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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 West 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 $4200.00 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. You can maximize your savings on generic medications, as there is no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled through a preferred pharmacy or preferred mail-order service. Standard pharmacies and mail-order options are also cost-effective, with copays starting at $2 for Tier 1 and $12 for Tier 2 prescriptions. For brand-name and specialty medications, your costs are determined by coinsurance 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 to all pharmacy and mail-order options, with Tier 5 specialty drugs 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 doctor visits, while specialist visits require no copay to a $20 copay. For inpatient hospital stays, members pay no coinsurance and a daily copay of $295 for days one through seven, followed by no copay for days eight through 90. Emergency care is covered with a $150 copay, and urgent care features a $40 copay, both with no coinsurance. Additional benefits include routine dental, vision, and hearing exams with no copay and no coinsurance, alongside a $1,000 annual maximum for dental services and up to $1,000 per ear yearly for prescription hearing aids. Eyewear is also covered with no copay up to a $200 annual maximum. Furthermore, members benefit from home health services and medical supplies with no copay or coinsurance, alongside a $35 monthly over-the-counter reimbursement.
Inpatient Hospital See details
Aetna Medicare Chronic Care (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a daily copay of $295 for days 1 through 7 and no copay for days 8 through 90. This benefit is partially covered because additional days, upgrades, and non-Medicare-covered stays 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 $295 copay for outpatient hospital services, a $295 copay per stay for observation services, and a $10 copay for outpatient substance abuse sessions. Ambulatory surgical center services and outpatient blood services are also covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance and a copay of either $55.00 or $180.00. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with prior authorization, requiring a $275.00 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or other 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 $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $150 to $275, up to a maximum benefit of $250,000.
Primary Care See details
Aetna Medicare Chronic Care (HMO C-SNP) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $20 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies are covered with a $10 copay and no coinsurance, while chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physicals, health education, and screenings, though kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered under this plan include medical nutrition therapy, weight management programs, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), featuring a $20 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are covered up to $1,000 per ear yearly with no copay or coinsurance, but OTC hearing aids and inner-ear, outer-ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers vision services with no copay and no coinsurance, including one routine eye exam and follow-up diabetic eye exams annually. Eyewear is partially covered with no copay and no coinsurance up to a $200 annual maximum for contact lenses, upgrades, and up to two pairs of eyeglasses, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan, which offers up to a $1,000 annual maximum with no copay and no coinsurance for covered preventive and comprehensive services, while Medicare-covered dental services require a $20 copay and no coinsurance. Specific services not covered under this plan include fluoride treatments, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics.
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. Covered Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan 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 (HMO C-SNP) with no copays, although prior authorization is required. Durable medical equipment has a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and medical and diabetic supplies feature no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance for diagnostic services, which include lab services at no copay and diagnostic tests with a $0 to $45 copay. Outpatient X-rays have no copay, diagnostic radiological services carry a minimum copay of $0, and therapeutic radiological services require a 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance, although in practice only some services are covered. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Chronic Care (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 to 20 and a daily copay of $218 for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance for covered benefits, which include a $35 monthly over-the-counter reimbursement, chronic illness meal benefits, annual wellness exams, and additional colorectal screenings. Acupuncture and highly integrated dual-eligible services are not covered.
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