For those enrolled in the Aetna Medicare Advantage plan AND have doctors with St. Joseph’s Health/Trinity Health, here is an update about their contract. This update is take from the St. Joseph website and the agreement has been extended to January 31, 2022. Here is the article:

Hope this helps with your decisions about changing your Aetna plan. You still have the month of January 2022 to find out if the contract will be renewed. 

You do have some options …. if you want to wait to see if Aetna and St Joseph sign a contract. 

You would be able to change your plan during the OEP or Open Enrollment Period which runs January 1st to March 31st …. if there ends up being no new agreement between Aetna and St Joseph. 

If you changed your Medicare Advantage plan in January 2022, your new plan would start February 1st, 2022.  

Please let me know in January 2022 if you still want to change your plan.

As winter approaches, I have received several calls and some emails about flu shots, vaccines, and shingle shots specifically related to how Medicare covers these.

Medicare covers vaccines and immunizations in two ways.  

Here is an article from the Medicare Interactive/Medicare Rights Center: 

However, some vaccinations are instead covered by Part B:

Part B also covers vaccines after you have been exposed to a dangerous virus or disease. For example, Part B will cover a tetanus shot if you step on a rusty nail, or a rabies shot if you are exposed to a bat.

 

Let’s start with how Medicare covers the flu shot. Medicare Part B covers one flu shot every flu season. The flu season usually runs from November through April. Depending on when you choose to get your flu shot, Medicare may cover a flu shot twice in one calendar year. For example, if you get a shot in January 2021 for the 2020/2021 flu season, you could get another shot in October 2021 for the 2021/2022 flu season.

 

Next, the pneumonia shot. Pneumonia is an infection that targets the lungs and can cause fever, difficulty breathing, and other symptoms. Pneumonia shots help prevent pneumonia. Medicare Part B covers two separate pneumonia vaccines. Part B covers the first shot if you have never received Part B coverage for a pneumonia shot before. You are covered for a different, second vaccination one year after receiving the first shot. You are not required to provide a vaccination history when receiving the pneumonia vaccine. You can verbally tell the health care professional administering the shot if/when you have received past shots.

 

Medicare Part B additionally covers hepatitis B shots if you qualify. Hepatitis B is a virus that attacks the liver and can cause chronic liver disease. Hepatitis B shots can help prevent the disease. Medicare Part B covers the hepatitis B vaccine if you are at medium or high risk for hepatitis B. If you are at low risk for hepatitis B, the shot will be covered under Part D.

 

And finally, let’s discuss how Medicare covers the COVID-19 vaccines. Original Medicare Part B covers COVID-19 vaccines, regardless of whether you have Original Medicare or a Medicare Advantage Plan.

Here is the article from the Medicare Interactive/Medicare Rights Center: 

You should bring your red, white, and blue Medicare card with you to your vaccination appointment, even if you have a Medicare Advantage Plan. The Food and Drug Administration (FDA) has approved an additional dose of the COVID-19 vaccine or booster for certain populations. Speak with your doctor to learn more about your eligibility for a third dose or for a booster.

 

If you qualify for the above vaccines, Original Medicare covers them at 100% of the Medicare-approved amount when you receive the service from a participating provider. This means you pay nothing (no deductible or coinsurance).

Medicare Advantage Plans are required to cover flu shots without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.