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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 Central Ohio 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 $28.70. 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 Chronic Care Total (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one, two, or three-month supplies filled at standard pharmacies or through standard mail order. Tier 2 generic drugs are also highly affordable, requiring a $5 copay for a one-month supply and a maximum of a $15 copay for a three-month supply. For higher-tier medications, costs are based on a percentage of the drug price rather than flat copays. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance at standard pharmacies and standard mail order. This 25% coinsurance applies to up to a three-month supply for Tiers 3 and 4, and a one-month supply for Tier 5 specialty drugs.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers robust medical coverage with no copay for primary care visits, routine lab tests, and home health services. Specialist visits, outpatient hospital services, and diagnostic screenings also require no copay, though coinsurance ranging from 0% to 20% may apply. For urgent situations, emergency care carries a $115 copay, while inpatient hospital stays require a set copay per stay with no coinsurance. This plan features strong supplemental benefits with no copay and no coinsurance, including up to $2,500 annually for dental care, up to $350 for eyewear, and $200 monthly for over-the-counter items. Routine hearing exams are available with no copay and 20% coinsurance, while prescription hearing aids are covered up to $1,250 per ear annually with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days and no coinsurance throughout your stay.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the Aetna Medicare Chronic Care Total (HMO C-SNP), with acute stays requiring a $2,220 copay per stay and psychiatric stays requiring a $2,080 copay per stay, both with no coinsurance. Prior authorization is required for these services, and 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 coinsurance and prior authorization may apply. Outpatient hospital and ambulatory surgical center services feature no copay and 0% to 20% coinsurance, outpatient substance abuse services have no copay and 20% coinsurance, and outpatient blood services require no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) 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, subject to prior authorization. While some transportation services are covered, transportation to plan-approved and any other health-related locations is not covered.
Emergency Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers emergency services with a $115 copay (waived if admitted within 24 hours) and urgent care with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 limit with a $115 copay and no coinsurance, while worldwide emergency transportation requires a 20% coinsurance and no copay.
Primary Care See details
Primary care services under Aetna Medicare Chronic Care Total (HMO C-SNP) feature no copay and no coinsurance for primary care doctor and podiatry visits, though chiropractic services are not covered. Specialist visits, therapy services, and mental health care require no copay with coinsurance ranging from 0% to 20%, while telehealth benefits have a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) provides partially covered preventive services, offering annual exams, health education, and fitness benefits with no copay and no coinsurance, while kidney disease education and screenings require a 20% coinsurance and no copay. Excluded from coverage are in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductible, offering routine hearing exams with no copay and a 20% coinsurance, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered up to $1,250 per ear annually with no copay or coinsurance, but OTC, inner ear, outer ear, and over-the-ear devices are not covered.
Vision Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers vision services with no deductibles, including routine eye exams with no copay and up to 20% coinsurance. Eyewear, including contacts and glasses, is also covered with no copay and no coinsurance up to a $350 annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), excluding maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services feature no copay and no coinsurance up to a $2,500 annual limit.
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 carry 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
Medical equipment is covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copays, though prior authorization is required. Durable medical equipment and medical supplies feature 0% to 20% coinsurance, while prosthetic devices and diabetic therapeutic shoes require 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers diagnostic and radiological services with prior authorization, offering diagnostic tests, lab services, and diagnostic radiology with no copay and no coinsurance. Therapeutic radiological services and outpatient X-rays are also covered with 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
Aetna Medicare Chronic Care Total (HMO C-SNP) does not cover Cardiac Rehabilitation Services, 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
Aetna Medicare Chronic Care Total (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay and no coinsurance, including over-the-counter items up to $200 monthly, an annual wellness exam, screening mammography, and additional gFOBT and FIT. Acupuncture, meal benefits, and dual eligible highly integrated services are not covered.
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