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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Chronic Care (HMO C-SNP) is a HMO C-SNP plan offered by Aetna Health Inc. (FL) available for the 2026 plan year 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
Health deductible: information not available.
This plan has a $200.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4200.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $4200.00 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)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
Drug Coverage
The Aetna Medicare Chronic Care (HMO C-SNP) plan features a $200 annual drug deductible. You can maximize your savings by using preferred pharmacies or preferred mail-order services, which offer no copay for Tier 1 preferred generic and Tier 2 generic drugs. Standard pharmacies and standard mail-order options are also available but require copays ranging from $2 to $36 depending on the drug tier and supply duration. For brand-name and specialty medications, costs are based on 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 carry a 30% coinsurance across all pharmacy types. Note that Tier 5 specialty drugs are limited to a 1-month supply.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan provides comprehensive medical coverage with no copays for primary care visits, annual physicals, and home health services, while specialist visits require a copay of up to ten dollars. Inpatient hospital stays feature no coinsurance, requiring a daily copay of two hundred twenty-five dollars for the first six days and no copay for days seven through ninety. Emergency care is accessible with a one hundred fifty dollar copay, which is waived if you are admitted, and urgently needed services carry a forty dollar copay. This plan also includes valuable supplemental benefits, such as a two thousand dollar annual maximum for dental care with no copays or coinsurance for most preventive and comprehensive services. Vision and hearing benefits feature no copays for routine annual exams, plus a three hundred dollar yearly allowance for eyewear and up to one thousand dollars per ear annually for prescription hearing aids. Additionally, members receive a fifty-five dollar monthly over-the-counter reimbursement and chronic illness meals with no copays or coinsurance.
Inpatient Hospital See details
Aetna Medicare Chronic Care (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $225 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered, as 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 $225 copay for outpatient hospital services and a $225 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $5 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Chronic Care (HMO C-SNP) covers partial hospitalization services with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers ambulance services with prior authorization, charging a $225.00 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services are not covered under this plan.
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 up to a $250,000 maximum benefit with no coinsurance and copays ranging from $150 to $225.
Primary Care See details
Aetna Medicare Chronic Care (HMO C-SNP) provides primary care and routine podiatry services with no copay and no coinsurance, while specialist visits require a $0 to $10 copay and no coinsurance. Physical, occupational, speech, mental health, psychiatric, and opioid treatment therapies carry a $5 copay and no coinsurance, though chiropractic services are not covered and telehealth options have a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), offering no copay and no coinsurance for annual physicals, health education, fitness benefits, remote access technologies, smoking cessation, and select screenings, though kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered 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) covers hearing exams with a $10 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations, all with no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, but inner ear, outer ear, over the ear, and OTC 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. The plan covers one annual routine eye exam, unlimited follow-up diabetic eye exams, and up to $300 yearly for contact lenses and up to two pairs of eyeglasses, though individual eyeglass lenses and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), offering a $2,000 annual maximum with no copay and no coinsurance for most preventive and comprehensive dental care, while Medicare-covered dental services require a $10 copay and no coinsurance. Covered benefits include cleanings, X-rays, and various restorative and surgical services, but fluoride treatments, other preventive services, maxillofacial prosthetics, implants, 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 insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B 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. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copays for any services, though prior authorization is required. Durable medical equipment carries a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and both medical and diabetic supplies feature no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan, with all services requiring referrals and prior authorization. Lab services feature no copay and no coinsurance, diagnostic tests have a $0 to $40 copay with no coinsurance, and radiological services require copays (starting at no copay for diagnostic radiological and X-ray services) and coinsurance, including a minimum 20% coinsurance for therapeutic services.
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 technically covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay, no coinsurance, and a referral, but the benefit is not covered in practice. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a three-day prior hospital stay is not required for admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Chronic Care (HMO C-SNP) partially covers other services with no copay and no coinsurance, which includes a monthly $55 over-the-counter reimbursement benefit, chronic illness meals, annual wellness exams, and additional cancer screenings. Acupuncture is not covered under this plan.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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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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