A non-government entity
Aetna Medicare FIDE (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare FIDE (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare FIDE (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare FIDE (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Virginia. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare FIDE (HMO D-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 FIDE (HMO D-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 FIDE (HMO D-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 FIDE (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.60. 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 $9250.00 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 FIDE (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare FIDE (HMO D-SNP) prescription drug plan has an annual drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs purchased at standard pharmacies or through standard mail order. This no copay benefit applies to one-month, two-month, and three-month supplies of these essential generic medications. For brand-name and specialty prescriptions, cost-sharing is based on coinsurance percentages at standard pharmacies and standard mail order. Tier 3 (Preferred Brand) drugs have a 22% coinsurance, while Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) medications require a 25% coinsurance. These coinsurance rates apply to one-, two-, and three-month supplies, with Tier 5 specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare FIDE (HMO D-SNP) offers comprehensive medical coverage, featuring no copay and a standard 20% coinsurance for primary care, specialist visits, dialysis, and outpatient hospital services. Inpatient hospital stays require a copay of $2,230 per acute stay and $2,080 per psychiatric stay, while emergency room visits carry a $115 copay that is waived if you are admitted. Additionally, skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. Preventive care, home health services, and diagnostic hearing exams are covered with no copay and no coinsurance. Covered preventive and comprehensive dental services also feature no copay or coinsurance up to a $3,000 annual maximum, though routine vision exams and eyewear are not covered. Members also benefit from a $280 monthly reimbursement for eligible over-the-counter items and no copay for home infusion services.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare FIDE (HMO D-SNP), requiring prior authorization and no coinsurance for covered stays. Medicare-covered acute stays require a $2,230 copay per stay and psychiatric stays require a $2,080 copay per stay, while additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Aetna Medicare FIDE (HMO D-SNP) covers outpatient services, including outpatient hospital, observation, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for outpatient hospital, observation, ambulatory surgical center, and substance abuse services.
Partial Hospitalization See details
Aetna Medicare FIDE (HMO D-SNP) covers partial hospitalization services with prior authorization, which cost either a 20% coinsurance with no copay or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare FIDE (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare FIDE (HMO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $250,000 lifetime limit.
Primary Care See details
Aetna Medicare FIDE (HMO D-SNP) covers primary care, specialist, therapy, and mental health services with no copay and a 20% coinsurance. Chiropractic services are not covered, while routine podiatry is covered for up to six visits per year with a 20% coinsurance and no copay. Telehealth services are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare FIDE (HMO D-SNP), featuring no copay and no coinsurance for annual physicals, fitness benefits, and health education, while kidney disease education and glaucoma screenings require a 20% coinsurance with no copay. Services not covered under this benefit include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Aetna Medicare FIDE (HMO D-SNP) covers hearing exams with no copay, no coinsurance, and no deductible, though routine exams and fitting evaluations are not covered. Additionally, some prescription hearing aid services are covered, but OTC hearing aids and all prescription types—including inner ear, outer ear, and over-the-ear devices—are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare FIDE (HMO D-SNP), which features follow-up diabetic eye exams with no copay and no coinsurance. Routine eye exams and all eyewear services, including contact lenses and eyeglasses, are not covered under this plan.
Dental Services See details
Aetna Medicare FIDE (HMO D-SNP) dental services are partially covered, with exclusions for prophylaxis (cleanings), maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require no copay and a 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $3,000 annual maximum.
Home Infusion bundled Services See details
Aetna Medicare FIDE (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin has a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and standard drugs require a coinsurance between 0% and 20%.
Dialysis Services See details
Aetna Medicare FIDE (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance, with prior authorization required.
Medical Equipment See details
Aetna Medicare FIDE (HMO D-SNP) covers medical equipment with no copays, although prior authorization is required. Plan members pay a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic shoes or inserts, while diabetic supplies are covered with no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare FIDE (HMO D-SNP) covers diagnostic and radiological services with no copayments, though prior authorization is required. Covered diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays carry a 20% coinsurance, while diagnostic radiological services are covered with no coinsurance.
Home Health Services See details
Aetna Medicare FIDE (HMO D-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare FIDE (HMO D-SNP) with no copay; however, only some services are covered, and cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare FIDE (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering 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
Aetna Medicare FIDE (HMO D-SNP) partially covers other services, offering over-the-counter (OTC) items, annual wellness exams, screening mammographies, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan, though eligible OTC items are covered up to $280 monthly via reimbursement.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* 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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved