats and grab bars.

If you qualify for both Medicare and Medicaid, you may be eligible for an Aetna Dual Eligible Special Needs Plan (D-SNP).

If you're 65 or older and have diabetes or an eligible heart disease, you may qualify for an Aetna Chronic Condition Special Needs Plan (C-SNP). C-SNPs are currently available in select counties in IL and PA.

You may be eligible for an Institutional Special Needs Plan (I-SNP) if you’ve lived (or plan to live) in a participating facility for 90+ days or you have Medicare Part A (hospital insurance) and Part B (medical insurance).
 

*FOR FALL-RELATED INJURIES SOURCE: Centers for Disease Control and Prevention. Facts about falls.  February 10, 2017. Accessed September 21, 2024. 

 

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area. If your plan’s Extra Benefits Card includes rollover, any unused amount will roll over into the next month. The monthly amount can be rolled over through the end of the plan year but will not carry over into the next plan year.

The benefits mentioned are part of special supplemental program for the chronically ill. Eligibility is determined by whether you have a chronic condition associated with this benefit. Standards may vary for each benefit. Conditions include hypertension, hyperlipidemia, diabetes, cardiovascular disorders, cancer. Other eligible conditions may apply. Contact us to confirm your eligibility for these benefits. If you have questions, call us at 1-833-228-1297 (TTY: 711) 7 days a week, 8 AM to 8 PM.

Eligibility for the Model Benefit or Reward and Incentive (RI) Programs under the Value-Based Insurance Design (VBID) Model is not assured and will be determined by Aetna after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).

Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change.

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2024 Tivity Health, Inc. All rights reserved. For more information about Aetna plans, refer to our website.

For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 14 days. You can call the number on your member ID card if you do not receive your mail-order drugs within this timeframe. Members may have the option to sign-up for automated mail-order delivery.

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