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Aetna Medicare Chronic Care Total (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care Total (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 Total (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 Total (HMO C-SNP) is a HMO C-SNP plan offered by Coventry Health Care of Missouri, Inc. available for the 2026 plan year to people living in Kansas City Metro Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Chronic Care Total (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 Total (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 Total (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 Total (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $55.20. 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 $615.00 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 $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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 Total (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 Total (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one-month, two-month, or three-month supplies through standard pharmacies and standard mail order. Tier 2 generic drugs are also affordable, with standard copays ranging from $5.00 for a one-month supply up to $15.00 at standard pharmacies or $10.00 via standard mail order for a three-month supply. For brand-name and specialty medications, the plan transitions to a coinsurance model. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail order services. Note that Tier 5 specialty drugs are limited to a one-month supply under these cost-sharing terms.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers comprehensive medical coverage with no copays for primary care, outpatient services, and home health care. Inpatient hospital stays require fixed copayments of $2,230 for acute care and $2,080 for psychiatric care with no coinsurance. Specialist visits, diagnostic services, and emergency care are also covered, featuring low or no copayments and coinsurance ranging from 0% to 20% depending on the service. Members benefit from supplemental coverage including dental services up to $975 annually and eyewear up to $175 annually with no copays or coinsurance. Routine hearing exams and medical equipment generally require a 20% coinsurance, while prescription hearing aids are covered up to $500 per ear. Additionally, the plan provides a generous $200 monthly allowance for over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers inpatient hospital services with no coinsurance, requiring a copayment of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. This benefit is partially covered, as prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers outpatient services with no copays, though prior authorization and a 0% to 20% coinsurance may apply to hospital, ambulatory surgical, and substance abuse services. Outpatient blood services are fully covered with no copay, no deductible, and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 6 one-way trips per year to plan-approved locations with no copay or coinsurance, though trips to other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers emergency services with a $115 copay and no coinsurance (waived if admitted to the hospital within 24 hours), and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent services are covered up to a $250,000 maximum with a $115 copay and no coinsurance, while worldwide emergency transportation requires a 20% coinsurance and no copay.
Primary Care See details
Primary care benefits are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), as routine and other chiropractic services are not covered. Covered services, including primary care and podiatry, feature no copay and no coinsurance, while specialist visits, therapies, and mental health services require no copay and 0% to 20% coinsurance.
Preventive Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers preventive services, including annual physical exams and screenings, with no copay and no coinsurance, though kidney disease education requires no copay and a 20% coinsurance. Additional supplemental benefits are partially covered with no copay and no coinsurance, excluding services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductible, featuring annual routine hearing exams for a 20% coinsurance and no copay, and fitting evaluations at no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductibles, featuring routine eye exams with no copay and a 20% coinsurance (limited to one per year) and other eye exams with no copay and no coinsurance. Covered eyewear, including contacts, lenses, frames, and upgrades, has no copay and no coinsurance up to a combined maximum benefit of $175 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), offering Medicare-covered dental with no copay and 20% coinsurance, and other preventive and comprehensive dental services with no copay and no coinsurance up to a $975 yearly maximum. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay, though prior authorization is required. Covered Medicare Part B insulin requires a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by the Aetna Medicare Chronic Care Total (HMO C-SNP) 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 Total (HMO C-SNP) with no copay for durable medical equipment, medical supplies, and diabetic supplies. Coinsurance ranges from 0% to 20% for durable medical equipment and medical supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers diagnostic and radiological services with no copays, though prior authorization is required. There is no coinsurance for diagnostic tests, lab services, and diagnostic radiology, while therapeutic radiology and outpatient X-rays require a 20% coinsurance.
Home Health Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Aetna Medicare Chronic Care Total (HMO C-SNP), but some services are covered while Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) are not covered. There is no copay for Cardiac and Intensive Cardiac Rehabilitation, while Pulmonary Rehabilitation and SET for PAD services require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day inpatient hospital stay is not needed for admission, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for annual wellness exams, screening mammographies, additional colorectal screenings, and over-the-counter (OTC) items up to $200 monthly. Acupuncture and meal benefits are not covered.
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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