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Aetna Medicare Chronic Care Value (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care Value (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 Value (HMO C-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Chronic Care Value (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 Value (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 Value (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 Value (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 Value (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $36.20. 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:
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Drug Coverage
The Aetna Medicare Chronic Care Value (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for 1-month, 2-month, or 3-month supplies at standard pharmacies and standard mail order. Tier 2 generic drugs require a low $5 copay for a 1-month supply, with 3-month supplies costing $15 at standard pharmacies and $10 through standard mail order. For higher-tier medications, the plan charges a consistent 25% coinsurance at standard pharmacies and standard mail order. This 25% coinsurance rate applies to Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs. While Tiers 3 and 4 allow for 1-month, 2-month, and 3-month supplies, the 25% coinsurance for Tier 5 specialty drugs is limited to a 1-month supply.
Additional Benefits
The Aetna Medicare Chronic Care Value (HMO C-SNP) plan offers robust coverage for everyday healthcare needs, featuring no copay and no coinsurance for primary care doctor visits, routine eye exams, and annual physicals. Specialist visits require a copay of $0 to $30, while inpatient hospital stays require a daily copay of $399 for the first six days of acute stays with no coinsurance. Emergency care is available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. For additional wellness needs, the plan provides dental coverage up to a $1,000 annual maximum and hearing aid coverage up to $750 per ear annually with no copay. Members also benefit from a $50 monthly reimbursement for over-the-counter items and no copay for home health services. Standard diagnostic lab services and outpatient X-rays are also covered with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with no coinsurance, though prior authorization is required. This partially covered benefit requires a daily copay of $399 for days 1 to 6 of acute stays and $260 for days 1 to 8 of psychiatric stays (with no copay for subsequent days), while additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with no coinsurance, including ambulatory surgical center and blood services at no copay. Outpatient hospital services require a copay of $0 to $399, observation services cost a $399 copay per stay, and outpatient substance abuse sessions have a $25 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) 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 are partially covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan, though transportation services to health-related locations are not covered. Medicare-covered ground ambulance services require a $275 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for all ambulance services.
Emergency Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $40 copay with no coinsurance, and worldwide emergency services are covered up to $250,000 with no coinsurance and copays ranging from $115 to $275.
Primary Care See details
Primary Care benefits under the Aetna Medicare Chronic Care Value (HMO C-SNP) feature no copay and no coinsurance for primary care doctor visits, while specialist visits require a $0 to $30 copay and no coinsurance. Physical and occupational therapy services have a $35 copay and no coinsurance, whereas chiropractic services are only partially covered because routine and other chiropractic care are not covered.
Preventive Services See details
Preventive Services under Aetna Medicare Chronic Care Value (HMO C-SNP) are partially covered, featuring an annual physical exam, health education, and select screenings with no copay and no coinsurance, alongside kidney disease education with no copay and 20% coinsurance. However, sub-services such as 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/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling are not covered.
Hearing Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers Medicare-covered hearing exams for a $30 copay and no coinsurance, while routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $750 maximum per ear annually, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers vision services with no coinsurance, offering routine eye exams and follow-up diabetic exams with no copay, while other eye exams have a copay of $0 to $30. Covered eyewear, including contacts, eyeglasses, and frames, has no copay and no coinsurance up to a combined maximum benefit of $100 annually.
Dental Services See details
Dental services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP), with Medicare-covered dental requiring a $30 copay and no coinsurance, and other covered dental services having no copay and no coinsurance up to a $1,000 annual maximum. This benefit is partially covered, as maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B insulin drugs under this benefit have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers medical equipment, offering durable medical equipment (DME) and medical supplies with no copay and a 0% to 20% coinsurance. Prosthetic devices are covered with no copay and a 20% coinsurance, while diabetic supplies and therapeutic shoes are available with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with prior authorization required. Diagnostic procedures and tests carry a $0 to $200 copay with no coinsurance, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers cardiac rehabilitation services with no copay and no coinsurance, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
The Aetna Medicare Chronic Care Value (HMO C-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond Medicare-covered limits are not covered.
Other Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) partially covers other services with no copay and no coinsurance for over-the-counter items (up to $50 monthly via reimbursement), annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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