Aetna, a CVS Health Company, announced on February 17, an agreement to provide members enrolled in Aetna Individual and Group Medicare Advantage plans access to Iora Health providers under the Iora Primary Care brand in Harris Сounty, Texas.
“A Medicare Advantage (MA) plan is another way to provide Original Medicare Part A (hospital) and Part B (medical) benefits and more. MA plans are offered through private insurance companies that have been approved by Medicare. With a Medicare Advantage plan, you don’t lose the coverage you get with Original Medicare. You get the same coverage as Original Medicare plus additional services not covered by Medicare, such as access to health and wellness programs. The Aetna Medicare Advantage coverage includes Medicare prescription drug coverage (Medicare Part D); therefore, you do not need a stand-alone Medicare Part D Plan,” – the company said.
Original Medicare And Medicare Advantage
Original Medicare (Medicare Part A and Part B) provides hospital and medical coverage. But it doesn’t cover prescription drugs, dental care, vision care or wellness programs.
All of the City of Houston’s Medicare Advantage Plans include Part D, and offer comparable or better pharmacy benefits. The drug formularies established by Medicare for 2021 serves as the model for Medicare plan formularies. If requested from your chosen provider, you will receive a formulary list when you enroll in a plan.
Iora Primary Care specializes in primary care for older adults on Medicare. With a care model based on relationships, Iora offers longer appointments, a full care team and a true omni-channel model of care delivery. This model includes text, email, video, telephone and in person in Iora practices or at home, depending on the patient’s needs.
Every patient works with a provider and has access to a full complement of team members, including a health coach, nurse, and behavioral health specialist, to help optimize health and wellness.
Agreement
Under the agreement, which became effective January 1, 2021, Houston-area Aetna Medicare Advantage members have access to six Iora Primary Care locations.
“The City of Houston is excited to announce our transition to Aetna Premier, Aetna Basic and KelseyCare Advantage HMO for our Medicare Advantage (MA) plans effective January 1, 2021. While we appreciate the service that UnitedHealthcare, WellCare/TexanPlus and Cigna HealthSpring have provided to our members, we were required to enter into a competitive bid process because their contracts were expiring,” – was reported in City of Houston Medicare Advantage Plan.
The result of this process yielded significant cost savings for you and the City. The new contracts were negotiated for $158 million for three years with two one-year renewal options. The current contracts were negotiated in 2014 for $185 million. This represents a $27 million or 14.5% savings. These cost reductions will help protect the City of Houston’s Medicare Advantage Health Plans’ fiscal sustainability and provide significant savings back to you while still providing great benefits. The City of Houston is thrilled that we’re able to provide this coverage to those who have dedicated their careers to serving The City of Houston.
“Aetna is committed to improving access to care for our members. Through our collaboration with Iora Health, one of the largest value-based provider groups in Texas, Aetna Medicare Advantage plan members now have access to vital health services from physicians who share our commitment to helping them on their path to better health,” – said Kristopher Scheurer, Chief Medicare Officer for Aetna’s South Central market.
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