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Foreign Service Benefit plan

Caring For Your Health Worldwide®

Frequently Asked Questions

FSBP — Aetna Medicare Advantage FAQs

Click on a question. Get an answer.

About the plan

As a FSBP High Option member you have the opportunity to opt in to the FSBP — Aetna Medicare Advantage plan.
The plan offers added value with $0 deductibles, prescription drugs with copays as low as $2, and a monthly credit to reduce Medicare Part B premiums.

It also provides access to programs and services such as Healthy Home Visits, meals after a hospital stay, nonemergency transportation for medical care and SilverSneakers®.

Federal retirees with Medicare Parts A and B will continue to pay Part B premiums. FSBP - Aetna Medicare Advantage provides the same coverage as Original Medicare, but with additional benefits you wouldn’t get otherwise. You’ll also get access to programs that can help you reach your health potential, including SilverSneakers®, Healthy Home Visits and more.

  • The plan also includes a credit that reduces your Medicare Part B premiums by $75/month (up to $900/year) per eligible member.
  • You can see any provider that is licensed to receive Medicare payments and accepts the plan.

Selecting FSBP — Aetna Medicare Advantage does not change your FSBP premium or enrollment code.

IRMAA is an amount you may have to pay in addition to your Part B or Part D premium if your income is above a certain level. If you are expected to pay IRMAA, SSA will notify you.

Members are automatically enrolled in a Medicare Part D plan when they opt into the plan. The cost is included in the premium unless member is subject to IRMMA.

No. This plan is a special offering available to you when you’re enrolled in the FSBP High Option, through the FEHB program, and have Medicare Parts A and B. By opting in to FSBP — Aetna Medicare Advantage you’ll receive enhanced benefits without suspending your FEHB coverage.

For existing FSBP members who opt in to FSBP — Aetna Medicare Advantage, you will receive a new ID card after you provide your Medicare information. You should always present this new card when asked for insurance information.
For new FSBP High Option members, you will initially receive a FSBP ID card. After you provide your Medicare information, you will receive a second ID card that indicates you are in the FSBP — Aetna Medicare Advantage plan. You should always present your FSBP — Aetna Medicare Advantage ID card when asked for insurance information.

You have options:

  • Review the Plan brochure and other information on this website.
  • Call us at  1-866-241-0262  (TTY: 711), Monday–Friday, 8 AM–8 PM ET.

Enrollment

It’s easy. If you’re currently enrolled in FSBP and retired with Medicare Parts A and B as your primary coverage and reside in the 50 United States, you can opt in by visiting AetnaRetireeHealth.com/FSBP and select Register now or by calling us at 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET.

Simply provide us with your effective dates for Medicare Parts A and B along with your Medicare Beneficiary ID number.

Participation in the FSBP — Aetna Medicare Advantage plan is voluntary. You must choose to participate. Since FSBP — Aetna Medicare Advantage is a Medicare Part C plan, we need your Medicare information to complete your enrollment per regulations set by the Centers for Medicare & Medicaid Services (CMS). Providing us with your Medicare information will allow us to enroll you in the FSBP — Aetna Medicare Advantage plan.

Coverage will be effective the first day of the month following enrollment.

You can opt in to this plan any time during the year, not just open season.

Opting in to the FSBP — Aetna Medicare Advantage plan is voluntary.  If you decide to opt in, you will continue to be a member of FSBP.  If you change your mind after opting in, you can switch back to your existing FSBP High Option coverage at any time, not just during open season.

Yes, you may return to the FSBP High Option plan. To do so, call us for a disenrollment form at 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET.

Doctors and networks

No. With the FSBP — Aetna Medicare Advantage, you have the freedom to see any licensed doctor or hospital as long as they accept Medicare payments and FSBP — Aetna Medicare Advantage — even if they’re not in the Aetna network.

Pharmacy

The FSBP — Aetna Medicare Advantage prescription drug benefits are managed by CVS Caremark®.

With FSBP – Aetna Medicare Advantage, your prescription copays for a 30-day supply will be:

  • $0 for a preferred generic drug at a preferred pharmacy, $2 at a standard pharmacy
  • $10 per covered non-preferred generic drug
  • $40 per covered preferred brand-name drug
  • $75 per covered non-preferred brand-name drug
  • 25% for specialty drugs ($150 maximum)

Yes, mail-order pharmacy is available for maintenance medications. Your share of the cost for a 90-day prescription will be:

  • $0 for a preferred generic drug at a preferred pharmacy, $4 at a standard pharmacy
  • $15 per covered non-preferred generic drug
  • $60 per covered preferred brand-name drug
  • $150 per covered non-preferred brand-name drug
  • 25% for specialty drugs ($150 maximum)

The plan uses a formulary list of covered medications. It can be found at FSBPhealth.com/retirement-medical-details.

What will I pay?

FSBP — Aetna Medicare Advantage is a Medicare Part C plan. Medicare pays Aetna to administer the plan and cover your claims. You do not need to do anything after opting in but be sure to use your FSBP — Aetna Medicare Advantage ID card when you get care. And let your doctors and pharmacy know you have a new plan.

You pay $0 when you visit a provider who is eligible to receive Medicare payments and accepts the plan, even if they’re not in the Aetna network.

Dental and vision

The FSBP - Aetna Medicare Advantage includes up to $750 in dental benefits for each covered
member including:

  • 100% coverage for preventive care
  • 50% coverage for other services after a $25 deductible

Routine eye exams are covered at 100%. Plus members will also receive an eyewear reimbursement of $300 every 24 months.

Member perks

Health advocacy and wellness programs are included with your plan for no extra cost. Most of these programs are only available if you have selected the FSBP — Aetna Medicare Advantage plan.

SilverSneakers®: An overall wellness program that may help you improve your health and live the life you want. The program gives you access to exercise equipment, classes and fun social activities at thousands of locations nationwide.

Teladoc Health: Licensed providers that you can meet with online, by phone or mobile app anywhere in the U.S.

Hearing aid reimbursement: Hearing aid reimbursement for retirees is $4,000/every 36 months.

Resources For Living®: Aetna signature program helps you find the resources you need in your daily life. With just one call, a life consultant can help you find local resources to make life easier and treat your entire health, including your social and mental well-being.

Nonemergency transportation program: A program that ensures you make it to and from doctor or hospital appointments without always having to rely on family or friends.

Meal benefit program: Aetna offers a meal benefit through our relationship with NationsMarket for members recently discharged from the hospital. The program offers 14 home delivered meals; convenience for when making a meal is a difficult option.

Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. 

For all of the details visit FSBPhealth.com/retiree Or call us at 1-866-241-02621 (TTY: 711),  Monday–Friday, 8 AM–8 PM ET.

Enroll now
If you’re currently a FSBP member, you can opt in by visiting AetnaRetireeHealth.com/FSBP by calling us at 1-866-241-0262  (TTY: 711), Monday–Friday, 8 AM–8 PM ET. Provide us with your effective dates for Medicare Parts A and B and your Medicare Beneficiary ID number (conveniently located on your Medicare ID card).

If you are new to FSBP, the FSBP - Aetna Medicare Advantage requires two easy steps for retirees with Medicare Parts A and B:

Step 1:  Enroll as you normally would. Civil service retirees will go through the OPM Retirement website at RetireeFEHB.OPM.gov
Or you can call 1-888-767-6738  (TTY: 711). Foreign Service retirees should email HRSC@state.gov or call 1-843-308-5539 (TTY: 711). Enroll in the FSBP High Option plan using enrollment code 401, 402 or 403. If you are enrolled in FSBP already, proceed to step 2.

Step 2:  Provide us with your Medicare information. Once you are enrolled through the OPM Retirement website, your basic information will be transferred to us. (Please allow 7–10 business days.) In addition, we will need the following to complete your enrollment which are located on your Medicare ID card:

  • Your Original Medicare effective dates for Parts A and B
  • Your Medicare Beneficiary ID number

 

You may go to AetnaRetireeHealth.com/FSBP or call us at 1-866-241-0262 
(TTY: 711), Monday–Friday, 8 AM–8 PM ET and provide us with this information.

Member tools

Talk to a doctor 24/7

  • Teladoc Health is a low cost, convenient and quality alternative to emergency room and urgent care for nonemergency medical care.
  • Care is available 24 hours a day, 7 days a week, 365 days a year by web, phone and the Teladoc Health mobile app.
  • Telehealth consultations are available to for the following specialties through our telehealth vendor, Teladoc Health:
    • Doctors of Medicine (MD)
    • Doctors of Osteopathic Medicine (DO)
    • Nutritionists
    • Licensed Clinical Social Workers (LCSW)
    • Psychiatrists
    • Psychologists
    • Dermatologists

 

Teladoc Health provides access to U.S. board-certified doctors who can prescribe medical treatment for a wide range of conditions and can send a prescription to your pharmacy of choice, when necessary. Teladoc Health is available wherever you are — at home, work, or traveling in the United States.
Get started at: Teladoc.com/Aetna.

Select Medicare Provider Lookup 

Step 1: Enter your home zip code

Step 2: Select ‘plan year’

Step 3: Select Employer or group-sponsored retiree plan and select View Plans

Step 4: Under Medicare Advantage Plans with Prescription Drugs, select PPO Aetna Medicare Plan (PPO) with Extended Service Area (ESA)

Step 5: Select Continue

Step 6: Browse for providers by category

Your Aetna member website lets you save time, avoid guess work and make informed decisions about your health. You’ll be able to:

  • Find doctors, pharmacies, labs, hospitals and urgent care centers
  • Order a FSBP — Aetna Medical Advantage member ID card or print a temporary card
  • Check your coverage details
  • Keep track of health care costs

 

You can manage your benefits and connect with care by logging in to your Aetna member website. Once logged in you’ll be able to:

  • View your health plan summary and get information about what’s covered
  • Track spending and progress toward meeting your deductibles for you and your family
  • Access your ID card whenever you need it
  • View claims details and pay your claims
  • Search for facilities, procedures and medications
  • Find in-network providers accepting new patients
  • Estimate and compare costs

 

Look what else you can do with your Aetna member website:

  • Complete an online health assessment
  • Print records of preventive shots and checkups
  • Get healthy living tips
  • Check claims and much more

 

Register and log in
Have your FSBP — Aetna Medicare Advantage member ID card ready. You’ll receive it after you enroll:

  • Step 1:  Go to Aetna.com
  • Step 2:  Select ‘Login’ link, then ‘Register’
  • Step 3:  Follow the simple prompts

That’s it. Log in anytime, from anywhere you have internet access.

Aetna® added programs

Healthy Home Visit program
Get an annual home visit from a licensed doctor or nurse to assess your health and safety needs.

A health advocate if you need one
You may not need help today, but if you ever do, an Aetna Nurse Advocate can be a key partner in your health journey. They’ll collaborate with your doctors and help you get the most from your health plan benefits.
Help for your health conditions
They’ll work with your doctor to:

  • Create a personal treatment plan for conditions such as diabetes or heart disease
  • Connect you to resources you may need

 

A partner in care
They can handle the challenges of navigating complex medical issues for you such as:

  • Managing logistics of transitioning home from the hospital
  • Coordinating health and community resources with your doctors
  • Helping you and your family with any ongoing concerns

Stay healthy and earn up to $400 in gift cards by completing eligible health activities by December 31st of the current year.

Get rewarded by completing eligible health activities throughout the year. These activities can include things like annual checkups, screenings, and attending wellness programs. Learn more about the Healthy Rewards Program.

Personalized support
Get the help you need. Have questions or need help from a representative? There are multiple ways to get live help.
Use the link below to find the best way to connect live with a friendly representative.

  • Register to attend a free interactive webinar and learn more about FSBP — Aetna Medicare Advantage, or watch our on demand webinars.
  • Have questions? Reach a representative by phone 7 days a week. Call Aetna Retiree Service Center at 1-866-241-0262  (TTY: 711), Monday–Friday, 8 AM–8 PM ET.

Aetna Medicare is a PPO plan with a Medicare contract. Enrollment in our plans depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Aetna members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. The formulary, provider and/or pharmacy network may change at any time. You will receive notice when necessary. 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.

CVS Caremark® Mail Service Pharmacy and Aetna® are part of the CVS Health® family of companies. 

Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies.

Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional.

Teladoc Health is not available to all members. Teladoc Health and Teladoc Health physicians are independent contractors and are not agents of Aetna. Visit Teladoc.com/Aetna for a complete description of the limitations of Teladoc services. Teladoc, Teladoc Health and the Teladoc Health logo are registered trademarks of Teladoc Health, Inc.

For mailorder, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 10-14 days. You can call the number on the back of your 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.

Aetna Medicare’s pharmacy network includes limited lower cost, preferred pharmacies in: all areas. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays.

Estimated costs are not available in all markets or for all services. We provide an estimate for the amount you would owe for a particular service based on your plan at that very point in time. It is not a guarantee. Actual costs may differ from an estimate for various reasons including claims processing times for other services, providers joining or leaving our network or changes to your plan.

DISCOUNT OFFERS ARE NOT INSURANCE. They are not benefits under your insurance plan. You get access to discounts off the regular charge on products and services offered by third party vendors and providers. Aetna makes no payment to the third parties–you are responsible for the full cost. Check any insurance plan benefits you have before using these discount offers, as those benefits may give you lower costs than these discounts.

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.

©2025 NationsBenefits, LLC. All rights reserved. NationsBenefits is a registered trademark of NationsBenefits, LLC. Other marks are the property of their respective owners.

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. Rewards earned may be considered taxable income. Please consult your tax adviser if you have any questions regarding the taxability of rewards. 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.

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FSBP and Medicare brochure cover

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.

2025 FSBP and Medicare brochure

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

Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). This is a brief description of the features of the Foreign Service Benefit Plan (FSBP). Before making a final decision, please read the Official Plan brochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Official Plan brochure. All trademarks and logos are the intellectual property of their respective owners.

©2025