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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:
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Drug Coverage
The Aetna Medicare Chronic Care (HMO C-SNP) plan features an annual drug deductible of $200. Under this plan, you can benefit from no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) prescription drugs when filled through preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For higher-tier medications, the plan transitions from flat copays to coinsurance percentages. Tier 3 (Preferred Brand) drugs require a 25% coinsurance, while Tier 4 (Non-Preferred) drugs carry a 30% coinsurance regardless of your choice of pharmacy. Specialty medications in Tier 5 are also covered at a 30% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, routine podiatry, home health, and cardiac rehabilitation. For hospital care, members pay a $150 daily copay for the first six days of inpatient stays, while outpatient hospital services range from no copay to a $150 copay. Emergency care requires a $150 copay, which is waived if admitted, and urgent care carries a low $25 copay with no coinsurance. The plan also provides routine benefits, including vision services with no copay, coinsurance, or deductible, alongside dental and routine hearing care that feature no copay or coinsurance for most covered services. Vision care includes a $200 annual limit for eyewear, while dental and hearing aid benefits offer generous annual maximums of $2,000 and $1,000 per ear respectively. Additionally, members benefit from a $60 monthly allowance for over-the-counter items and no copay or coinsurance for chronic illness meals and annual physicals.
Inpatient Hospital See details
Aetna Medicare Chronic Care (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with a $150 daily copay for days 1 through 6, no copay for days 7 through 90, and 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 (HMO C-SNP) covers outpatient services with no coinsurance, featuring a $0 to $150 copay for outpatient hospital services, a $150 copay per stay for observation services, and a $5 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for most treatments.
Partial Hospitalization See details
Aetna Medicare Chronic Care (HMO C-SNP) covers partial hospitalization services with a copay ranging from $15.00 to $180.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Aetna Medicare Chronic Care (HMO C-SNP), with ground ambulance requiring a $315 copay and no coinsurance, and air ambulance requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and while transportation is technically covered, only some services are covered as trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers emergency services with a $150 copay (waived if admitted within 24 hours) and urgently needed services with a $25 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 limit with no coinsurance and copays ranging from $150 to $315.
Primary Care See details
Aetna Medicare Chronic Care (HMO C-SNP) provides primary care physician and routine podiatry services with no copay and no coinsurance, while specialist visits range from a $0 to $15 copay with no coinsurance. Physical, occupational, mental health, and speech therapies require a $5 copay and no coinsurance, telehealth services carry a $0 to $25 copay and 20% coinsurance, and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, health education, and wellness screenings, while kidney disease education has no copay but requires a 20% coinsurance. Some supplemental benefits are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing Services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), offering Medicare-covered exams for a $15 copay and no coinsurance. Routine hearing exams, fittings, and prescription hearing aids (up to $1,000 per ear annually) are covered with no copay and no coinsurance, though OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers vision services with no copay, no coinsurance, and no deductible, including one routine eye exam per year and unlimited follow-up diabetic eye exams. Eyewear is also covered with no copay or coinsurance up to a $200 annual maximum for contact lenses and up to two pairs of eyeglasses, though individual eyeglass lenses and frames are not covered separately.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), featuring a $15 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,000 annual maximum. Fluoride treatments, other preventive dental services, 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 (HMO C-SNP) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Chronic Care (HMO C-SNP) covers durable medical equipment (DME) with no copay and 0% to 20% coinsurance, and prosthetic devices with no copay and 20% coinsurance. Diabetic equipment, therapeutic shoes, and medical supplies are covered with no copay and no coinsurance. Prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers diagnostic and radiological services, requiring prior authorization and referrals for both. Diagnostic procedures and tests have no coinsurance and a copay of up to $25, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by 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 by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance, but a referral is required. Although some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy for peripheral artery disease 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, 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 Medicare-covered limit are not covered.
Other Services See details
Other services under the Aetna Medicare Chronic Care (HMO C-SNP) are partially covered, featuring no copay and no coinsurance for chronic illness meals, annual wellness exams, screening mammographies, additional gFOBT and FIT, and up to $60 monthly for over-the-counter items. Acupuncture is not covered under this plan.
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