Aetna Fitness Benefit change

[wehotex]

Just go to same place you order kits and it says 2024 Nations OTC catalog and you can order them.

Nope. It ONLY allows a way to print it myself or view it online, no Hard Copy or means to send to a member.
I don’t feel like using that much printer ink to print 40 pages to send to a member for a multi-million $ company who should do that small token of appreciation for the member.

 

[GoPokes]

Which copays would you like to see them lower? Mine are mainly covered for their hospital stays with the GTL HI plan. I would probably say the physical, speech and occupational therapy being $35-$40 per time would be the one I would like to see lowered. Dr copays, people are used to them from their coverage before Medicare and outpatient surgery is not going to generate alot of complaints having to pay $350 for a $12000 + surgery.

You are right though, old people love all the extra free stuff they receive from MA plans. See alot of clients at the YMCA every morning using their gym membership and people live for the OTC benefits for some reason. So far they were all loving the Aetna fitness benefit but that could change now that they can't get their new shoes for free.

It sort of makes sense to me... I would love to have a free gym membership with my health plan. I really dont get any use out of my plan, it's good coverage from my wife's employer, but I am in good health. It would be nice to be in good health, and also feel as though I am getting something from the plan...

 

[goillini52]

Nope. It ONLY allows a way to print it myself or view it online, no Hard Copy or means to send to a member.
I don’t feel like using that much printer ink to print 40 pages to send to a member for a multi-million $ company who should do that small token of appreciation for the member.

Go to Individual Medicare, scroll down to helpful tools,

• Order kits, plan guides and plan summary worksheet, if you have to login use your NPN for user name and password, underMedicare Broker Materials and click next, on the left is a menu and the OTC Catalog is 4th item from the top. Uncheck the other items and you'll be able to order. I just did it and ordered some more.

They don't make it easy.

 

[DonP]

Which copays would you like to see them lower? Mine are mainly covered for their hospital stays with the GTL HI plan. I would probably say the physical, speech and occupational therapy being $35-$40 per time would be the one I would like to see lowered. Dr copays, people are used to them from their coverage before Medicare and outpatient surgery is not going to generate alot of complaints having to pay $350 for a $12000 + surgery.

You are right though, old people love all the extra free stuff they receive from MA plans. See alot of clients at the YMCA every morning using their gym membership and people live for the OTC benefits for some reason. So far they were all loving the Aetna fitness benefit but that could change now that they can't get their new shoes for free.

How are you handling the hospital copays?Many of the plans i sold were $300 a day for 5 days so i matched that up with the hospital plan . In 2024 many plans when to $300 a day for 7 and 8 days? Are you adding more days to the plans or leaving it be? Actually was writing all gtl them about 5 months ago i switched to medico’s Hi plan . It’s 5-7% cheaper and Gi ages 60-79. But what’s really crazy when you ad the cancer rider on the Hi plan there asking no cancer questions for preexisting . I quizzed medico and they act like it’ll pay the cancer claim after 6 months of no preexisting . That seems crazy

 

[Midlevel]

How are you handling the hospital copays?Many of the plans i sold were $300 a day for 5 days so i matched that up with the hospital plan . In 2024 many plans when to $300 a day for 7 and 8 days? Are you adding more days to the plans or leaving it be? Actually was writing all gtl them about 5 months ago i switched to medico’s Hi plan . It’s 5-7% cheaper and Gi ages 60-79. But what’s really crazy when you ad the cancer rider on the Hi plan there asking no cancer questions for preexisting . I quizzed medico and they act like it’ll pay the cancer claim after 6 months of no preexisting . That seems crazy

Mine are still all 350/day for 5 days on their MA plans and most had a 1000.00 deductible when I wrote them so did 300.00/day for 10 days. Now they did away with deductible so if in 10 days they just make 1250.00. If only 5 days they owe 250.00 after GTL pays them.

 

[GarrisonC]

Aetna can't do this. It's breach of contract, pure and simple. They could do this for the next contract year, but not this year. Also, there's the issue of promissory estoppel, or detrimental reliance. I'm sure there are many people who chose to enroll in Aetna because of the athletic shoe benefit. That being the case, Aetna can't turn around and say "Sorry suckers, we're not gonna do it." The law prohibits them from doing this, but who's going to enforce it? If it weren't such an essentially trivial issue, a class action would be appropriate. I would suggest that anyone who really wants a pair of athletic shoes should buy them and submit a claim to Aetna, and when they deny the claim, take them to small claims court. You should win. But of course, who wants to spend the time making this minor point. But shame on Aetna!

 

[goillini52]

Aetna can't do this. It's breach of contract, pure and simple. They could do this for the next contract year, but not this year. Also, there's the issue of promissory estoppel, or detrimental reliance. I'm sure there are many people who chose to enroll in Aetna because of the athletic shoe benefit. That being the case, Aetna can't turn around and say "Sorry suckers, we're not gonna do it." The law prohibits them from doing this, but who's going to enforce it? If it weren't such an essentially trivial issue, a class action would be appropriate. I would suggest that anyone who really wants a pair of athletic shoes should buy them and submit a claim to Aetna, and when they deny the claim, take them to small claims court. You should win. But of course, who wants to spend the time making this minor point. But shame on Aetna!

CMS said they couldn't reimburse for athletic shoes, tents, etc.

 

[vic120]

Aetna can't do this. It's breach of contract, pure and simple. They could do this for the next contract year, but not this year. Also, there's the issue of promissory estoppel, or detrimental reliance. I'm sure there are many people who chose to enroll in Aetna because of the athletic shoe benefit. That being the case, Aetna can't turn around and say "Sorry suckers, we're not gonna do it." The law prohibits them from doing this, but who's going to enforce it? If it weren't such an essentially trivial issue, a class action would be appropriate. I would suggest that anyone who really wants a pair of athletic shoes should buy them and submit a claim to Aetna, and when they deny the claim, take them to small claims court. You should win. But of course, who wants to spend the time making this minor point. But shame on Aetna!

I know I have seen it in the past on carrier trainings, a least several years ago, used to always be on the Coventry trainings when they were in existence and there were others too

they would say the Extra benefits are NOT guaranteed and the terms are subject to change

I will say though I do not remember seeing it in these recent years

Focus has been on other things

 

[Midlevel]

Aetna can't do this. It's breach of contract, pure and simple. They could do this for the next contract year, but not this year. Also, there's the issue of promissory estoppel, or detrimental reliance. I'm sure there are many people who chose to enroll in Aetna because of the athletic shoe benefit. That being the case, Aetna can't turn around and say "Sorry suckers, we're not gonna do it." The law prohibits them from doing this, but who's going to enforce it? If it weren't such an essentially trivial issue, a class action would be appropriate. I would suggest that anyone who really wants a pair of athletic shoes should buy them and submit a claim to Aetna, and when they deny the claim, take them to small claims court. You should win. But of course, who wants to spend the time making this minor point. But shame on Aetna!

Don’t think Aetna wanted to do this according to the Sales Managers. Think we had some other carriers who didn’t think to add this benefit cry to CMS. Makes total sense though to cover bowling balls, golf clubs, pickleball racquets, treadmills, etc but God forbid they get shoes for said activities.

 

[wehotex]

Don’t think Aetna wanted to do this according to the Sales Managers. Think we had some other carriers who didn’t think to add this benefit cry to CMS. Makes total sense though to cover bowling balls, golf clubs, pickleball racquets, treadmills, etc but God forbid they get shoes for said activities.

It is odd to me that the local Devoted HMO is still able to offer “Brokerage Bucks” that can reimburse a mb for Apple Watch. An Apple Watch helps to promote Activity. So does a pair of running shoes.