Medical Plans & Pharmacy Benefits Info
For Medicare-Eligible Plans
Medicare is a federal health insurance program for:
- Individuals 65 or older,
- Certain individuals under age 65 who are disabled,
- Individuals with End Stage Renal Disease (ESRD), or
- Individuals with Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
If you are eligible for Medicare, you can enroll in one of the Edison Medicare plans. If you enroll in our medical coverage, you and any covered dependents will be automatically enrolled in prescription drug coverage at no additional cost.
| Medical Plan Options — Medicare | ||
|---|---|---|
| Plan | Prescription Drug Coverage | Availability |
| Aetna HMO MAP | Express Scripts Medicare | Available in select counties throughout the U.S. |
| Aetna PPO MAP | Express Scripts Medicare | Nationwide |
| Aetna PPO 90/70 Medicare Coordinated Plan | Express Scripts Medicare | Nationwide |
| Kaiser Permanente Senior Advantage MAP | Kaiser Permanente | In California only |
Aetna
Aetna HMO Medicare Advantage Plan (MAP)
Aetna Plan Identifier for Flex Retirees: Medicare (S05) HMO (MAP)
Aetna Plan Identifier for PrimeCare Retirees: Medicare (P01) HMO (MAP 100%)
- Available nationwide
- Pharmacy benefit provided by Express Scripts
About the Aetna HMO MAP: With Medicare Advantage Plans (also known as Medicare Part C), you assign your Medicare coverage to Aetna but you retain your Original Medicare coverage. This “bundled” plan include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). With the Aetna HMO MAP, you’ll need to use health care providers who participate in the plan’s network.
Resources:
Aetna PPO Medicare Advantage Plan (MAP)
Aetna Plan Identifier for Flex Retirees: Medicare (S02) ESA PPO (MAP)
Aetna Plan Identifier for PrimeCare Retirees: Medicare (C04) ESA PPO (MAP 100%)
- Available nationwide
- Pharmacy benefit provided by Express Scripts
About the Aetna PPO MAP: With Medicare Advantage Plans (also known as Medicare Part C), you assign your Medicare coverage to Aetna but you retain your Original Medicare coverage. This “bundled” plan include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). With the Aetna PPO MAP, you can see any provider (whether in the network or not), and you pay the same out-of-pocket cost for both covered in-network and out-of-network medical benefits as long as the provider is eligible to receive Medicare payment and willing to bill and accept payment from Aetna.
Resources:
Aetna Medicare Coordinated Plan
Aetna Plan Identifier for Flex Retirees: Choice POS II (PPO 90/70)
Aetna Plan Identifier for PrimeCare Retirees: Choice POS II (100%)
- Available nationwide
- Pharmacy benefit provided by Express Scripts
About the Aetna Medicare Coordinated Plan: You retain Medicare as separate medical insurance coverage. Medicare pays benefits first and Edison’s plan picks up all or a portion of the costs left over after Medicare pays. For covered Medicare services, Aetna will waive the calendar year deductible, office visit copay, and per admission copay, and will coordinate up to 100% of any remaining allowed charges.
Resources:
Kaiser Permanente
Kaiser Permanente Senior Advantage Medicare Advantage Plan (MAP)
- Available in California only
- Prescriptions dispensed at Kaiser facilities only
About the Kaiser Permanente Senior Advantage MAP: With this Medicare Advantage Plan (also known as Medicare Plan C), you assign your Medicare coverage to Kaiser but retain your Original Medicare coverage. This “bundled” plan include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). You are required to select a PCP to coordinate your care, and all of your medical services are provided at Kaiser facilities.