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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 Youngstown 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 prescription drug deductible of $615. Under this plan, Tier 1 preferred generic drugs are covered with no copay for one-, two-, or three-month supplies filled at standard pharmacies or through standard mail order. Tier 2 generic medications are also highly affordable, with standard copays starting at just $5 for a one-month supply. For brand-name and specialty medications, costs transition to coinsurance rather than set copays. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both require a 25% coinsurance for standard pharmacy and mail order fills. Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) offers comprehensive medical coverage with no copay for primary care doctor visits and specialist visits, though specialists may require up to a 20% coinsurance. For hospital stays, members pay a copay of $2,230 per inpatient acute admission and $2,080 per psychiatric admission, while outpatient services generally feature no copay and up to a 20% coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted, and urgent care visits require a $40 copay. This plan also provides robust supplemental benefits, including preventive and comprehensive dental care up to $2,500 annually and eyewear up to $350 per year with no copay or coinsurance. Additionally, members can receive up to $1,250 per ear annually for prescription hearing aids and a $225 monthly allowance for over-the-counter items with no copay or coinsurance. Skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers inpatient hospital services, requiring prior authorization with no coinsurance. Covered acute stays carry a $2,230 copay per admission and psychiatric stays require a $2,080 copay per admission, while upgrades, additional days, 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 be required for certain treatments. Outpatient hospital, ambulatory surgical center, and substance abuse services carry a coinsurance of 0% to 20%, while outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan 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
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. While transportation services are technically covered, in practice, some services are covered but transportation to plan-approved or any 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 to the hospital within 24 hours) and no coinsurance, and urgent care with a $40 copay and no coinsurance. Worldwide emergency and urgent services are covered up to a $250,000 limit with a $115 copay and no coinsurance, while worldwide emergency transportation has a 20% coinsurance and no copay.
Primary Care See details
Primary care services under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan feature no copay and no coinsurance for primary care physician visits, while specialist visits require no copay and 0% to 20% coinsurance. Most other primary care benefits, including physical, occupational, and mental health therapies, have no copay and a 20% coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), offering annual physicals, health education, smoking cessation, and memory fitness with no copay and no coinsurance, while kidney disease education and diabetes self-management training carry no copay and a 20% coinsurance. Several supplemental benefits are not covered, including in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, and weight management programs.
Hearing Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) offers partially covered hearing services, featuring routine hearing exams with a 20% coinsurance and no copay, 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 hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers vision services with no deductibles, offering eye exams with no copay and 0% to 20% coinsurance. Covered eyewear, including eyeglasses and contact lenses, features no copay and no coinsurance up to a combined maximum benefit of $350 every year.
Dental Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) offers partially covered dental services with no copay and no coinsurance for preventive and most comprehensive care up to a $2,500 annual maximum, while Medicare-covered dental services require no copay and a 20% coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Covered Medicare Part B chemotherapy, radiation, and other drugs require a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. These services feature no copays, with coinsurance ranging from no coinsurance to 20% for DME and medical supplies, and a flat 20% coinsurance for prosthetic devices and diabetic therapeutic shoes.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers diagnostic and radiological services with prior authorization required. Diagnostic procedures, lab services, and diagnostic radiological services are covered with no copay and no coinsurance, while therapeutic radiological services and outpatient X-ray services have no copay and a 20% coinsurance.
Home Health Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers Home Health Services 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. This includes cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services, which 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, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, and a $218 copay per day for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered under the Aetna Medicare Chronic Care Total (HMO C-SNP), excluding acupuncture and meal benefits. Covered benefits, including annual wellness exams, screening mammographies, additional gFOBT and FIT, and up to $225 monthly for over-the-counter items, are available with 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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