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Aetna | AEP Updates and Wrap-Up Information

November 22, 2023

As we head into the last part of AEP, we want to thank you for all of your hard work and partnership. We’re excited about the feedback we’re hearing from all of you. That said, we’ve received a number of questions about some of our new benefits and plans. In this email, we want to make sure you have the comprehensive information you need to support your clients and help them get the full value of their plan. Specifically, we’ll address:

  • Fitness reimbursement benefit
  • High-value provider bonus benefit
  • Reminders for narrow network plans
  • Finishing AEP strong: Ensure all enrollments are processed

Fitness Reimbursement Benefit Clarification

In 2024, some non-SNP Aetna Medicare plans offer a fitness reimbursement benefit. With this benefit, members can be reimbursed for eligible activities and supplies that improve fitness and health outcomes.

To ensure you and your clients understand how this benefit works, we’ve created a new guide. It provides clarity on the reimbursement process.

We’ve also updated our broker flyer on this benefit. Be sure to check out the new version.

Help Clients take Advantage of the new High-Value Provider (HVP) Bonus Benefit

In 2024, some plans offer a new HVP bonus benefit. With these plans, eligible members can receive increased funds loaded onto their Extra Benefits Card by selecting a primary care provider (PCP) from a designated HVP group.

Please ensure your clients know they must select a PCP from one of these HVP groups as one of the requirements to receive this benefit.

Remember, you can find a list of participating HVP providers on Producer World. These providers appear with a special indicator in most provider search tools.

Clients who’ve already enrolled in one of these plans can call Member Services to add or update their PCP on file to an HVP.

Remember, for narrow network plans, ensure your clients select an in-network PCP

For 2024 plans that have a narrow network, like Prime plans, please encourage your clients to select an in-network PCP when they enroll. Or if they already enrolled without one, they can call Member Services to change their PCP on file. This is especially important for narrow network plans because if beneficiaries don’t select a PCP when they enroll, we will auto-assign one.

Finish AEP Strong

Review AEP Enrollment Deadlines

  • December 7: All AEP enrollment applications must be completed, signed, dated, and received by the agent no later than 11:59 PM, December 7, 2023.
  • 48 hours: We must receive signed enrollment applications within two calendar days after you receive them from beneficiaries.
  • December 9 is the last day to submit all applications that were signed and dated December 7, 2023.

If you receive a completed enrollment application after AEP ends on December 7, do not hold or destroy it. Under CMS rules, you must still submit it to us within two calendar days as noted above. We then will process or deny the enrollment as appropriate.

Ensure your enrollments are processed – Encourage clients to contact us if their enrollment is pending due to a request for information (RFI)

You can check the app status report in Producer World to see if any enrollments are in a “pending RFI” status. Encourage these clients to call us so we can verify any outstanding items and finish processing their enrollment. They should call the customer service number in the message we leave or the letter they receive.

If we’re not able to reach them (within 21 days or by the end of the enrollment period, whichever is longer), their application will be denied.

We wish you a happy Thanksgiving!

We appreciate your partnership! If there is any way we can help during AEP, please contact your local Aetna Medicare Broker Manager. Or reach out to Aetna Medicare Broker Services at 1-866-714-9301 or brokersupport@aetna.com.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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