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Aetna Develops Medicare POS Plan

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NU Online News Service, Dec. 17, 4:11 p.m. – Aetna Inc., Hartford, will be offering a new point-of-service plan, the Aetna Golden Choice Plan, to 1.3 million Medicare beneficiaries in parts of Maryland, New Jersey and Pennsylvania starting in 2003.

The point-of-service plan, which is based on a health maintenance organization model, is part of a Medicare managed care demonstration project. The plan is more flexible than a traditional HMO but offers more benefits than the basic, barebones Medicare program, Aetna says.

Members who join the Golden Choice plan can get some reimbursement for care from doctors outside the Aetna provider network as well as full reimbursement for care from doctors in the network, and they can also see specialists without obtaining referrals from their primary care doctors.

The plan provides coverage for prescription drugs, with a $15 co-payment per generic prescription and no annual dollar limit on prescriptions for generic drugs.


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