Aetna’s New Enrollment Requirements Per CMS

Compliance Connection

For Aetna Medicare Distribution Partners

September 27, 2023

In this edition we’ll continue to review some of the new sales presentation elements and questions from the Centers for Medicare and Medicaid Services (CMS) that you need to address with your clients. Through the “beneficiary blues” scenarios, we’ll demonstrate the positive impact you can have on your clients’ satisfaction. These requirements apply to enrollments completed after September 30, 2023. Your agency may already require you to cover some of these items.


SilverScript Application Email Error Notification

Silverscript Agent Email Notification from 5/8/23: 

On Friday May 5, 2023 there was a trend identified of brokers receiving emails in error with the subject “Subject: Your client’s SilverScript application was cancelled.” After researching, the members were still enrolled. 11,704 emails were sent in error. 


The email shares the following information:


Please note that the SilverScript enrollment application you submitted on behalf of your client XXXXX XXXXXX has been cancelled. Most likely this occurred because of one of the following reasons:

  • Your client enrolled in another Medicare plan.
  • Your client requested to cancel the enrollment or change the effective date.
  • Your client is already a member of SilverScript, or a duplicate application was submitted.

We suggest that you contact your client to make sure he or she is aware of this cancellation and that they have arranged alternate Part D drug coverage. If your client still wants to enroll in a SilverScript PDP, then please complete a new enrollment application, validate that the client is entitled to Medicare Part D, and that all fields on the application are correct.

Thank you for your efforts.

SilverScript Insurance Company

Unfortunately, this email is an automated notification, which is unable to receive replies. If you have questions, please contact your agency or upline administrator.


The verbiage below was added into the portal and to our Broker Support reply backs regarding the erroneous emails. We wanted to share in case you receive any questions. If a broker has questions regarding their member’s enrollment status, please direct them to broker support. We will verify if they were sent the emails in error and advise on their member’s enrollment status. 


Aetna’s MA Compliance Connection: Feb. 2023 Edition

In this issue, Aetna will discuss two topics including:

  • Caution to agents: Do not steer clients based on “scheduling fees”
  • Reminder: You can only require a zip code or county, and other location details from clients to review plans


Georgia Market – OEP 2023 D-SNP Sales Incentive Program  – Learn More! 

Aetna is excited to announce to all brokers in Georgia that we have a NEW SALES INCENTIVE to help support you during Lock-In.

The top three D-SNP producers will be able to access marketing dollars in the form of traditional co-op or funds through our Medicare Marketing Studio, marketing collateral to support community events, and local Aetna support to host community events throughout the year.

Producer Rewards & Qualifications

Top 3 Producer Rewards:

#1 Top Producer
• $5,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#2 Top Producer
• $3,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#3 Top Producer
• $1,500 in marketing co-op dollars in Q1 Only
• Aetna Swag

Sales Incentive Details & Qualifying Criteria:

• New to Aetna D-SNP sales for February 1- April 1 effective dates (CMS issued sales only).
• Final sales numbers will run in early May. Winners will be announced at that time.
• Cancelled applications and rapid disenrollments will be removed from final counts.
• To qualify for the contest, the broker must have a minimum of 10 New Sales
• Top three winners will be announced in each of the following markets:
Atlanta Metro/North Georgia
Macon/Columbus/South Georgia

***NOTE: Plan replacement is excluded***


The Qualifying Plans Include the Following:
• Aetna Medicare Dual Choice Plus Plan (PPO Full D-SNP)
• Aetna Medicare Dual Preferred Plan (HMO Full D-SNP)
• Aetna Dual Choice Plan (PPO Partial D-SNP)
• Aetna Medicare Dual Select Plan (HMO Partial D-SNP)

The Aetna Medicare FULL D-SNP plans are available in 78 counties in Georgia. Our plans offer competitive benefits and includes many extras:

• Extra Benefits Card: $600 combined quarterly allowance on a prepaid debit card for OTC and healthy foods. No pre-qualifying conditions required.
• $0 Rx copays on all tiers at standard and preferred pharmacies.
• Dental: up to $4,500 allowance that covers preventive comprehensive care, including dentures and implants (excluding cosmetic services).
• Eyewear: up to $500 allowance.
• Transportation: up to 60 one-way trips (100 Mile radius) to medical appointments, pharmacies and SilverSneakers locations through SafeRide.
• LifeStation Personal Emergency Response: $0
• Hearing aids: up to $1,250 allowance per ear.
• Fall Prevention: $150 for home/bath safety devices.
• Plus … earn an extra $110 service fee when you complete the HRA via electronic submission.

Aetna: Think Agent – New Profile & PURL Access

Sourced from Aetna/Think Agent Email Communication from 10/13/2022:


Introducing more tools for you this AEP!

On 10/15, we have one fantastic delivery we’d like to share with you – NEW! Profile & PURL.

For those interested, we’re delivering the following new features this AEP & including the below training to help you learn how they work!


Profile – You may have already found the “Profile” button in Think Agent and found it to be inactive. Well, we’ve been hard at work developing this cool new feature to share with you; and we’re excited to announce it’s ready!

  • The Profile is customizable, allows you to change and update your contact information (does not affect other Aetna sites), link social media, add a profile picture and create an ‘About Me’ description of yourself.
  • What’s especially neat is your contact information will now pre-populate in forms such as the SOA, eKit and enrollment. Test it out for yourself
  • Even more, these items will also appear on your PURL for prospects to see!

PURL – Never heard of such a thing? PURL stands for Personalized URL and it’s a unique feature of Think Agent you’re going to like!

  • The PURL comes linked to your Think Agent Profile and access is granted automatically.
  • Copy & share your PURL address on your social media, MMS flyers, business cards, etc. for prospects and clients to access.
  • From your PURL site, your Profile information will display; as well as an option for prospective Medicare clients to shop for Aetna Medicare plans in their area, or request a free quote about products in which they are interested from you!*
  • If a client shops for plans from your PURL, they may enroll themselves by choosing “Enroll Now” on a plan in their geography, and you’ll be their AOR!


*An email notification will be sent directly to you from only when the ‘Free Quote’ feature is used on your PURL, and the prospect has indicated they wish to learn about products where you are currently RTS (based upon state).


To learn more about these exciting new features of Think Agent, please see our trainings here:


What you need to know about the Inflation Reduction Act (IRA) – From Aetna Medicare Solutions

Sourced from Aetna’s Medicare Solutions Broker Email from 9/30/2022:

President Biden’s signing of the Inflation Reduction Act (IRA) marks the beginning of implementing many years of substantial change to the Medicare Part B and Part D programs.

The two most imminent changes, which take effect January 1, 2023, include:
• Limiting the member cost-share of covered insulins to $35
• Introducing $0 member cost-sharing on Part D vaccines

We’re updating materials to convey this information to members. Members will receive information by mail, and information will also be available in enrollment kits and on our website. In addition, we’re working to operationalize these changes by January 1, 2023, as required.

Please use the information below to help answer your clients’ questions this AEP.


How does the IRA impact 2023 Medicare Advantage plans (MAPD) and Prescription Drug Plans (PDP)?

It limits the member cost-share on covered insulins to $35. 

  • This means members won’t pay more than $35 for a one-month supply of each insulin product covered by their plan, no matter what cost-sharing tier it’s on, even if their plan has a deductible that hasn’t been met.
  • While some members already benefit from plans that offer $35 insulin, this legislation ensures that all seniors who use insulin benefit from this out-of-pocket cost limit.
  • Members receiving LIS will continue to pay the CMS statutory maximum cost share for insulin, which is less than $35.
  • In Florida, some 2023 Aetna MAPD plans will offer select insulins for a $0 cost share at preferred pharmacies and a $20 copay at standard pharmacies. On these plans, other covered insulins will be available for the $35 IRA copay.
  • In addition, the 2023 SmartSaver PDP (which is non-commissionable for new sales), available in all 50 states, offers covered insulin for a $10 copay at preferred pharmacies and a $20 copay at standard pharmacies.

It eliminates member costs and improves access for Part D vaccines.

Our 2023 plans will cover most Part D vaccines for a $0 cost share, even if a plan has a deductible that hasn’t been met.


What information will members receive?

Member materials are being updated in accordance with CMS guidance to ensure members are properly informed of the changes.


How will insulin and vaccine benefits be displayed on Medicare Plan Finder?

Beginning October 1, the Medicare Plan Finder site ( will reflect Part D sponsors’ insulin and vaccine benefits and cost sharing as they were submitted in their 2023 bid and formulary submissions, prior to IRA being enacted. However, new insulin and vaccine drug footnotes and other help features will be displayed to explain the benefit changes resulting from the IRA.

Because of this, CMS is granting a Special Enrollment Period (SEP) for Exceptional Circumstances to allow beneficiaries to add, drop, or change their Part D coverage if they find a better option after the 2022 Annual Enrollment Period (AEP) and through the end of 2023. This SEP will be available for all beneficiaries who use a covered insulin product and begins on December 8th, 2022, and ends on December 31, 2023. Beneficiaries may use this SEP one time during this period. To utilize this SEP, beneficiaries must call 1-800-MEDICARE so a customer service representative can process the enrollment change; they cannot use a broker for this SEP. Consistent with current policy, when Part D enrollees change plans mid-year, their True Out-of-Pocket (TrOOP) costs carry over from one plan to the next.

What’s coming in 2024?

Additional IRA requirements that will be implemented in 2024 include:
• $0 cost sharing in the catastrophic phase for Part D
• Expansion of the low-income subsidy eligibility to 150% of the federal poverty line


What additional impacts will IRA have in the future? 

Additional IRA requirements will be implemented annually through 2029. We’ll share more information as we approach those implementation dates.

Aetna’s Think Agent Updates – New Desktop Version



Sourced from Aetna’s Think Agent email communication from 7/28/22:

Great news, Think Agent users!


Aetna has a new desktop version coming to you this Friday, 7/29! With this new version, Aetna is delivering many enhancements and time-saving features that will make doing business with Aetna Medicare faster, simpler and better for you this AEP!

The mobile app will be updated to include these features in the coming weeks.

See below for some of the exciting new features coming with this new desktop version!


  1. Application “Save” option. Begin & save an application and open it later – Right where you left-off!Find the saved draft application in your My Enrollments to re-open, edit and complete.

2.  “Quick Help” in the More component will display you local Aetna Broker Manager’s contact information, as well as other helpful contacts.


3. D-SNP eligibility now displayed on each D-SNP plan card. Verify Medicaid in Think Agent, and we’ll let you know if your client is eligible for the D-SNP plans in the area!


4. Look for these “i” icons beside popular items like eKit & SOA to learn more!


5. Now add your client’s providers to their lead! After – When shopping for plans to enroll – you’ll see network status displayed on the plan cards, helping you to make an enrollment decision.


Aetna/Silverscript: Producer World Reporting Updates

Sourced from broker communication on 3/7/22:

There have been some changes to the IVL Producer World reporting.

Changes to the fields are as follows:

  • Old (legacy) membership ID
  • New (migrated) membership ID
  • Member Address 1
  • Member Address 2
  • Member Date of Birth
  • Member Phone Number

Demographic fields are added to the Producer World Book of Business report only and the Member Search tool.

Legacy and New Member ID’s are added to all reports and the Member Search tool.  Agents are able to search both ID’s in the Member Search tool to find a client.


If you have any questions, please contact your CSM Service Rep.

NEW! Aetna Supplemental E-Signature Option for CSG E-Apps

Exciting News! 


Aetna Senior Supplemental has approved their security questions signature for CSG Actuarial E-Apps! Agents can now EASILY capture signatures over the phone or in person with this option.

This is approved for all over the phone/remote sales.

If you have any further questions, please reach out to your CSM Representative.


Negotiations Completed with Trinity – Mount Carmel Health System – OH in the Central Ohio network

Aetna announced they have reached a new multi-year agreement with Trinity – Mount Carmel Health System – OH effective 01/01/2022. Trinity will be sending out a patient letter. As a result of this successful negotiation process, Trinity – Mount Carmel Health System – OH will continue to participate in Aetna’s Central Ohio network for the following products:

• Open Choice® PPO
• Aetna Open Access® Managed Choice® POS
• Aetna Select℠
• Aetna Open Access® Elect Choice® EPO
• Quality Point-of-Service® (QPOS®)
• Aetna Health Network Only℠ (HNO)
• Aetna Medicare℠ Plan (HMO)
• National Advantage Program (NAP)
• Mount Carmel Neighborhood Network
• Central Ohio Primary Care Managed Choice • Aetna Choice® POS II
• Managed Choice® POS
• Open Access Aetna Select℠
• Aetna Choice® POS
• Aetna Health Network Option℠ (HNO)
• Aetna Medicare℠ Plan (PPO)
• Aetna Premier Care Network℠
• Aetna Whole Health℠ – (NAME OF ACO
• National Advantage™ Program

There has been no interruption to member access because an agreement was reached before the contract’s termination date. Member letters were never released; therefore, retraction member letters are not necessary.


Provider Search/directory information
Trinity – Mount Carmel Health System – OH is included in Aetna’s online provider search tool and in their current printed provider directories.

Click HERE to read Trinity- Mount Carmel Health’s announcement regarding the completed negotiations.



Questions? Reach out to your Sales or Service Rep at any time!


or by email: