Simple ways to get your flu shot

Ask your doctor before scheduling an appointment Call your doctor to see if they offer the flu shot. If so, schedule an appointment.

Keep in mind — you may have to pay a copay or coinsurance if you’re visiting your doctor for any services other than your flu shot.

Visit one of our network providers

See our list of flu shot providers on the next page. Or go to www.aetnamedicare.com/flu.

Keep in mind — your network flu shot providers [First [Middle Initial] [Last Name] Name] [Street address 1] line [Street address 2] line [City], [State] [ZIP code]-[plus 4] may not be the same as your overall plan network. So Prevent the flu make sure you check the list before you get your flu shot. Getting your flu shot If you go out of the flu shot provider network, you’ll just got easier need to pay the cost up front. To get reimbursed, you’ll need to send us a copy of your receipt. Just be sure to include your member ID on the receipt.

You can download the reimbursement form from our website. Just go to www.aetnamedicare.com/en/ contact-us/print-forms.html and click “Claims & Reimbursements” to get your form. And you can find our claims address on your member ID card. www.aetnamedicare.com Health and wellness or prevention information. 09/2017 NR_0002_10606 Aetna Inc. ©2017 (9/17) 72.02.342.1 72.02.342.1 (9/17) Aetna Medicare is a PDP, HMO, PPO plan with a Medicare Choose from our list of network Network flu shot providers (continued) contract. Our SNPs also have contracts with State Medicaid flu shot providers SAVEMART THRIFTY WHITE programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete Getting your flu shot is simple. All you need to do is visit SAV-MOR/PROGRESSIVE TOM THUMB PHARMACY description of plan benefits, exclusions, limitations and one of our network flu shot providers. The best part? -TWENTY-FIVE TOPS MARKETS conditions of coverage. Plan features and availability may You don’t have to pay out of pocket. vary by service area. This information is not a complete SHOPKO — SAFEWAY description of benefits. Contact the plan for more Network flu shot providers SHOPRITE PHARMACY WALGREENS information. Limitations, copayments, and restrictions may apply. Benefits and/or co-payments/co-insurance ACME PHARMACY HARMONS PHARMACY/ SMITH’S may change on January 1 of each year. Other Pharmacies/ WHOLE HEALTH Physicians/Providers are available in our network. The STOP AND SHOP WEGMAN’S PHARMACY PHARMACIES formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when BARTELL DRUG H.E. BUTT GROCERY SUPERVALU PHARMACIES WINN-DIXIE necessary. Participating physicians, hospitals and other health care providers are independent contractors and BI-LO PHARMACY HY-VEE FOOD STORES TARGET STORES are neither agents nor employees of Aetna. The availability BROOKSHIRE GROCERY of any particular provider cannot be guaranteed, and CARRS QUALITY CENTERS KMART If you have questions, provider network composition is subject to change. Out- Questions? of-network/non-contracted providers are under no COBORN'S COMPANY you can call us at the number on obligation to treat Aetna members, except in emergency PHARMACIES LEADER DRUG STORE situations. For a decision about whether we will cover an your member ID card (TTY: 711). out-of-network service, we encourage you or your provider CVS PHARMACY LEWIS DRUGS/LEWIS to ask us for a pre-service organization determination FAMILY DRUG before you receive the service. Please call our customer DIERBERGS FAMILY LONGS DRUG STORES service number or see your Evidence of Coverage for more PHARMACIES information, including the cost-sharing that applies to out- of-network services. Aetna complies with applicable PHARMACY Federal civil rights laws and does not discriminate on the DISCOUNT DRUG MART NEW ALBERTSONS basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, DUANE READE SUPER MARKETS free language assistance services are available. Visit our FARM FRESH QUICK CHEK FOOD STORES website at www.aetnamedicare.com or call the phone number on your member identification card. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de FRED’S RANDALL’S FOOD MARKETS idiomas. Visite nuestro sitio web en www.aetnamedicare. FRY’S FOOD AND DRUG RITE AID com o llame al número de teléfono que se indica en su tarjeta de identificación de afiliado. 繁體中文 (CHINESE): 請 MARKETS ROUNDY’S 注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我 SAFEWAY 們的網站 www.aetnamedicare.com 或致電您的會員卡上的電 話 號 碼。 HANNAFORD BROS SAM’S CLUB