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Aetna Medicare Chronic Care Total (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care Total (HMO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Chronic Care Total (HMO C-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Chronic Care Total (HMO C-SNP) is a HMO C-SNP plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Cleveland/Akron-Canton Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Chronic Care Total (HMO C-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 Chronic Care Total (HMO C-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 Chronic Care Total (HMO C-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 Chronic Care Total (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $28.60. 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:
Sign up for Aetna Medicare Chronic Care Total (HMO C-SNP)
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Drug Coverage
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are highly affordable, offering no copay for one, two, or three-month supplies through standard pharmacies and standard mail order. For Tier 2 generic medications, standard pharmacy copays range from $5 to $15, while mail-order costs are capped at $10 for a three-month supply. For higher-tier medications, the plan requires a 25% coinsurance across standard pharmacies and standard mail order. This 25% coinsurance rate applies to Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs. These clear cost-sharing tiers help you understand your out-of-pocket prescription costs when choosing this Aetna Medicare plan.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive services, home health care, and diagnostic lab tests. Specialist visits and outpatient hospital services generally carry no copay but may require a coinsurance of up to 20 percent. For major medical needs, inpatient hospital stays require a $2,205 copay per stay for acute care, while emergency room visits carry a $115 copay that is waived if you are admitted. This plan also provides generous dental, vision, and hearing benefits, including a $2,500 annual dental limit and a $350 annual eyewear allowance with no copay or coinsurance for most services. Members can also take advantage of a $1,250 annual prescription hearing aid benefit per ear and a $225 monthly allowance for over-the-counter items. While routine transportation and cardiac rehabilitation are not covered, skilled nursing facility care is available with no copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $2,205 copayment per stay for acute care and a $2,080 copayment per stay for psychiatric care. Both services require prior authorization, while additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers outpatient services with no copays, though prior authorization and a 0% to 20% coinsurance apply to outpatient hospital, ambulatory surgical center, and substance abuse services. Outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers partial hospitalization services with a copay of $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, though prior authorization is required. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent services are covered up to a $250,000 maximum with a $115 copay and no coinsurance, while worldwide emergency transportation requires a 20% coinsurance and no copay.
Primary Care See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers primary care physician and podiatry services with no copay and no coinsurance, while chiropractic services are not covered in practice. Specialist, therapy, psychiatric, and opioid treatment services are covered with no copay and 0% to 20% coinsurance, while telehealth benefits carry a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), offering annual physical exams, health education, and fitness benefits with no copay and no coinsurance. Kidney disease education and screenings for glaucoma and diabetes have no copay but require a 20% coinsurance, while services like in-home safety assessments, personal emergency response systems, and nutritional benefits are not covered.
Hearing Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers hearing services, offering routine exams with a 20% coinsurance and no copay, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $1,250 per ear annually with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers vision services with no deductible, offering routine and follow-up diabetic eye exams with no copay and 0% to 20% coinsurance. Covered eyewear has no copay and no coinsurance, providing a combined maximum benefit of $350 per year for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan, which offers up to a $2,500 annual maximum with no copay and no coinsurance for most preventive and comprehensive dental care. Medicare-covered dental services have no copay and a 20% coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers home infusion bundled services with no copay, requiring prior authorization. Under this benefit, Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers medical equipment, prosthetics, and diabetic supplies with no copays, though prior authorization is required for these services. Patients will pay 0% to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies, and a flat 20% coinsurance for prosthetic devices and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with prior authorization required. There is no copay or coinsurance for diagnostic procedures, lab services, and diagnostic radiological services, while therapeutic radiological services and outpatient X-rays require no copay and a 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan. While the plan indicates some services are covered, in practice, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, additional days beyond the 100-day limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), excluding acupuncture and meal benefits. Covered services, including annual wellness exams, screening mammography, additional gFOBT and FIT, and up to $225 monthly for over-the-counter items via reimbursement, feature no copay and no coinsurance.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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