Employees from Aetna companies should make it a point to review their Medicare Part A benefits ahead of time to steer clear of any surprise expenses. The costs linked to coinsurance and deductibles can pile up before you know it. Partnering with a consultant such as Brent Wolf from The Retirement Group at Wealth Enhancement Group can make the process of transitioning into retirement health planning much smoother.
'Navigating through Medicare Part A may pose challenges for Aetna workers. It can get complicated when dealing with benefit periods and coverage restrictions. Seeking advice from Kevin Landis at The Retirement Group—a part of Wealth Enhancement Group—can assist employees in creating a tailored plan to handle healthcare expenses during their retirement years.'
In this article, we will discuss:
1. Exploring Medicare Part A, its coverage details for Aetna staff members, and associated expenses.
2. Understanding Benefit Period Guidelines and Coverage Information in Medicare, including determination of benefit period length for inpatient hospital care and skilled nursing facility services.
3. Expanded Medicare Part A Benefits include services for home healthcare support and hospice care, along with coverage for hospital stays and the opportunity to take part in research studies.
What is this thing?
Many big companies in the Aetna are worried about Medicare Part A. It is the part of Medicare that doesn't come with a premium and is open to everyone who meets the criteria*. Medicare Part A covers hospital stays, hospice care services, and skilled nursing facilities, along with home health care services.
While Part A might be complimentary for individuals, it's crucial for Aetna clients to know that those requiring coverage may end up shelling out about $499. Furthermore, there are expenses that Aetna staff should keep in mind, such as:
The coinsurance charges for hospital stays of 61 to 90 days will go up by $11 to reach $400 per day in 2023 as compared to $389 per day in the year 2022.
In the year 2023, the coinsurance amount for stays at skilled nursing facilities ranging from 21 to 100 days is set to rise from $194 in the previous year to $200, reflecting a hike of $6.
You may need to pay a 20 percent copayment for health services linked to hospitalization.
What exactly is included in Medicare Part A coverage?
One common query from our clients at Aetna is about the coverage provided by Medicare Part A regarding medical care expenses. It includes:
Patients being admitted to the hospital. During stays at nursing facilities, individuals receive skilled nursing and rehabilitation care as opposed to staying in custodial nursing homes. Mobile healthcare services Nursing patients in a hospital. End-of-life care
Medicare Part A coverage depends on the duration of benefit periods.
How are the durations of benefits decided upon?
Some of the companies listed in the Aetna might be wondering about how they figure out benefit periods for their employees' healthcare coverage plans. Under Medicare Part A rules, once you're admitted to a hospital or skilled nursing facility for treatment for an illness or injury, a benefit period of 60 days begins. During this time, if there's no need for care and 60 days pass by without interruption, then the benefit period ends. Medicare won't pay for services that are mainly focused on care like help with bathing or eating. There's a deductible to pay at the start of each benefit period to keep in mind.
Your Medicare coverage continues for 60 days after you leave the hospital or skilled nursing facility following an illness spell or medical treatment period. During this time frame, any readmission within 60 days is considered part of the coverage period by Medicare, whereas being readmitted more than 60 days later is seen as a new medical event by the program. The positive news is that you won't have to pay a deductible if you're admitted again within 60 days; however, the downside is that your initial admission will be factored into the coverage calculation under Medicare's 60-day limit for full coverage support. Medicare extends coverage for a number of episodes over a person's lifetime.
Uncle George was admitted to the hospital on June 1 and discharged on July 31st, only to be readmitted on November 1st. After Uncle George covers his deductible again in November, Medicare will cover all his expenses until December 30. If Uncle George gets readmitted to the hospital within 60 days of his discharge on July 31, there will be no extra deductible to pay.
Hospitalization Insurance Coverage
Medicare will provide coverage for the hospital admissions:
You will cover all expenses for a maximum of two months of hospitalization after meeting the requirement in 2022 at a cost of $1,556 per benefit cycle. After two months have passed following the start of their benefits scheme in 2022, recipients are expected to cover coinsurance expenses at a rate of $389 per day. Beneficiaries also have the right to a 60-day reserve for their lifetime, during which they need to pay $778 per day for days 91 to 150 if they choose to use these reserve days in 2020. If you opt not to tap into your lifetime reserve fund for expenses covered by Medicare and stay in the hospital for 90 days or receive care for 60 days without a caregiver's assistance, for the condition after exhausting your reserve fund options.
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Tip: Part A coverage takes care of all the expenses for hospital services that are approved by Medicare, except for the bills from your physician, which fall under Part B coverage.
Types of Services Included in Part A
We want Aetna clients to know about the services included in Part A.
In a secluded room.
Nursing care is provided in both settings and specialized facilities, like care units to meet various needs of patients. Medicine given while in the hospital. Laboratory tests for diagnosis. The field of radiology and radiotherapy Medical items like bandages and IV tubes Incorporating the use of devices like wheelchairs Fees for the theater and post-op area Rehabilitation services offered at hospitals include therapy and speech therapy programs.
Medicare doesn't cover things like a TV in your room or a private room unless it's medically required based on your condition.
Insurance for Professional Nursing Home Services
So what is a nursing home exactly? In short, it's not the same as a nursing facility! Medicare won't foot the bill for care in a nursing home. It does cover care in a nursing facility, whether it's within a hospital setting, as part of a standalone facility, or even located within a nursing home setup itself! The key point to note is the kind of support that's offered. In a nursing facility, you can expect to receive nursing and rehabilitation services that are deemed medically necessary.
Insurance for health hospitalization
Medicare Part A provides coverage for services during psychiatric treatment as it does for hospital stays in a general hospital.
Hospice Care Insurance Coverage
End-of-life care is a form of treatment for those facing illnesses or conditions nearing the end-of-life stages. Medicare Part A offers support for managing symptoms and pain control to terminally ill individuals in their homes or residing facilities. To qualify for coverage:
Medicare must authorize the healthcare provider to offer hospice services. The doctor and the head of the hospice program need to confirm that the patient is expected to live for six months or less and is critically ill.
Inserted Analogy:
Picture Medicare Part A Hospital Insurance as a base for your healthcare requirements during retirement. Similar to a strong structure that ensures safety and reassurance for you and your loved ones, Medicare Part A plays a role for individuals in need of coverage for hospital care that requires admission.
Sources:
1. Centers for Medicare & Medicaid Services. 2025 Medicare Costs. CMS, Dec. 2024, https://www.medicare.gov/publications/11579-medicare-costs.pdf .
2. Humana Inc. Understanding the Medicare Benefit Period and Part A. Humana, 2023, https://www.humana.com/medicare/medicare-resources/benefit-period .
3. Centers for Medicare & Medicaid Services. Inpatient Hospital Care Coverage. Medicare.gov, 2025, https://www.medicare.gov/coverage/inpatient-hospital-care .
4. Centers for Medicare & Medicaid Services. Medicare Benefit Policy Manual, Chapter 3: Duration of Covered Inpatient Services. CMS, 4 Oct. 2019, https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c03pdf.pdf .
5. Hartman, Rachel. Medicare Costs Are Going Up in 2025—Here's the Impact on Your Wallet. Investopedia, Nov. 2024, https://www.investopedia.com/what-medicare-will-cost-you-in-2025-8744175 .
How does Aetna Inc.'s frozen pension plan affect employees' eligibility for benefits, and what specific criteria must current employees meet to qualify for any benefits from the Retirement Plan for Employees of Aetna Inc.?
Eligibility for Benefits: Aetna Inc.'s pension plan has been frozen since January 1, 2011, meaning no new pension credits are accruing. Employees who were participants before this date remain eligible for benefits but cannot accrue additional pension credits. To qualify for benefits, participants need to have been vested, which generally occurs after three years of service(PensionSPD).
In what ways can employees at Aetna Inc. transition their pension benefits if they leave the company, and what implications does this have for their tax liabilities and retirement planning?
Transitioning Pension Benefits: If employees leave Aetna, they can opt for a lump-sum distribution or an annuity. Employees can roll over their lump-sum payments into an IRA or other tax-qualified plans to avoid immediate taxes. However, direct rollovers must follow the tax-qualified plan's rules. If not rolled over, employees are subject to immediate tax and potential penalties(PensionSPD).
What steps should an Aetna Inc. employee take if they become disabled and wish to continue receiving pension benefits, and how does the company's policy on disability impact their future retirement options?
Disability and Pension Benefits: Employees who become totally disabled and qualify for long-term disability can continue participating in the pension plan until their disability benefits cease or employment is terminated. No additional pension benefits accrue after December 31, 2010, but participation continues under the plan until employment formally ends(PensionSPD).
Can you explain the implications of the plan amendment rights that Aetna Inc. retains, particularly concerning any potential changes in the pension benefits and what this could mean for employee planning?
Plan Amendment Rights: Aetna reserves the right to amend or terminate the pension plan at any time. If the plan is terminated, participants will still receive benefits accrued up to the date of termination, protected by ERISA. Any future changes could impact employees' planning and retirement options(PensionSPD).
How does the IRS's annual contribution limits for pension plans in 2024 interact with the provisions of the Retirement Plan for Employees of Aetna Inc., and what considerations should employees keep in mind when planning their retirement contributions?
IRS Contribution Limits: The IRS sets annual contribution limits for pension plans, including defined benefit plans. In 2024, employees should ensure that their pension contributions and tax planning strategies align with these limits and the provisions of Aetna's pension plan(PensionSPD).
What are the options available to Aetna Inc. employees regarding pension benefit withdrawal, and how can they strategically choose between a lump-sum distribution versus an annuity option?
Withdrawal Options: Aetna employees can choose between a lump-sum distribution or various annuity options when withdrawing pension benefits. The lump-sum option allows for immediate access to funds, while annuities provide monthly payments over time, offering a more stable income stream(PensionSPD).
How does Aetna Inc. ensure compliance with ERISA regulations concerning the rights of employees in the retirement plan, and what resources are available for employees to understand their rights and claims procedures?
ERISA Compliance: Aetna complies with ERISA regulations, ensuring employees' rights are protected. Resources are available through the Plan Administrator and myHR, providing information on claims procedures, plan rights, and how to file appeals if necessary(PensionSPD).
What documentation should employees of Aetna Inc. be aware of when applying for their pension benefits, and how can they ensure that they maximize their benefits based on their years of service?
Documentation for Benefits: Employees should retain service records and review their benefit statements to ensure they receive the maximum pension benefits. They can request additional documents and assistance through myHR to verify their years of service and other relevant criteria(PensionSPD).
How do changes in interest rates throughout the years affect the annuity payments that employees at Aetna Inc. might receive upon retirement, and what strategies can they consider to optimize their retirement income?
Impact of Interest Rates on Annuities: Interest rates significantly affect annuity payments. Higher interest rates increase the monthly annuity amount. Employees should consider the timing of their retirement, especially at the end of the year, when interest rates for the following year are announced(PensionSPD).
If employees want to learn more about their pension options or have inquiries regarding the Retirement Plan for Employees of Aetna Inc., what are the best channels to contact the company, and what specific resources does Aetna provide for assistance?
Contact for Pension Inquiries: Employees can contact myHR at 1-888-MY-HR-CVS (1-888-694-7287), selecting the pension menu option for assistance. Aetna also provides detailed resources through the myHR website, helping employees understand their pension options and benefits(PensionSPD).