A non-government entity
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.
Aetna Medicare Chronic Care Total (HMO C-SNP) is a HMO C-SNP plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Upstate South Carolina. 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 $17.20. 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
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 Chronic Care Total (HMO C-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 Chronic Care Total (HMO C-SNP) plan features an annual prescription drug deductible of $615. Beneficiaries enjoy no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through standard mail order for up to a three-month supply. For higher-tier medications, the plan transitions to a coinsurance model. You will pay a 25% coinsurance for Tier 3 (Preferred Brand) and Tier 4 (Non-Preferred Drug) medications, as well as a 25% coinsurance for a one-month supply of Tier 5 (Specialty Tier) drugs filled at standard pharmacies or through standard mail order.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers robust coverage for everyday healthcare needs, featuring no copay and no coinsurance for primary care visits. For more intensive care, inpatient hospital stays require an $1,820 copay per admission with no coinsurance, while outpatient services generally have no copay and coinsurance ranging from 0% to 20%. Emergency room visits carry a $115 copay, which is waived if you are admitted, and urgent care services are available with a $40 copay. This plan also includes strong supplemental benefits, including dental coverage up to a $2,000 annual limit and vision eyewear up to a $200 yearly maximum, both with no copay or coinsurance. Additionally, members benefit from hearing aid coverage up to $1,250 per ear annually and a $125 monthly allowance for over-the-counter items with no copay or coinsurance. Skilled nursing facility care is also highly accessible, offering no copay or coinsurance for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers inpatient acute and psychiatric hospital stays with a $1,820 copay per admission and no coinsurance, though prior authorization is required. This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers outpatient hospital, ambulatory surgical, and observation services with no copay and coinsurance ranging from 0% to 20%. Outpatient substance abuse services are covered with no copay and 20% coinsurance, while outpatient blood services have no copay and no coinsurance.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under the Aetna Medicare Chronic Care Total (HMO C-SNP) include ground and air ambulance services covered with a 20% coinsurance and no copay, though prior authorization is required. Routine transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Aetna Medicare Chronic Care Total (HMO C-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 require a $40 copay and no coinsurance, while worldwide emergency and urgent care are covered up to a $250,000 maximum with a $115 copay and no coinsurance, plus 20% coinsurance for worldwide emergency transportation.
Primary Care See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers primary care and podiatry services with no copay and no coinsurance, while chiropractic services are not covered in practice. Specialist visits, therapies, and mental health services feature no copay and 0% to 20% coinsurance, and telehealth benefits are available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under Aetna Medicare Chronic Care Total (HMO C-SNP), with no copay and no coinsurance for annual physical exams, health education, smoking cessation counseling, memory fitness, and remote access technologies. Other covered benefits, including kidney disease education, glaucoma screenings, diabetes self-management training, digital rectal exams, and post-welcome-visit EKGs, feature no copay but require a 20% coinsurance. Several supplemental benefits are not covered, including in-home safety assessments, personal emergency response systems, weight management programs, and medical nutrition therapy.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), featuring annual routine exams with a 20% coinsurance and no copay, alongside fitting evaluations with no copay. Prescription hearing aids are covered up to $1,250 per ear yearly with no copay or coinsurance, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers vision services with no deductibles, offering yearly routine and follow-up diabetic eye exams with no copay, though some exams may carry a 0% to 20% coinsurance. Eyewear, including contacts and eyeglasses, is covered with no copay and no coinsurance up to a $200 annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), offering Medicare-covered dental services with no copay and a 20% coinsurance, and other dental services with no copay and no coinsurance up to a $2,000 annual maximum. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Part B insulin carries a $35 copay with no coinsurance, while chemotherapy and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers medical equipment with no copay for durable medical equipment (DME), medical supplies, and diabetic supplies. Coinsurance ranges from 0% to 20% for DME 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 prior authorization required and no copayments. You will pay no coinsurance for diagnostic procedures, lab services, and diagnostic radiological services, while a 20% coinsurance applies to therapeutic radiological services and outpatient X-rays.
Home Health Services See details
Home health services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) provides Cardiac Rehabilitation Services, and while some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered in practice. Eligible cardiac and intensive cardiac rehabilitation services have no copay, whereas pulmonary 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 prior authorization and no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), featuring no copay and no coinsurance for over-the-counter items up to $125 monthly, annual wellness exams, and additional cancer screenings. Acupuncture and meal benefits 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