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New benefits and mental health

What you need to know about: New benefits available with Aetna Medicare Advantage PPO

What other programs & services are included in the Aetna Medicare Advantage PPO plan? Fitness/wellness? Mental health?

The additional Aetna programs & services you will receive through the Aetna Medicare Advantage PPO plan include:

  • Medical alert system/fitness tracker, 4G LifeStation Sidekick
  • $500 hearing aid reimbursement yearly
  • A formalized telehealth and Teledoc access at same cost as in-person visits (GHI Senior Care did not have a formalized telehealth program)
  • 24/7 registered nurse hotline
  • Free transportation to doctor or pharmacy via Access2Care program
  • Virtual mental health appointments with zero copay and no visit limitations
  • Two weeks of meals (which accommodate different diets) after a hospital stay
  • $120 annual allowance ($30 every three months) for eligible over-the-counter health products, such as vitamins, incontinence supplies, cough and flu remedies and much more
  • Free basic membership at participating health clubs and fitness centers via Silver Sneakers
  • Wellness rewards
  • Retiree support programs/referrals for retiree services

Visit Aetna's website to learn more about the additional benefits and services you have access to through this plan. 

What is the coverage for mental health services and addiction treatment?

  • Inpatient mental health care: $0 per stay in 2023; In 2024: $300 per stay, $750 max/year
  • Outpatient mental health care: $15 per visit
  • Partial hospitalization: $15
  • Inpatient substance abuse: $0 per stay in 2023; In 2024: $300 per stay, $750 max/year
  • Outpatient substance abuse: $15 per visit

Aetna administers all behavioral health and substance abuse benefits. Providers include therapists, psychiatrists, social workers, couples’ counselors and more. The cost share for outpatient mental health and substance abuse is $15 per visit. The $15 cost share will also apply if the visit is provided via telemedicine directly to a provider.

Virtual mental health appointments through the MDLive program have zero copays and no visit limitations. They are specially trained in issues that are common with older adults like depression, anxiety, trauma, and loss. These providers can diagnose conditions, provide therapy, and prescribe medications. Appointments are usually available within three to seven days with flexible hours, including nights and weekends. Appointments can be scheduled with the same provider for continuity of care. They have 111,568 providers nationwide, including 9,119 in downstate New York.