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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 Cincinnati Dayton 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 $28.40. 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) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one-, two-, or three-month supplies filled through standard pharmacies or standard mail order. Tier 2 generic drugs carry a $5.00 copay for a one-month supply, with three-month supplies costing $15.00 at standard pharmacies or $10.00 through standard mail order. For Tier 3 preferred brand and Tier 4 non-preferred drugs, you will pay a 25% coinsurance for one-, two-, or three-month supplies at standard pharmacies and standard mail order. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply. This straightforward cost structure helps you easily plan your monthly and yearly healthcare expenses.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers comprehensive coverage with no copays for primary care visits, home health services, and outpatient diagnostic tests. Inpatient hospital stays require copays of $2,230 for acute care and $2,080 for psychiatric care, both with no coinsurance. Outpatient services and specialist visits also feature no copays, though they may require a coinsurance of up to 20 percent. Members benefit from generous supplemental coverage, including a $2,500 annual dental limit and a $350 yearly eyewear allowance with no copays or coinsurance for most services. Prescription hearing aids are covered up to $1,250 per ear annually with no copay, and the plan provides a $200 monthly allowance for over-the-counter items. Emergency care is covered with a $115 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, with no coinsurance for either service. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copays across all categories, though prior authorization is required for most services. Patients will pay a 0% to 20% coinsurance for outpatient hospital and ambulatory surgical center services, a 20% coinsurance for observation and outpatient substance abuse services, and no coinsurance for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP), which offers medicare-covered ground and air ambulance services with a 20% coinsurance, no copay, and prior authorization requirements. For transportation, some services are covered, but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) 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 coverage is available up to $250,000 with a $115 copay (no coinsurance) for care and a 20% coinsurance (no copay) for emergency transportation.
Primary Care See details
Aetna Medicare Chronic Care Total (HMO C-SNP) provides primary care and podiatry services with no copay and no coinsurance, while specialist visits, therapies, and mental health services feature no copay and up to 20% coinsurance. Telehealth services range from a $0 to $40 copay with 20% coinsurance, but chiropractic services are not covered in practice as routine and other chiropractic services are excluded.
Preventive Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) provides partial coverage for preventive services, offering annual physical exams, health education, and fitness benefits with no copay and no coinsurance. Kidney disease education and specific screenings, including glaucoma and diabetes self-management training, carry a 20% coinsurance and no copay, while services like in-home safety assessments, medical nutrition therapy, and personal emergency response systems are not covered.
Hearing Services See details
Hearing Services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductibles, offering prescription hearing aids up to $1,250 per ear annually with no copay or coinsurance. One routine hearing exam and one fitting evaluation are covered yearly with no copay (routine exams require a 20% coinsurance), while Medicare-covered exams require a copay, and OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers vision services with no deductible, offering eye exams with no copay and 0% to 20% coinsurance. Covered eyewear, including contacts and eyeglasses, is available with no copay or coinsurance up to a maximum benefit of $350 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), featuring a $2,500 annual maximum with no copay and no coinsurance for most preventive and comprehensive care. Medicare-covered dental services require no copay but have a 20% coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers durable medical equipment and medical supplies with no copay and coinsurance ranging from no coinsurance to 20%. Prosthetic devices are covered with no copay and a 20% coinsurance, while diabetic supplies have no copay and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers diagnostic and radiological services with prior authorization required and no copayments. There is no coinsurance for diagnostic procedures, lab services, and diagnostic radiological services, while therapeutic radiological services and outpatient X-rays require a 20% coinsurance.
Home Health Services See details
Home health services are covered under the 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, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, though a prior three-day inpatient hospital stay is not, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers other services with no copay and no coinsurance, including annual wellness exams, screening mammographies, additional gFOBT and FIT, and up to $200 monthly in reimbursed over-the-counter items. Acupuncture and meal benefits are not covered under this plan.
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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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