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Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Illinois statewide. The overall rating for this plan is not yet available for 2025.
It's important to know that Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan).
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan), 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan) has an enhanced alternative drug benefit. There is no deductible for prescription drugs. If you qualify for the low-income subsidy, you will not pay anything for your Part D drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) offers a wide range of benefits with many services available with no copay, including primary care, emergency services, and home health. The plan also includes coverage for hearing and vision services such as routine eye exams, and hearing exams. You'll have access to dental services, including oral exams and cleanings. This plan also covers ambulance services and offers a monthly allowance for over-the-counter (OTC) items, as well as a meal benefit. Some services, like outpatient and inpatient services, and skilled nursing facility (SNF) services, require prior authorization. The plan covers prescription hearing aids with a limit, and eyeglasses, but excludes coverage for certain services such as cardiac rehabilitation and private duty nursing.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, with prior authorization required. Additional days and non-Medicare-covered stays are covered for both, but upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services are covered under the Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan), including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, with prior authorization required for some services. Outpatient Substance Abuse Services are partially covered, but individual and group sessions are not covered.
Partial Hospitalization See details
Partial Hospitalization benefits are covered, but require prior authorization. There is no information about the cost of this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no copay and no coinsurance for all ambulance services. Transportation Services to a plan-approved health-related location are covered, while ground and air ambulance services, as well as transportation services to any other health-related location, are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered with no copay and no coinsurance, however, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) covers primary care physician services, occupational therapy, physician specialist services, podiatry services, other health care professionals, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay and no coinsurance. Chiropractic services are partially covered, but routine chiropractic care is not covered, and mental health specialty services and psychiatric services are partially covered, but individual and group sessions are not covered.
Preventive Services See details
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) covers preventive services, including Medicare-covered preventive services with no copay, and additional preventive services such as health education, smoking cessation counseling (42 visits), fitness benefits (Memory Fitness), Remote Access Technologies, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit. Annual physical exams, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers of enrollees, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, and counseling services are not covered.
Hearing Services See details
Hearing services are covered, including routine hearing exams and fitting/evaluation for hearing aids, with no copay. Prescription hearing aids (all types) are covered with a limit of one every three years, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) covers vision services including routine eye exams once per year, and other eye exam services as medically necessary. The plan also covers contact lenses as medically necessary, and eyeglasses (lenses and frames) once every two years; however, eyeglass frames and upgrades are not covered.
Dental Services See details
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) covers dental services including oral exams, dental x-rays, prophylaxis (cleaning), and fluoride treatment, with a limit of one visit every six months for each service; however, implant services and orthodontics are not covered. This plan also covers restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, removable, maxillofacial prosthetics, prosthodontics, fixed, and oral and maxillofacial surgery.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs are also covered, and this plan does not have a service-specific maximum out-of-pocket cost. Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered by the Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan). There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment and Prosthetics/Medical Supplies with no copay or coinsurance. However, Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by the Aetna Better Health Premier Plan MMAI plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan), including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Better Health Premier Plan MMAI, and include additional days beyond Medicare-covered and non-Medicare-covered stays. Prior authorization is required for SNF services.
Other Services See details
The Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) covers Over-the-Counter (OTC) Items with a maximum benefit coverage amount of $60.00 every month, and covers a Meal Benefit with prior authorization required. The plan also covers Institution for Mental Disease Services for Individuals 65 or Older, Nursing Home Services, and other services such as Hospice, Behavioral Health, Telehealth, Emergency Dental, Cell Phone Benefit, Tobacco Cessation Counseling for Pregnant Women, Medication Assisted Treatment (MAT), Crisis Services (Expanded), and Gender-Affirming Services. Acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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.
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