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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 South FL. This plan received an overall rating of 4.5 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 $200.00 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 $3900.00 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) prescription drug plan features an annual drug deductible of $200. You can enjoy no copay for Tier 1 preferred generic and Tier 2 generic drugs when filling your prescriptions through a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail order, Tier 1 copays range from $2 to $6 and Tier 2 copays range from $12 to $36 depending on the supply length. For brand-name and specialty medications, costs are based on a coinsurance percentage rather than flat copays. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 30% coinsurance. These coinsurance rates apply across all pharmacy and mail-order options, with Tier 5 specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care, specialist visits, and home health services. Inpatient hospital stays require a $125 daily copay for the first six days, while emergency room visits carry a $150 copay that is waived if you are admitted within 24 hours. Outpatient hospital services feature copays ranging from no copay to $125, with no coinsurance required for these services. This plan also provides robust additional benefits, including no copays or coinsurance for routine dental care up to $2,000 annually, vision exams and eyewear up to a $300 yearly limit, and prescription hearing aids up to $1,000 per ear. Members benefit from no copay for the first 20 days in a skilled nursing facility and a $60 monthly reimbursement for over-the-counter items. Durable medical equipment and dialysis services are covered with no copays and coinsurance ranging up to 20 percent.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, though prior authorization is required. For both acute and psychiatric stays, there is a $125 copayment per day for days 1 through 6 and no copayment for days 7 through 90, while upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $125 copay for outpatient hospital services and a $125 copay per stay for observation services. Ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services are covered with no copays and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Chronic Care (HMO C-SNP) covers partial hospitalization services with prior authorization, requiring no coinsurance and copays ranging from no copay to $180.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers ground ambulance services with a $125 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $25 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 lifetime maximum with no coinsurance and copays ranging from $125 to $150.
Primary Care See details
Primary Care benefits are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance for primary care visits, specialist services, physical and occupational therapy, mental health, and podiatry, though chiropractic services are not covered. Additional telehealth benefits are also available with a 20% coinsurance and a copay ranging from $0 to $25.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance for most services, except for kidney disease education which carries a 20% coinsurance and no copay. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, 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) offers partially covered hearing services with no copay, no coinsurance, and no deductible for routine exams, fitting evaluations, and Medicare-covered exams. Prescription hearing aids are covered up to $1,000 per ear every year 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
Vision services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay, no coinsurance, and no deductible for covered services, including routine eye exams and eyewear up to a $300 annual limit. While contact lenses and complete eyeglasses are covered, individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance for covered services, up to a maximum plan benefit of $2,000 per year. While exams, cleanings, and various restorative services are covered, fluoride treatments, other preventive dental services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are 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 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Chronic Care (HMO C-SNP) covers medical equipment with no copay for all categories, though prior authorization is required. Durable medical equipment carries a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and both medical supplies and diabetic equipment (limited to specified manufacturers) have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers diagnostic and radiological services, with prior authorization and referrals required for care. Diagnostic tests and procedures have a $0 to $25 copay and no coinsurance, lab services and diagnostic radiology have no copay, and therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services, including intensive cardiac, pulmonary, and supervised exercise therapy for symptomatic peripheral artery disease, are not covered by the Aetna Medicare Chronic Care (HMO C-SNP) plan.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Aetna Medicare Chronic Care (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, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Aetna Medicare Chronic Care (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for chronic illness meals, wellness and mammography screenings, and a monthly $60 over-the-counter item reimbursement. Acupuncture is not covered under this plan.
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