FSBP — Aetna Medicare Advantage FAQs
About the plan
As a FSBP High Option member, beginning this Open Season, you’ll 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 with FSBP — Aetna Medicare Advantage. It 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® fitness membership, 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 Federal Plan brochure and other information on this website.
- Call us at 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET.
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 begins on January 1, 2023, as long as you opt in by December 13, 2022. If you opt in between December 14–December 31, 2022, your coverage will still be effective January 1, 2023, but you may not receive all of your plan information before that effective date. If you opt in after January 1, your coverage will be effective the first day of the month after your opt-in date.
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.
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/retiree
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.
By opting into the plan, Medicare will have the necessary information to automatically reduce your Part B premium. Your Social Security account will be credited $75 a month (up to $900 a year) for each eligible member.
If you do not have Part B paid through Social Security, the credit is taken off your OPM Federal Annuity for Part B or however you pay for Part B, reducing the amount you are billed.
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. Members also get 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.
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® fitness: 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®: 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 GA Foods 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.
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 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET. Foreign Service retirees should email HRSC@state.gov or call 1-866-241-0262 (TTY: 711), Monday–Friday, 8 AM–8 PM ET. 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.
Tools and resources to manage your health and budget. Dig deeper with the tools below and get smart about your health choices! Find a doctor and tools to manage your health. Use the buttons below to read about our member tools:
Step 1: After clicking on “Find Your Provider”, choose “2023 Medicare plans you through your employer.”
Step 2: Enter your home ZIP code or city, state then select from the drop-down.
Step 3: Choose ”Select plan to find providers”
Step 4: Choose “Medicare Advantage with Prescription Drug Plan”
Step 5: Under PPO section — ”Select Aetna Medicare Plan (PPO)”
Step 6: Then choose ”Medical” and click ”Continue to find care” at the bottom right of your screen to find providers
Note: As a member of the FSBP — Aetna Medicare Advantage plan (PPO), you can receive services from any provider that is eligible to receive Medicare payment and is willing to treat you. Your cost share will be the same as in-network care. Out-of-network providers are under no obligation to treat you, except in emergency situations.
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
- Check balances on 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 the “Register now” link
- Step 3: Follow the simple prompts
That’s it. Log in anytime, from anywhere you have internet access.
Talk to a doctor 24/7
- Teladoc 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 mobile app.
- Telehealth consultations are available to for the following specialties through our telehealth vendor, Teladoc:
- Doctors of Medicine (MD)
- Doctors of Osteopathic Medicine (DO)
- Licensed Clinical Social Workers (LCSW)
Teladoc 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 is available wherever you are — at home, work, or traveling in the United States.
Get started at: Teladoc.com/Aetna.
Teladoc® is not available to all members. Teladoc and Teladoc 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.
Aetna® added programs
FSBP — Aetna Medicare Advantage comes with more ways to help you save.
Save on gym memberships, weight-loss programs, vision services, hearing aids and more — just for being a member. These built-in discounts aren’t insurance. And there are no claims, referrals or limits on use.
Just log in to your member website at Aetna.com to start saving. Learn more about our discount programs (PDF)
Healthy Home Visit program
An Aetna health professional will provide you with advice in the comfort of your own home. They can also work with your doctor to help coordinate your care.
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 31, 2023.
How can you participate? It’s easy as:
Step 1: Complete activities
Earn rewards for completing eligible activities. Each activity is worth $5 to $50 in rewards. Register or log in to your member website to get started.
Step 2: Let us know
Self-report after completing eligible activities on the member website or by calling us.
Step 3: Enjoy rewards
Redeem your rewards for a digital or physical gift card from CVS Pharmacy®, Home Depot, Kohl’s®, Best Buy and more. Receive digital gift cards within 48 hours.
Reasons to participate
- No cost to you
- It’s easy to join and track your rewards
- Learn healthy behaviors and improve your health
We’re committed to providing you with the resources, tools and support that help ensure you achieve your best health. All of our health advocacy and wellness programs are available to you — at no extra cost.
An overall wellness program that helps 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® telehealth services
We partner with Teladoc, who has U.S. board-certified, state-licensed health care professionals. This virtual option provides you the added convenience of reaching health care providers online, by phone or mobile app.
Hearing aid reimbursement
Hearing aid reimbursement for retirees, to help you engage and communicate with the world around you. Reimbursement 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 support your physical and mental well-being.
Nonemergency transportation program
A program to help you make it to and from doctors or hospital appointments without always having to rely on family or friends.
Meal benefit program
After a hospital stay, Aetna offers a meal benefit through our relationship with GA Foods. The program offers 14 home-delivered meals — convenience for when making a meal is a difficult option.
Live webinars available
Meetings wherever you are to fit your busy schedule. Register for a live webinar hosted by the Aetna federal team and get answers to your questions. Or watch our on-demand webinars anytime to learn more about Aetna Medicare Advantage.
Get the help you need. Have questions or need help from a representative selecting a plan? 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.
- 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 an HMO, 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.© 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. Out-of-network/non-contracted providers are under no obligation to treat plan 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. Aetna Medicare’s pharmacy network includes limited lower cost, preferred pharmacies in applicable 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. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. 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 10 days. You can call 1-866-241-0357 (TTY: 711), Monday – Friday 8AM – 8PM ET 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. 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.
All trademarks and logos are the intellectual property of their respective owners.
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.
©2022 Aetna Inc.