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Aetna Medicare Chronic Care (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care (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 (HMO C-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Chronic Care (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 (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 (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 (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 (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. 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 $6750.00 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 (HMO C-SNP)
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Drug Coverage
The Aetna Medicare Chronic Care (HMO C-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay when filling prescriptions through preferred pharmacies or preferred mail-order services. Tier 2 generic drugs are also cost-effective, with copays starting at $5 for a one-month supply at preferred pharmacies. Higher-tier medications are subject to coinsurance, starting with a 22% coinsurance for Tier 3 preferred brand drugs. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance for a one-month supply across all pharmacy and mail-order options. Utilizing preferred network pharmacies is the most effective way to minimize your out-of-pocket prescription costs with this plan.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan provides comprehensive medical coverage with predictable out-of-pocket costs, including no copay and no coinsurance for primary care visits, routine podiatry, and annual physicals. Specialist doctor visits range from a $0 to $25 copay, while outpatient hospital services feature a copay between $0 and $325 with no coinsurance. For inpatient hospital stays, members pay a $325 daily copay for days one through six, with no copay required for days seven through 90. In addition to core medical care, this plan offers valuable extra benefits like a $40 monthly reimbursement for over-the-counter items and home health services with no copay. Dental care includes no copay for preventive services and up to $2,000 yearly for comprehensive services, while vision and hearing benefits feature no copay for routine exams alongside generous annual allowances for eyewear and hearing aids. Some specialized services, such as dialysis and durable medical equipment, carry up to a 20% coinsurance and no copay.
Inpatient Hospital See details
Aetna Medicare Chronic Care (HMO C-SNP) inpatient hospital benefits are partially covered with no coinsurance and require prior authorization. For both acute and psychiatric stays, there is a $325 daily copay for days 1 through 6 and no copay for days 7 through 90, while additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, featuring a $0 to $325 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $25 copay and no coinsurance.
Partial Hospitalization See details
The Aetna Medicare Chronic Care (HMO C-SNP) plan covers partial hospitalization services with a copay of $60.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency services are also covered up to a $250,000 limit with no coinsurance, featuring a $130 copay for emergency or urgent care and a $250 copay for emergency transportation.
Primary Care See details
Aetna Medicare Chronic Care (HMO C-SNP) offers primary care benefits with no copay and no coinsurance for primary care doctor visits and routine podiatry. Specialist visits range from a $0 to $25 copay and physical, occupational, mental health, psychiatric, and opioid therapies carry a $25 copay with no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers preventive services with no copay and no coinsurance for annual physicals and screenings, though kidney disease education requires a 20% coinsurance and no copay. These additional preventive services are partially covered, as the plan excludes coverage for in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs for chemotherapy-related hair loss, 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, home and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Chronic Care (HMO C-SNP) hearing services are partially covered, featuring a $25 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered with no copay and no coinsurance up to $1,000 per ear yearly, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers vision services with no coinsurance or deductibles, offering routine and diabetic eye exams with no copay, and Medicare-covered exams with a $0 to $25 copay. Eyewear, including contact lenses and eyeglasses, is also covered with no copay up to a combined maximum benefit of $225 per year.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan, offering preventive care with no copay and no coinsurance, and Medicare-covered dental with a $25 copay and no coinsurance. Comprehensive dental services are covered up to a $2,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered dialysis services.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Chronic Care (HMO C-SNP) plan with no copays for all categories, though prior authorization is required. Durable medical equipment and medical supplies carry a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and diabetic equipment is provided with no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Chronic Care (HMO C-SNP), though prior authorization is required. Lab services feature no copay and no coinsurance, diagnostic tests range from no copay to a $20 copay with no coinsurance, and radiological services require a $20 copay for X-rays and 20% coinsurance for therapeutic treatments.
Home Health Services See details
Home health services are covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond standard Medicare-covered days are not covered.
Other Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers coverage for select additional services with no copay and no coinsurance, including a $40 monthly reimbursement for over-the-counter (OTC) items, annual wellness exams, screening mammographies, and additional gFOBT and FIT tests. Acupuncture and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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