To enroll in this plan, you must obtain
a special enrollment application directly from the health plan.
The Aetna Golden Medicare 10 plan is available to City of
New York Medicare beneficiaries living in NY (the five boroughs and the counties
of Rockland and Westchester); the entire state of New Jersey and certain
counties in Pennsylvania. All individuals entitled to Medicare Part A and
enrolled in Medicare Part B, including the disabled, may apply. Each Aetna
Golden Medicare member selects a participating primary care physician (PCP) to
coordinate his/her care and issue specialist and hospital referrals. Primary
care physician visits are covered with a $10 copayment, specialists visits have
a $15 copayment and routine preventative care visits are covered with a zero
co-payment. There are no deductibles to pay. Emergencies are covered worldwide
with a $50 co-payment (waived if admitted).
Aetna NavigatorTM is Aetna™s
member website (www.aetna.com), which provides a single source for online health
and benefits information 24 hours a day, 7 days a week.
DocFind®, an online provider list located at www.aetna.com;
InteliHealth®, an online consumer health information network
located at www.intelihealth.com; and Informed Health® Line, a
telephonic nurse line are available 24 hours a day, 7 days a week.
Aetna Special Medical Programs
Disease
Management programs aimed at slowing or avoiding complications of
certain diseases through early detection and treatment to help improve outcomes
and quality of life.
Wellness Programs including Healthy
Breathing® a 8-to-12-week smoking-cessation program; and
Healthy Eating, which offers information and tools to help
develop long-term, realistic healthy eating plans. Natural
Alternatives offers contracted discounted rates for alternative types
of health care. Vision One® Discount Program offers
discounts on eye care needs, such as prescription eyeglasses, contact lenses,
non-prescription sunglasses, contact lens solutions and eye care accessories.
Members can call 1-800-793-8618 to find the Vision One® locations nearest to
them. This benefit is in addition to, not in place of, members™ union welfare
fund vision benefits.
Prescription Drug Coverage
Retirees who receive
prescription drug coverage through their union welfare fund will continue to
access that coverage.
Retirees who do not receive prescription drug coverage through their union
welfare fund will automatically receive the following prescription
benefit:
Retail: $0/$20/$40 for a 30-day
supply.
Mail Order: $0/$40/$80
Copays are
effective up to $2,700 then 50% coinsurance for Generic/Brand drugs up
to true-out-of-pocket costs for covered drugs up to $4,350.
Once
member reaches $4,350 the copays are $2.40 or 5% for covered generic (including
brand names treated as Generic) drugs or the greater of $6.00 or
5% for all other covered drugs.
Cost
There is no cost for the basic medical plan.
The cost for the plan with prescription drugs can be viewed on the rate
page.
See the rate page
For More Information
For more details, refer to the City
of New York/Aetna Golden Medicare packet or call (800) 445-8742, 8:00 am - 6:00
pm, Monday through Friday. You can send your questions in writing to:
Aetna
99 Park Avenue
New York, NY 10016
Attn: City of New York
Department
Visit the Plan Web site
Updated to reflect changes to Prescription Drug Benefit effective
January 1, 2009.