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Aetna Medicare Chronic Care (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care (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 (HMO C-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Chronic Care (HMO C-SNP) is a HMO C-SNP plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Charlotte Metro North 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 (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 (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 (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 (HMO C-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 $6750.00 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:
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Drug Coverage
The Aetna Medicare Chronic Care (HMO C-SNP) plan features an annual drug deductible of $615. Under the initial coverage phase, Tier 1 preferred generic drugs have no copay when filled at preferred pharmacies or through preferred mail order. For Tier 2 generic medications, copays start as low as $5 for a one-month supply at preferred locations, while standard pharmacies and mail-order services charge higher copays. Brand-name and specialty medications are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These coinsurance rates apply uniformly across both preferred and standard pharmacy and mail-order options.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan offers comprehensive medical coverage with predictable cost-sharing, featuring no copay for primary care visits and preventive screenings. Specialist visits and outpatient services generally range from no copay up to a $45 or $382 copay, depending on the service, with no coinsurance required. Emergency care is covered with a $130 copay, while inpatient hospital stays require daily copays for the first eight days before transitioning to no copay for the remainder of the stay. This plan also includes essential wellness benefits, offering routine dental, vision, and hearing exams with no copay. Members receive allowances for hardware, including up to $100 annually for eyewear and up to $500 per ear annually for prescription hearing aids with no copay. Additionally, the plan provides up to $40 monthly for over-the-counter items and covers home health services with no copay.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, featuring a daily copay of $382 for days 1 to 8 of an acute stay and $292 for days 1 to 8 of a psychiatric stay, followed by no copay for days 9 to 90. This benefit is partially covered, as additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, including ambulatory surgical center and blood services which feature no copay. Outpatient hospital copays range from no copay to $382, while observation services cost a $382 copay per stay and outpatient substance abuse sessions require a $25 copay.
Partial Hospitalization See details
Aetna Medicare Chronic Care (HMO C-SNP) covers partial hospitalization services with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Aetna Medicare Chronic Care (HMO C-SNP), which features ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance transport, and routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum with no coinsurance, requiring a $130 copay for emergency or urgent care and a $275 copay for emergency transportation.
Primary Care See details
Primary care benefits under Aetna Medicare Chronic Care (HMO C-SNP) are partially covered, as routine and other chiropractic services are not covered. Covered services like primary care visits and podiatry have no copay and no coinsurance, while specialists, therapies, and mental health services require no coinsurance and copays ranging from $0 to $45. Telehealth services are also available with a 20% coinsurance and a $0 to $50 copay.
Preventive Services See details
Preventive services are partially covered under Aetna Medicare Chronic Care (HMO C-SNP), featuring no copay and no coinsurance for annual exams and screenings, while kidney disease education has no copay and a 20% coinsurance. Excluded sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), offering Medicare-covered exams for a $45 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids have no copay or coinsurance with a $500 maximum benefit per ear annually, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, featuring no copay for annual routine and follow-up diabetic eye exams, and a $0 to $45 copay for Medicare-covered exams. The plan also covers eyewear, including contact lenses and eyeglasses, with no copay and no coinsurance up to a $100 annual maximum allowance.
Dental Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers partially covered dental services, featuring Medicare-covered dental care for a $45 copay and no coinsurance, plus routine exams, cleanings, and X-rays with no copay and no coinsurance. Restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, fluoride, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copays, though prior authorization is required. Durable medical equipment and medical supplies carry a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and diabetic equipment is covered with no coinsurance from specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers diagnostic and radiological services, requiring prior authorization for both. Diagnostic procedures and tests have a copay ranging from $0 to $200 with no coinsurance, while lab services and outpatient X-rays are covered with no copay. Diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Chronic Care (HMO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and coverage does not extend to additional days beyond the standard Medicare-covered period.
Other Services See details
Aetna Medicare Chronic Care (HMO C-SNP) partially covers other services with no copay and no coinsurance, which includes an annual wellness exam, additional colorectal screenings, and up to $40 monthly in over-the-counter item reimbursements. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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