Aetna's 2027 Dallas/Fort Worth Lead Plans at a Glance
Three Aetna plans to know before your next Dallas/Fort Worth appointment
A Dallas client wants a $0 premium plan with strong dental, and a client in Parker County wants a PPO with no referrals. Knowing which Aetna plan fits each of them before you sit down saves you from digging through a full plan guide in the middle of the conversation.
Here's a quick reference to three of Aetna's 2027 lead plans in the market. These highlights don't cover Aetna's full DFW portfolio, so attend an MST and review Producer World for complete plan details.
Aetna Medicare Prime Care (HMO) H4523-021
Aetna's lead plan in Dallas/Fort Worth pairs a $0 premium with the lowest MOOP and the richest supplemental benefits of the three, for clients comfortable with an HMO that requires PCP selection and referrals.
Counties: Collin, Dallas, Tarrant
Premium: $0
Copays: $0 PCP, $25 Specialist
MOOP: $4,200
OTC: $65 quarterly allowance
SSBCI: SSBCI-qualified members receive an additional $50 quarterly Extra Supports Wallet. SSBCI-qualified members who select a High Value Provider (HVP) as their PCP receive an additional $30 quarterly HVP Wallet.
Dental: $3,000 annual allowance (Aetna Dental, Deluxe EPO Mandatory 50)
Eyewear: $275 annual allowance (EyeMed)
Hearing: $1,000 annual allowance (NationsHearing)
Referrals: PCP selection and referrals required
Aetna Medicare Enhanced Extra (PPO) H2293-039: New for 2027
The new plan in the market reaches the most counties of the three, including Hunt, Parker, and Wise, with no referrals required.
Counties: Collin, Dallas, Hunt, Parker, Tarrant, Wise
Premium: $60
Copays: $0 PCP, $50 Specialist
MOOP: $7,150
OTC: $30 quarterly CVS OTC allowance
Dental: Preventive dental coverage (Aetna Dental PPO Mandatory)
Eyewear: $100 annual allowance (EyeMed)
Hearing: $500 annual allowance (NationsHearing)
Referrals: No referrals required
Aetna Medicare Value Plus (PPO) H3288-002
Aetna designed this plan primarily for members who qualify for the Low-Income Subsidy (LIS)/Extra Help Program. If a member does not qualify for LIS/Extra Help, certain supplemental benefits may be reduced.
Counties: Collin, Dallas, Tarrant
Premium: $5 (LIS/Extra Help members have a $0 plan premium)
Copays: $0 PCP, $75 Specialist
MOOP: $6,350
OTC: $15 quarterly allowance
SSBCI: Members who meet the 3-prong SSBCI eligibility and have Extra Help receive an additional $30 quarterly Extra Supports Wallet.
Dental: $500 annual allowance (Aetna Dental, Deluxe PPO Mandatory 50/30)
Eyewear: $100 annual allowance (EyeMed)
Hearing: $500 annual allowance (NationsHearing)
Referrals: No referrals required
Full Plan Details and Tools
The rest of Aetna's DFW plan documents are available through Aetna's Plan Guide. Look for the plans listed under DFW / Upper East / North non Metro.
You'll also want these on hand for AEP:
Think Agent enrollment portal: https://app.thinkagent.com/sign-in
Find an Aetna training near you: https://www.aetnamedicareagenttraining.com
Aetna Producer World: https://www.aetna.com/producer_public/login.fcc
Aetna Broker Support: 866-714-9301
Questions?
For Aetna plan questions in Dallas/Fort Worth, reach out to Heycel Ferman, Aetna Broker Manager, at 469-435-9679 (call or text) or [email protected]. During AEP, response times may run a little longer than usual. For questions about selling Aetna through The Brokerage Inc., email our Medicare team at [email protected].
