Medicare Producer News
Individual MA/MAPD, PDP: January 26, 2018
• Shingrix is a covered drug starting Feb. 1
• SilverSneakers fitness benefit
• Diabetes supplies – How your clients can save
• How to switch to OneTouch diabetic supplies
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Shingrix®, a shingles vaccine, is a covered drug starting Feb. 1
Starting February 1, Shingrix is a covered drug on Aetna and Coventry MAPD and PDP plans, giving members another option for preventing shingles. Here’s what you need to know:
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Shingrix will be a Tier 3 medication.
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There’s a Quantity Limit (QL) of 2 injections per year.
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The 2 doses (0.5 mL each) should be administered intramuscularly, according to the following schedule: first dose, followed by a second dose 2 - 6 months later.
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There is no change in coverage for Zostavax®, another vaccine for shingles; it’s still a Tier 3 medication with a QL.
In October, the Advisory Committee on Immunization Practices (ACIP) recommended Shingrix for healthy adults aged 50 years and older, and for adults who previously received the current shingles vaccine (Zostavax), to prevent shingles and related complications.
Please advise your clients to speak to a medical provider to determine if the treatments referenced above are appropriate for them. This communication does not constitute medical advice.
Get a jump start on the SilverSneakersSM fitness benefit
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Did you know your Aetna and Coventry MA/MAPD clients get a no-cost membership at participating SilverSneakers fitness facilities? Yep! It’s included with their 2018 MA/MAPD plan. Here’s the basic information your MA/MAPD clients need to know:
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Once enrolled, members just need their SilverSneakers ID number.
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If this is their first time with a plan that has SilverSneakers, they’ll get their SilverSneakers ID number in the mail.
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If members previously had a plan with SilverSneakers (regardless of the health plan), their SilverSneakers ID number remains the same. Members can look up their number by calling SilverSneakers or visiting SilverSneakers.com.
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Next, they can find participating fitness locations at SilverSneakers.com.
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Then let the fun and fitness begin.
Want to let your clients know about this benefit? Download a SilverSneakers fitness flyer from the Aetna Medicare Marketing Studio today to share with your clients.
Save on diabetic testing supplies with OneTouch® products
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OneTouch® by LifeScan is the exclusive manufacturer for diabetes supplies for 2018 Aetna and Coventry MA/MAPD plans. This means your MA/MAPD clients can access:
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OneTouch meters and test strips for $0 cost share
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OneTouch diabetes supplies like lancets, lancing devices and solutions for $0 cost share
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Download a OneTouch diabetic supplies flyer to share with your clients from the Aetna Medicare Marketing Studio.
It’s easy for members to switch to OneTouch products
OneTouch offers multiple blood glucose meters with different features, giving members several choices to fit their needs. OneTouch blood glucose meters are available from:
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OneTouch without a prescription. Members can visit www.onetouch.orderpoints.com or call 1-877-764-5390 and use order code 123AET200.
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Local pharmacies with a prescription. At in-network pharmacies, members pay a $0 copay.
OneTouch test strips are available at pharmacies with a prescription. If the pharmacy is in network, or if members use the Aetna Rx Home Delivery® mail-order pharmacy, there’s a $0 copay.
Can members get diabetes supplies made by other manufacturers?
If members need diabetes supplies not manufactured by OneTouch, they must demonstrate medical necessity (for example, sight impairment requiring a talking meter). This will require getting a prior authorization from our plan. With proven medical necessity, members pay 20% for non-OneTouch diabetes supplies. Without it, they pay 100% for non-OneTouch diabetes supplies.
Questions? We're here to help!
If you have any questions, just contact the Aetna Medicare Broker Services Department at 1-866-714-9301 or brokersupport@aetna.com. Normal business hours are 8 a.m. to 8 p.m. ET from Monday - Friday.
Quick links
Producer World
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Aetna Medicare certification website
Provider lookup -- Aetna
Provider Lookup -- Coventry
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Prior to engaging in the sale of Aetna or Coventry Medicare products, producers must be ready to sell, which means certified, contracted, licensed in the applicable states, and appointed by Aetna in accordance with state law. As permitted in certain states, Aetna will order appointments after the first sale. This communication is intended for use by brokers only and is not intended for distribution to Medicare beneficiaries. Any publication or distribution of this communication to unauthorized recipients without Aetna’s approval is prohibited.
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