Aetna Medicare Advantage: COVID-19 FAQs and resources

Note: “Medicare Advantage (MA)” includes Individual MA-only (MA) and Medicare Advantage Prescription Drug (MAPD) plans, Joint Venture MA plans, Dual Eligible Special Needs Plans (DSNP), Medicare-Medicaid Plans (MMP), and Group MA and MAPD plans. We sell Medicare Advantage products under the names Aetna Medicare, Innovation Health, Allina Health, and Aetna Better Health.

    Medication access
     

    The CDC encourages people to stay at home as much as possible. CVS Health provides convenient options to avoid visiting the pharmacy for refills or new prescriptions.

    Aetna offers 90-day maintenance medication prescriptions for insured and Medicare members.

    Read more about how CVS Health is working to ensure medication access for patients.

    Telehealth

    What is telehealth?

    Telehealth is the term Medicare uses for telemedicine. Telemedicine refers to real-time virtual care. This can include:

    • Live-video conferencing with providers

    • Telephone-only consultations with providers

    • Services provided by vendors like Teladoc®

    Medicare Advantage members should use telemedicine as their first line of defense to limit potential exposure to COVID-19 in physician offices.

    How is Aetna covering telehealth services for their Medicare members?

    Through September 30, 2020, Aetna is extending all member cost-sharing waivers for in-network telehealth visits for outpatient behavioral and mental health counseling services for all Medicare Advantage plan members.

    Aetna is also waiving member out-of-pocket costs for all in-network primary care visits, whether done in-office and via telehealth, for any reason, and encourages members to continue seeking essential preventive and primary care during the crisis. This is effective May 13, 2020, through September 30, 2020.

    Medicare Advantage members should use telemedicine as their first line of defense for appropriate symptoms or conditions to limit potential exposure to COVID-19 in physician offices.

    Medicare Advantage members may use telemedicine for any reason, not just COVID-19 diagnosis. This means members can continue to receive clinical care from their providers, for example, discuss their diabetes care plan or schedule a sick visit, without having to leave their home and risk exposure to COVID-19.Disclaimer: Regulations regarding telehealth services and care package availability for Aetna Medicaid members varies by state and, in some cases, are changing in light of the current situation. Aetna Medicaid members with questions about their benefits are encouraged to call the member services phone number on the back of their ID cards.

    How can our Medicare Advantage members access telehealth services?

    Members should contact their doctor to see which telehealth services they may be able to offer their patients and how to schedule them.

    Can our Medicare Advantage members use Teladoc?

    Yes, we have temporarily made Teladoc available to all of our Medicare Advantage members for general medical care only, at no cost, through September 30, 2020. However, we encourage members to seek virtual care from their own doctors first when possible to maintain care continuity.

    To access Teladoc, members can call 1-855-TELADOC (855-835-2362) or visit https://member.teladoc.com/aetna for help. It’s available 24/7 to help.Disclaimer: Regulations regarding telehealth services and care package availability for Aetna Medicaid members varies by state and, in some cases, are changing in light of the current situation. Aetna Medicaid members with questions about their benefits are encouraged to call the member services phone number on the back of their ID cards.

    Can Teladoc provide the same telemedicine services as Medicare Advantage members’ own doctors?

    No, Teladoc can be used by Medicare Advantage members for general medical care only. Members should seek other telehealth care, such as dermatology and behavioral health services, from their own doctors.

    For Group Medicare Advantage members with the Teladoc benefit, is the copay waived?

    Yes, along with all telehealth services, we have waived copays through September 30, 2020.Regulations regarding telehealth services and care package availability for Aetna Medicaid members varies by state and, in some cases, are changing in light of the current situation. Aetna Medicaid members with questions about their benefits are encouraged to call the member services phone number on the back of their ID cards. Members may see Teladoc providers for general medical care; however, they should consult their providers for virtual dermatology and behavioral health services.

    For Aetna Group Medicare Advantage members without the Teladoc benefit, will members be able to access Teladoc?

    Yes, we have temporarily made Teladoc® available to all of our Medicare Advantage members at no cost. However, we encourage members to seek virtual care from their own doctors when possible to maintain care continuity.Disclaimer: Regulations regarding telehealth services and care package availability for Aetna. Members should consult their providers for virtual dermatology and behavioral health services.

    Does CVS MinuteClinic offer virtual visits to Medicare members?

    Yes, MinuteClinic offers two telemedicine options: MinuteClinic Video Visits and E-Clinic visits.

    Are CVS MinuteClinic Video Visits covered for Medicare Advantage members?

    Yes. MinuteClinic Video Visits are now covered by most Aetna Medicare Advantage plans and copays are waived through September 30, 2020. At this time, MinuteClinic Video Visits are not covered by these plans: Aetna Better Health of Virginia (HMO SNP), Aetna Better Health of Ohio, a MyCare Ohio plan (Medicare-Medicaid Plan), Aetna Better Health of Michigan Premier Plan (Medicare-Medicaid Plan), and Aetna Better Health of Illinois Premier Plan (Medicare-Medicaid Plan).

    To access MinuteClinic Video Visits, members can visit the MinuteClinic website or download the CVS mobile application. It’s available 24/7.

    Are CVS MinuteClinic E-Clinic visits covered under the telemedicine cost-sharing waiver for Medicare members?

    Yes, E-Clinic visits are part of the no-cost telemedicine waiver for most Medicare members. There is no cost to Medicare Advantage members for this service through September 30, 2020. E-Clinic visits are available for most Medicare Advantage plans, including Aetna Better Health of Ohio, a MyCare Ohio plan (Medicare-Medicaid Plan), Aetna Better Health of Michigan Premier Plan (Medicare-Medicaid Plan) and Aetna Better Health of Illinois Premier Plan (Medicare-Medicaid Plan). E-Clinic visits are not covered by Aetna Better Health of Virginia (HMO SNP).

    To access E-Clinic visits, members can members can visit the MinuteClinic website and select “Clinic Visit” under “Plan a Visit.” E-Clinic visits are available between 9 AM and 5 PM local time.

    What type of services are available via an E-Clinic visit?

    E-Clinics offer many of the same services as the retail MinuteClinics. They can evaluate, diagnose and treat common injuries, illnesses and skin conditions. They can also help manage chronic conditions like diabetes and high blood pressure for established patients. Providers can also assess a patient’s symptoms and risk factors for COVID-19 and provide guidance on how to access testing or treatment if infection with the virus is suspected. For more information, members can visit MinuteClinic.com.

    What’s the difference between a MinuteClinic Video Visit and E-Clinic visit?

    Here’s a side-by-side comparison of these services:
     
    E-Clinic Video Visits

    Provides support for over 150 services, similar to services provided in retail clinic setting

    Cover smaller subset of services related to minor illnesses and conditions

    Staffed by MinuteClinic nurse practitioners and physician assistants

    Staffed mainly by Teladoc physicians

    Available in Washington, D.C., and the 33 states where MinuteClinic operates (View complete list)

    Available in 43 states and Washington, D.C., including states where there is not a physical MinuteClinic presence. (View complete list)

    Available between 9:00 AM and 5:00 PM local time

    Available on-demand or by appointment, 24 hours a day, 7 days a week

    Offers patients the opportunity to connect with a local MinuteClinic provider via video conferencing

    Uses Teladoc's technology platform and is initiated through the patient’s computer or mobile device, at MinuteClinic.com or through the CVS Pharmacy app

     

    Prescriptions

    How do Medicare Advantage members get their medications if they are in self-isolation or quarantined?

    We recommend using mail-order – it’s available for most maintenance medications (medication members take regularly for things like high blood pressure, asthma or diabetes). There’s no delivery fee and members can have up to a 90-day supply delivered directly to their home.

    To get started with mail-order, members can either call the phone number on their ID card or visit Aetna Medicare.

    In addition to mail-order, most home delivery fees have been waived for prescriptions purchased from a CVS retail pharmacy. Through June 30, 2020, charges for standard 1-2 day delivery fees are waived. Same-day delivery cost is $7.99.

    What is CVS Pharmacy® doing to help our Medicare Advantage members with Part D benefits in response to COVID-19?

    CVS Pharmacy has waived most home-delivery fees for prescriptions purchased from them. Through June 30, 2020, charges for standard 1- to 2-day delivery fees are waived. Same-day delivery cost is $7.99.

    Can Medicare Advantage members request early refills on their prescriptions?

    Yes, all Medicare members with prescription drug coverage (MAPD and PDP) may request early refills on maintenance medications, if needed.

    • If the drug is on a non-specialty tier, we’re waiving early refill limits up to a 90-day supply.

    • If the drug is on a specialty tier, we’re waiving early refill limits for a 30-day supply.

    • All prescriptions must comply with state dispensing requirements and have enough refills to be filled. To get an early refill, the pharmacy will need to do an override (they should follow standard message codes to complete this action). They can always call the pharmacy help desk for assistance.

    Should Medicare Advantage members call their plan to request an early refill?

    No, members can contact their pharmacy directly for assistance.

    Can Medicare Advantage members with Part D benefits use out-of-network pharmacies?

    Yes, however, members will have to pay for their prescription and submit a claim form to get reimbursed. Therefore, we strongly recommend that members use network pharmacies. Members with specific network issues should call the phone number on their ID card.

    Are there any dangers regarding medications manufactured in China?

    The Food and Drug Administration (FDA) has not indicated there are any concerns with drugs manufactured in China. The FDA protects public health by promoting supply chain integrity and working to ensure medicines imported to the U.S. meet legal and regulatory requirements. Imported drugs must meet FDA’s standards for quality, safety and effectiveness.

    Should Medicare Advantage members be worried about a risk of shortages in their medications?

    We are closely monitoring drug supply and currently do not see any disruptions to the supply chain as a result of COVID-19 that would affect our ability to fill prescriptions. As always, we encourage you to fill your prescriptions in a timely manner.

    COVID-19 testing & treatment

    Will Medicare Advantage members have to pay for COVID-19 testing?

    If a doctor requests testing related to COVID-19 for a Medicare member, the test will be fully covered, with no copay or cost share.

    Will Medicare Advantage members have to pay for COVID-19 treatment?

    No, we will cover the cost for treatment of COVID-19 for our members in full in the provider office. We will also cover the cost of the hospital stay for all of our Medicare Advantage members admitted March 25, 2020 through September 30, 2020.

    The Healing Better program

    Does the Healing Better program include all Medicare Advantage members?

    Yes. All members discharged from the hospital with a COVID-19 diagnosis will get a care package from us.Distribution is dependent on recent hospital discharge for COVID-19 diagnosis and supply availability. It has info to help answer member questions and remind them of the resources we offer to help them recover. The package may also include personal and household cleaning supplies to help keep others in the home protected from potential virus exposure.

    Resources For Living® program

    How do plan sponsors get a Resources For Living toolkit?

    The toolkit is an online resource with helpful info about the coronavirus and tips for staying healthy. It also includes a recorded webinar to help members cope with coronavirus fears. Access the toolkit.

    Is there a Medicare version of the Resources For Living toolkit for plan sponsors?

    No. There isn’t a separate Medicare version.

    Other

    What’s the phone number for the Crisis Response Line (Aetna Resources For Living)?

    The phone number is 1-866-370-4842 (TTY: 711) for Medicare members.

    What’s the phone number for the Aetna 24-hour Nurse Line?

    The phone number is 1-800-556-1555 (TTY: 711).

    Additional resources

    What support is Aetna providing to the community regarding Coronavirus?

    Aetna Resources For Living (RFL) is offering support and resources to individuals and organizations who have been impacted by Coronavirus. Through this liberalization, those in need of support can access RFL services whether or not they have it as part of their benefits.

    • Individuals and organizations who don’t have RFL can contact RFL at 1-833-327-AETNA (1-833-327-2386).

    • Members and plan sponsors who do have RFL should call their designated RFL number available in program materials.

    What is included with RFL liberalized services?

    Support to individuals and organizations that don’t have RFL includes:

    • In-the-moment phone support to help callers cope with the emotional impact of the COVID-19 outbreak

    • Informational brochures about dealing with a crisis

    • Community resource referrals, including local support services in the local area

    • Management consultation to help organizations respond to the needs of their employees, even if they’re not RFL customers

      • Employers may contact our specialized support line at 1-800-243-5240.

      • Group support services may be available telephonically or onsite where appropriate on a fee-for-service basis to help managers and employees manage the disruption and distress of this situation.

    Are there benefits that can be extended to non-Aetna members?

    While the cost share waivers do not apply to non-members, crisis support is available.  Resources For Living® (RFL) has liberalized its phone lines, offering support and resources to individuals and organizations who have been impacted by the COVID-19.  Through this liberalization, those in need of support can access RFL services whether or not they have it as part of their benefits. For those individuals without Aetna benefits, RFL can be reached at 1-833-327-2386. More details are available about RFL services.

    What other RFL resources are available to the public?

    RFL has also developed several articles, webinars and other materials to help members experiencing stress and anxiety related to COVID-19. These resources are now available publicly.

    Has RFL been liberalized to include international coverage?

    No, not currently. We don't currently have the ability to manage international but are working to explore options. 

    Where can I get more information?

    You can find more information on COVID-19 at these links:

    The information contained in this FAQ is subject to change at the discretion of CVS at any time, for any reason and without advanced notice.

    05.28.20