Aetna Employees: What to Look For in an Extended-Care Policy

Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more

Paul Bergeron, from The Retirement Group, underlines the importance of Aetna workers comprehending the details of long-term care insurance to choose a policy that meets their requirements while guaranteeing access to care without jeopardizing their financial well-being.

Tyson Mavar, from The Retirement Group, suggests that employees of Aetna companies should focus on grasping the benefit setups like elimination periods and inflation protection to make sure their long-term care policy adapts as their needs change over time.

Here are three key themes to explore in your article.

Exploring the elements of long-term care insurance policies, such as the range of facilities and services covered in the plans. Analyzing factors involves looking at the benefits offered such as payout amounts and waiting periods before coverage kicks in along with considering inflation adjustments and potential tax impacts. Assessing the robustness of a policy involves examining the stability of the insurance company and looking into policy perks such as the option for premium refunds.

Long-term care insurance often proves to be quite complex in nature, raising questions for Aetna workers regarding the expenses and advantages associated with coverage options.

What kinds of services are included in the coverage? Extended care policies for Aetna companies often include coverage for nursing homes, care services as home health care options like respite care and hospice care along with in-home personal assistance services and assisted living facilities among others such as adult day care centers and community facilities in general. Many policies provide coverage for a mix of these services so it's advisable to inquire about the amenities covered when considering a policy.

What is the amount of benefits that are provided each day or each week or each month? Employees working for Aetna companies usually receive their benefits either daily, weekly, or monthly payments. Before deciding to go with an insurance plan or policy, it would be useful to find out the pricing structure of eldercare facilities in your vicinity and understand how they charge for the services they offer.

What is the maximum amount an employee can receive in benefits under Aetna policies during the contract period is often restricted by limits set by the company's terms and conditions. Some express this restriction in terms of years served while others do so in a fixed dollar amount; it is important to discuss this aspect.

What does the elimination period refer to? Individuals who retire from Aetna companies may not immediately qualify for benefits under extended care policies upon moving into a nursing home facility. Many policies specify an elimination period, a period of time wherein the policyholder's accountable for covering all expenses related to their care. In instances within these policies, set the elimination span at 30 days following admission to a nursing home facility, in case of disability.

Does the plan include safeguards against inflation changes? Including safeguards against inflation in a plan might lead to expenses for an executive at a company like Aetna; however, it could be essential as the expenses for extended health care could significantly rise as time goes on.

Insurers usually have conditions to determine when benefits are activated in extended care policies; they typically kick in when the insured individual needs help with two to three out of six activities known as ADLs. Bathing; incontinence care; dressing; dining; toileting; and transferring tasks are commonly included by insurance companies as qualifying activities for benefits eligibility consideration. Employee benefit plans at Aetna companies should also take into account how a medical diagnosis of Alzheimer's disease or other types of dementia could lead to benefits for the individual.

Is the policy eligible for tax benefits? If so and depending upon the circumstances involved in this scenario, the policyholder might be eligible for a tax credit from either the state government entities. It is important for employees of Aetna companies to understand that in accordance, with regulations and certain state statutes, premiums paid towards an extended care policy can be considered as deductible medical expenses once specific criteria are met. According to regulations governing this matter, the older you are may entitle you to a deduction amount. It is essential to note that in order to avail of such a tax advantage, one must opt for itemizing deductions when filing taxes.

Before making changes to your long-term care plan or approach it is important to seek advice from a tax expert since this article serves for purposes solely and should not replace advice.

How reliable is the insurance company's financial strength evaluated by organizations that provide ratings for companies Aetna employees can access these ratings to get an insight into the company's stability and performance-based analysis provided.

When looking into long-term care insurance options, for individuals to consider aspects before making a decision. The suitable coverage for you could depend on factors, like your individual circumstances and financial goals .

I've included a detail; Have you heard about some long-term care insurance plans that come with a premium refund option? This extra detail could be useful for Aetna workers who are considering their long-term care insurance options. Receiving a refund of the premiums paid is possible, with a premium refund feature if you never end up using the policy benefits. This feature might involve an added expense. It offers a financial safety net should you not need long-term care services at all. Exploring an insurance plan that includes a return of premium option might offer security and peace of mind for Aetna workers as they prepare for the years ahead (Source citation from Investopedia, on 'Return of Premium (ROP)' dated February 16th, 2023).

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Incorporating a Comparison; Select the extended care plan for Aetna staff is like choosing a car for a demanding road trip, as an experienced traveler seeking a reliable vehicle to navigate rough roads and ensure a pleasant journey. Hey! Each aspect of the car symbolizes an element to think about when reviewing an extended care policy. When you're looking at a car's safety ratings and fuel efficiency and considering its cargo space and reliability to make a decision about buying it – similar due diligence is required when selecting an extended care policy by reviewing the coverage options at facilities and comparing benefit amounts along with factors like elimination periods and inflation protection provided by the insurance company to ensure you choose the best policy for your needs. When Aetna workers thoroughly analyze these factors akin, to evaluating a car's features and attributes they can choose an insurance plan that provides robust assistance safeguards their stability and ensures peace of mind as they navigate their retirement path.

Sources:

1. 'Long-Term Care Insurance Explained.'   NerdWallet , NerdWallet, 2021,  https://www.nerdwallet.com/article/insurance/long-term-care-insurance . Accessed 19 Feb. 2025.

2. 'Understanding Long-Term Care Insurance.'   AARP , AARP, 2021,  https://www.aarp.org/caregiving/financial-legal/info-2021/understanding-long-term-care-insurance.html . Accessed 19 Feb. 2025.

3. 'Long-Term Care Insurance Cost & Benefits.'   U.S. Bank , U.S. Bank, 2021,  https://www.usbank.com/financialiq/plan-your-future/health-and-wellness/costs-and-benefits-of-long-term-care-insurance.html . Accessed 19 Feb. 2025.

4. 'Long-Term Care (LTC) Insurance: Definition, Costs, Alternatives.'   Investopedia , Investopedia, 2021,  https://www.investopedia.com/terms/l/ltcinsurance.asp . Accessed 19 Feb. 2025.

5. 'What You Should Know About Long-Term Care Insurance.'   District of Columbia Department of Insurance, Securities and Banking , 2021,  https://disb.dc.gov/disb-page/what-you-should-know-about-long-term-care-insurance-0 . Accessed 19 Feb. 2025.