Retiree Plan Details
FSBP – Aetna Medicare Advantage plan for retirees with Medicare Parts A and B.
Get to know your Retiree plan and extras
As an Aetna Medicare Advantage for FSBP member, you’ll get benefits and programs that address the whole you — physical, emotional and social — at no additional cost to you.
If your income is above a certain limit, and you are enrolled in Medicare Parts B and D, you may be required to pay an Income-Related Monthly Adjustment Amount, or IRMAA, to the government. This is in addition to the standard premium amount. Since Aetna is not responsible for IRMAA please see the chart provided by Medicare which lists extra costs by income at: Medicare.gov/Basics/Costs/Medicare-costs
If you must pay an extra amount, Social Security, not your Medicare plan, will send you a letter telling you what that extra amount will be and how to pay it. The Part B extra amount will be withheld from your Social Security, Railroad Retirement Board or Office of Personnel Management benefit check, no matter how you pay your plan premium.
For more information contact Medicare, Social Security or visit: Medicare.gov/Basics/Costs/Medicare-costs
How the plan works
You’ll have $0 deductibles, copayments and coinsurance for most medical care. With FSBP — Aetna Medicare Advantage, members will get additional benefits and added programs that aren’t included with the FSBP High Option for no additional FEHB premium.
- $900 ($75 monthly) Medicare Part B premium reduction for eligible members
- Added programs like SilverSneakers® and Healthy Home Visits
- $0 deductible and coinsurance for medical care
- Prescriptions as low as $0 (be sure to check the formulary to confirm your cost for your prescription)
Benefits wherever you are
This plan lets you use any doctors and hospitals that are licensed to receive Medicare payment and willing to accept and bill your plan.
And with the Aetna Medicare Advantage for FSBP, your coverage follows you wherever you travel, nationwide.
Wellness and value-added programs
Get to know the Aetna Medicare Advantage plan
FSBP and Medicare: A guide for FSBP retiree health and prescription drug plans. As an FSBP – Aetna Medicare Advantage plan member, you have a suite of programs and services available at no extra cost to you. Download the brochure to learn more.
Benefit comparison
FSBP High Option with Medicare compared to Aetna Medicare Advantage for FSBP
Benefits at a glance
The RCBP High Option column shows benefits when Medicare Parts A and B are your primary coverage.
RCBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and RCBP.
Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.
| Benefit Type | Current – FSBP with Medicare | FSBP Aetna Medicare Advantage Plan |
|---|---|---|
| Annual Part B premium reduction | N/A | $900 per eligible person ($75 per month) |
| Deductible | $0 | $0 |
| Out-of-pocket maximum | $5,000 per person (medical and prescription) | $0 (medical) $2,000 per person (prescription) |
| Coinsurance | $0, except prescription drugs | $0, except prescription drugs |
| Customer service | Calls handled by American Foreign Service Protective Association (AFSPA) | Calls handled by Aetna Retiree Service Center representatives |
| Prior authorization | Most services do not require prior authorization | Some services require prior authorization** such as, but not limited to: inpatient hospital, outpatient surgery, physical therapy and massage therapy. |
Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. FSBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov
Medical coverage
The RCBP High Option column shows benefits when Medicare Parts A and B are your primary coverage.
RCBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and RCBP.
Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.
| Medical Coverage | Current – FSBP with Medicare | FSBP Aetna Medicare Advantage Plan |
|---|---|---|
| Adult annual physical exam | $0 | $0 |
| Lab, X-ray and other diagnostic tests | $0 | $0 |
| Primary care and specialty physician visits | $0 | $0 |
| Chiropractic services | $0, up to $75 per visit, up to 50 visits per year. You pay all charges after 50 visits. | $0 no maximum |
| Physical, occupational and speech therapy | $0, up to 125 visit combined maximum | $0 unlimited visits Prior authorization required |
| Routine vision exam | Not covered | $0, limited to 1 routine exam every year |
| Massage therapy | $0, up to maximum of $75 per visit, up to 50 visits per year, no referral required. You pay all charges after 50 visits. | $0, up to 50 visits* per year when medically necessary (prior authorization is required). You pay all charges after 50 visits |
| Inpatient hospital | $0 | $0 |
| Outpatient hospital | $0 | $0 |
Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. FSBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov
Prescription drug benefits
The RCBP High Option column shows benefits when Medicare Parts A and B are your primary coverage.
RCBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and RCBP.
Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.
| Prescription Coverage | Current – FSBP with Medicare | FSBP Aetna Medicare Advantage Plan |
|---|---|---|
| Preferred generic | N/A | Preferred pharmacies: $0 (30 days), $0 (90 days) Standard pharmacies: $2 (30 days) $4 (90 days) |
| Generic | $10 copay (up to 30 days) $15 (90 days) |
$10 (30 days) $15 (90 days) |
| Preferred brand | 25% ($30 min; $100 max) (up to 30 days) $60 (90 days) |
$40 (30 days) $60 (90 days) |
| Non-preferred brand | 35% ($60 min; $200 max) (up to 30 days) 35% ($80 min; $500 max) (90 days) |
$75 (30 days) $150 (90 days) |
| Specialty generic | 25% (up to $150 max) (up to 30 days) 25% (up to $150 max) (90 days) |
25%; max $150 (30 days) 25%; max $150 (90 days) |
| Specialty preferred brand | 25% (up to $200 max) (up to 30 days) 25% (up to $200 max) (90 days) |
25%; max $150 (30 days) 25%; max $150 (90 days) |
| Specialty non- preferred brand | 35 % (up to $300 max) (up to 30 days) 35 % (up to $300 max) (90 days) |
25%; max $150 (30 days) 25%; max $150 (90 days) |
| Pharmacy Benefit Manager – Different formularies apply | Express Scripts | CVS Caremark® |
Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. FSBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov
Wellness and value-added programs
The RCBP High Option column shows benefits when Medicare Parts A and B are your primary coverage.
RCBP waives your calendar year deductible and most copayments and coinsurance, (except for prescription drugs), and pays Medicare’s deductible and coinsurance for services covered by both Medicare and RCBP.
Do not rely on this chart alone. All benefits are fully described in the official Plan Brochure.
| Wellness and value- added programs | Current – FSBP with Medicare | FSBP Aetna Medicare Advantage Plan |
|---|---|---|
| SilverSneakers® | Not included | Included |
| Meal benefit program | Not included | Included – up to 14 meals after discharge per patient |
| Routine transportation | Not included | Included – 24 one-way trips up to 60 miles |
| Healthy Home Visits | Not included | Included |
| Resources For Living® | Not included | Included |
| Wellness Rewards | Earn up to $400 to be deposited in a Wellness Fund account by participating in the Simple Steps to Living Well Together Program | Earn up to $400 in gift cards by participating in the Healthy Rewards Program |
| Over-the-counter supplies | Limited to ACA requirements | $30 allowance every three months via mail order. |
Note: This chart assumes Medicare Parts A and B are primary and that covered services are provided by doctors and facilities that participate with Medicare. FSBP does not pay 100% when services are provided by a doctor under a private contract that provides for direct billing and no Medicare coverage. This is also a summary of Medicare features. For more information on Medicare call 1-800-MEDICARE or visit Medicare.gov
Getting access to Aetna Medicare Advantage
Everyone covered under your plan who has Medicare Parts A and B as primary coverage has the choice to opt into the plan. To complete your enrollment in FSBP — Aetna Medicare Advantage plan:
- Please go to AetnaRetireeHealth.com/FSBP or call us at 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET.
- Provide your Original Medicare effective date for Parts A and B and your Medicare Beneficiary ID. (All available on your Medicare ID card.)
Retiree plan resources to help you with your benefits
Retiree documents
- 2023 Retiree plan brochure PDF - opens in a new window
- 2023 Medicare – Evidence of Coverage PDF - opens in a new window
- 2023 Medicare – Plan Document Notice PDF - opens in a new window
- 2023 Medicare – Schedule of Cost Sharing PDF - opens in a new window
- 2023 Medicare – Summary of Benefits PDF - opens in a new window
Pharmacy Cost Calculator and Locator Tool
Retiree prescription drug information
Claim forms and appeals resources
FSBP Aetna Medicare Advantage
It’s easy to opt in (with Aetna).
Visit AetnaRetireeHealth.com/FSBP or call 1-866-241-0262 (TTY: 711)
Monday–Friday, 8 AM–8 PM ET
Get Live Help
Have questions or need help selecting a plan? We offer multiple ways to get live help. Don’t wait, our friendly representatives are here for you.
*Please see the Summary of Benefits/Plan benefit guide at FSBPHealth.com/Retiree for a list of services that require prior authorization.
**We’ve partnered with American Specialty Health Group (ASH Group) to provide you with therapeutic massage services. As a Aetna Medicare Advantage PPO member, you can visit providers in and out of the ASH network at the same cost share, as long as they accept Medicare and your Aetna plan. Therapeutic massage treatments must be medically necessary, as determined by ASH Group, and provided by a state licensed massage therapist. We do not cover therapeutic massage for comfort or relaxation purposes.
Aetna Medicare is a PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.
SilverSneakers is a registered trademark of Tivity Health, Inc.©2025 Tivity Health, Inc. All rights reserved. Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies. The formulary, provider and/or pharmacy network may change at any time. Participating physicians, hospitals and other 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. Medicare rules don’t allow earned rewards to be used for Medicare-covered goods or services, including medical or prescription drug out-of-pocket costs. Earned rewards may not be used to pay for medical copays, prescription costs, or any other Medicare covered good or services. Earned rewards may also not be used on alcohol, tobacco or firearms or be converted to cash.
The 2026 Your Healthy Rewards program is only applicable to active members with eligible MA and/or MAPD plans. Qualifying participants who are eligible to perform the program activities may earn rewards by completing all or some of the program activities. Rewards will be distributed to participants in the form of a gift card. The 2026 Your Healthy Rewards program is available to our members until the last day of the year. You will need to earn and redeem your reward by December 31, 2026 or the date you leave the plan, whichever comes first. Participants should check the terms of their Evidence of Coverage (EOC) prior to participating in any program activities. Except as set forth in the EOC, Aetna shall not be responsible for any costs associated with, or arising from, a participant’s performance of program activities. Your participation in the Your Healthy Rewards program is voluntary and does not affect your benefits from your Aetna health plan. Eligibility is limited to the Aetna member that this communication was addressed to. Subject to benefits and eligibility verification.
Rewards earned may be considered taxable income. Please consult your tax adviser if you have any questions regarding the taxability of rewards.
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Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Incentive-based activity awards will only be given for completing select wellness programs as determined by the plan sponsor.
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