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Aetna Medicare HIDE (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare HIDE (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare HIDE (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare HIDE (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in Kentucky. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare HIDE (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Aetna Medicare HIDE (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare HIDE (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Aetna Medicare HIDE (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $33.80. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Aetna Medicare HIDE (HMO D-SNP) plan features an annual prescription drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 Preferred Generic and Tier 2 Generic drugs filled at standard pharmacies or through standard mail order. This $0 cost applies to one-month, two-month, and three-month supplies of these generic medications. For higher-tier medications, cost sharing is based on coinsurance rather than flat copayments. You will pay 22% coinsurance for Tier 3 Preferred Brand drugs and 25% coinsurance for Tier 4 Non-Preferred Drugs. Tier 5 Specialty Tier drugs also carry a 25% coinsurance for a one-month supply at standard pharmacies and standard mail order.
Additional Benefits
The Aetna Medicare HIDE (HMO D-SNP) plan offers robust medical coverage, featuring primary care and preventive services with no copay. For major medical needs, inpatient hospital stays require a $1,970 copay per stay with no coinsurance, while outpatient services generally feature no copay and a 20% coinsurance. Emergency room visits carry a $115 copay, which is waived upon admission, and urgent care services require a $40 copay. This plan also provides valuable everyday benefits, including preventive and comprehensive dental care up to a $2,750 annual limit with no copay. Vision eyewear is covered up to $325 annually with no copay, and hearing aids are covered up to $2,000 per ear with no copay or coinsurance. Additionally, members benefit from a $170 monthly over-the-counter allowance and up to 36 free one-way trips per year to plan-approved locations.
Inpatient Hospital See details
Aetna Medicare HIDE (HMO D-SNP) partially covers inpatient hospital services, requiring a $1,970 copayment per stay and no coinsurance for acute and psychiatric care, with prior authorization required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare HIDE (HMO D-SNP) covers outpatient services with no copays, though patients are responsible for a 20% coinsurance and prior authorization is required for most treatments. Covered care includes outpatient hospital and observation services, ambulatory surgical center visits, outpatient substance abuse sessions, and outpatient blood services with no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare HIDE (HMO D-SNP) and require prior authorization. Depending on the service, you will pay either a 20% coinsurance with no copay or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare HIDE (HMO D-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 36 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare HIDE (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copays or coinsurance up to a $250,000 maximum plan benefit.
Primary Care See details
Primary care benefits under Aetna Medicare HIDE (HMO D-SNP) generally feature no copay and coinsurance ranging from no coinsurance to 20% for services such as primary care, specialist visits, therapies, and psychiatric care. Telehealth services are covered with a copay ranging from no copay to $40 and 20% coinsurance, while chiropractic services are not covered.
Preventive Services See details
Aetna Medicare HIDE (HMO D-SNP) preventive services are partially covered, offering annual physicals and select supplemental benefits with no copay and no coinsurance, while kidney disease education and screenings have no copay and a 20% coinsurance. Sub-services not covered include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Aetna Medicare HIDE (HMO D-SNP) covers hearing services with no deductible, offering Medicare-covered exams and fitting evaluations with no copay and no coinsurance, and annual routine exams with a 20% coinsurance and no copay. Prescription hearing aids are partially covered with no copay and no coinsurance up to $2,000 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare HIDE (HMO D-SNP) with no deductible, featuring no copay for annual routine and diabetic eye exams, though routine exams carry a 20% coinsurance. Eyewear is covered up to a $325 annual limit with no copay for lenses, frames, and upgrades, while contact lenses require a 20% coinsurance.
Dental Services See details
Aetna Medicare HIDE (HMO D-SNP) dental services are partially covered, offering preventive and comprehensive care with no copay and no coinsurance up to a $2,750 annual maximum, while Medicare-covered dental requires no copay and 20% coinsurance. Specific services including implants, orthodontics, and maxillofacial prosthetics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare HIDE (HMO D-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin carries a $35 copay and no coinsurance, while Part B chemotherapy and other drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare HIDE (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment benefits under Aetna Medicare HIDE (HMO D-SNP) are covered with no copay and a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic supplies. Diabetic therapeutic shoes and inserts are also covered with a 20% coinsurance, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare HIDE (HMO D-SNP) with prior authorization required and no copays. Covered diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays carry a 20% coinsurance, while diagnostic radiological services have no coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare HIDE (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare HIDE (HMO D-SNP) covers some Cardiac Rehabilitation Services with no copay, but several key services are not covered. Specifically, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare HIDE (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the Aetna Medicare HIDE (HMO D-SNP) are partially covered with no copay and no coinsurance, providing a $170 monthly over-the-counter reimbursement, chronic illness meal benefits, annual wellness exams, and additional cancer screenings. Acupuncture is not covered under this plan's benefit.
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