A non-government entity
Aetna Medicare Full Dual Care (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Full Dual Care (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 Full Dual Care (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Full Dual Care (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Select Counties Statewide in AR. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Full Dual Care (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 Full Dual Care (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 Full Dual Care (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 Full Dual Care (HMO D-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 $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 Full Dual Care (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 Full Dual Care (HMO D-SNP) plan features an Enhanced Alternative drug benefit with a $615.00 prescription drug deductible. Individuals who qualify for the Low-Income Subsidy (LIS or "Extra Help") can reduce their Part D premium and LIS costs to $0. During the initial coverage phase, standard pharmacy costs include no copay for Tier 1 preferred generic drugs, 22% coinsurance for Tier 2 standard generics, and 25% coinsurance for Tier 3 preferred brands and Tier 4 non-preferred drugs. These initial coverage rates apply until your total drug costs reach $2,100.00. Once your yearly out-of-pocket drug costs reach this $2,100.00 threshold, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D prescription drugs.
Additional Benefits
The Aetna Medicare Full Dual Care (HMO D-SNP) plan offers robust medical coverage where many outpatient, primary care, and diagnostic services require no copay and a 20% coinsurance. For inpatient hospital stays, members pay a $2,050 copay per stay with no coinsurance, while emergency room visits carry a $115 copay that is waived upon admission. Additionally, routine home health services and telehealth visits are fully covered with no copay and no coinsurance. This plan also features valuable supplemental benefits, including preventive and restorative dental care with no copay and no coinsurance up to a $3,750 annual limit. Members benefit from a $375 annual eyewear allowance and up to $1,250 per ear for prescription hearing aids with no copay or coinsurance. Other key perks include a $190 monthly over-the-counter item allowance and up to 36 routine one-way transportation trips per year with no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Full Dual Care (HMO D-SNP) offers partially covered inpatient hospital benefits with a $2,050 copay per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Room upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered under this plan.
Outpatient Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these covered outpatient services.
Partial Hospitalization See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers partial hospitalization benefits with a $110.00 copay and 20% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 36 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, while worldwide emergency services are available with no copay up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers primary care, specialist, therapy, and psychiatric services, generally requiring a 20% coinsurance and no copay. Telehealth services are covered with no copay and no coinsurance, while routine chiropractic and podiatry services are covered with no copay and a 20% coinsurance.
Preventive Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) partially covers preventive services, with no copay and no coinsurance for annual physicals, fitness benefits, and health education, but a 20% coinsurance and no copay for kidney education and other select screenings. Sub-services that are not covered under this plan include in-home safety assessments, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, counseling, weight management, telemonitoring, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, and enhanced disease management.
Hearing Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers hearing services, including routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with no copay and no coinsurance up to $1,250 per ear annually, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers vision services with no deductibles, including one routine eye exam per year with no copay and 20% coinsurance. Additionally, the plan provides a $375 annual allowance for eyewear, offering contact lenses with no copay and 20% coinsurance, and eyeglasses, lenses, frames, and upgrades with no copay.
Dental Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) partially covers dental services, excluding maxillofacial prosthetics, implant services, and orthodontics. Most covered preventive and restorative services require no copay and no coinsurance up to a $3,750 annual limit, while Medicare-covered dental services require a 20% coinsurance and no copay.
Home Infusion bundled Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers home infusion bundled services with prior authorization, featuring a $35 copay and no coinsurance for Medicare Part B insulin. Other covered Part B chemotherapy, radiation, and miscellaneous drugs require no copay and carry a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Full Dual Care (HMO D-SNP) with no copays, though prior authorization is required. Durable medical equipment, prosthetics, medical supplies, and diabetic shoes or inserts carry a 20% coinsurance, while diabetic supplies are covered with no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under Aetna Medicare Full Dual Care (HMO D-SNP) with no copay for all diagnostic, lab, and radiological procedures. Prior authorization is required, and members will pay between no coinsurance and 20% coinsurance depending on the specific service.
Home Health Services See details
Aetna Medicare Full Dual Care (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 not covered under the Aetna Medicare Full Dual Care (HMO D-SNP) plan, meaning there is no coverage, copay, or coinsurance for cardiac, pulmonary, or supervised exercise therapy rehabilitation.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Full Dual Care (HMO D-SNP), as additional days beyond Medicare-covered stays are not covered. For covered stays, there is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance, with prior authorization required.
Other Services See details
Aetna Medicare Full Dual Care (HMO D-SNP) partially covers other services with no copay and no coinsurance for covered benefits, including chronic illness meal benefits, wellness exams, and a $190 monthly over-the-counter item allowance. Acupuncture and dual eligible SNPs with highly integrated services are not covered under this plan.
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