Aetna 2024 High Value Provider Bonuses in AL, AR, GA, LA and MS

Starting January 2024, Aetna Medicare will offer a new high value provider bonus to eligible members on select plans in Alabama, Arkansas, Georgia, Louisiana and Mississippi!

When eligible members select a qualifying high value provider as their primary care provider (PCP), members will receive increased funds on their Extra Benefits Card at a frequency of monthly (for D-SNP and LIS plans) or quarterly (other MA/MAPD plans). You can view a list of all plans that offer this benefit and eligibility criteria by clicking here.

What is a high value provider?

High value providers are those designated by Aetna as being focused on excellence in primary care for older adults and others with chronic conditions. Providers that currently hold this designation include:

• Oak St. health
• ChenMed
• Dedicated Senior Medical Center
• Jencare Senior Medical Center
• CenterWell
• One Medical Seniors
• Sage Health

This list can change throughout the year. 

How can the high value provider bonus be used?

Eligible members can use their bonus on:

• Healthy foods
• Utilities
• Transportation - including gas at the pump
• Personal care supplies
• Pet supplies
• Rent or mortgage assistance
• Over-the-counter (OTC) items (select plans)

Who is eligible for this benefit?

To be eligible, members must:

• Be enrolled in a plan that offers this benefit
• Select one of the designated high value providers as their PCP
• Qualify for the Aetna Assist Program through LIS status/Extra Help (for Aetna Medicare Value PlusSM plans)
• Have this benefit as a D-SNP plan member, and select a high value provider as their PCP
• Be diagnosed with at least one of the 17 CMS designated chronic health conditions.* Available for members with select plans that are eligible for SSBCI due to a chronic condition.

*Members diagnosed with one or more of the conditions listed below and meet certain criteria may be eligible for additional benefits. For exact eligibility per CMS condition(s) and criteria, please refer to the plan EOC. Below are general conditions:

• Certain autoimmune disorders
• Cancer
• Certain cardiovascular disorders
• Chronic alcohol and other drug dependence
• Certain chronic and disabling mental health conditions
• Chronic heart failure
• Certain chronic lung disorders
• Dementia
• Diabetes
• End-stage liver disease
• End-stage renal disease (ESRD) requiring dialysis
• HIV/AIDS
• Hyperlipidemia
• Hypertension
• Certain neurologic disorders
• Certain severe hematologic disorders
• Stroke

How does a member select a high value provider?

There are three ways members can select a high value provider as their PCP on file:

• During enrollment, by including the PCP name, PCP ID, and Provider ID on the enrollment form
• By calling Member Services after the plan's effective date
• Through the member website after the plan's effective date

The bonus only goes into effect when eligible members have a qualifying PCP on file.

Check out the flyer on the high value provider bonus to find plans that offer this benefit and to learn more.

If you have questions, please contact your local Aetna Medicare Broker Manager.

Call us today at 866-568-9649 if you need help finalizing your product portfolio for the 2024 selling season.