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 IN Northwest. This plan received an overall rating of 3 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 $38.40. 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. Under this plan, Tier 1 preferred generic drugs have no copay for one, two, or three-month supplies filled at standard pharmacies or through standard mail order. Tier 2 generic medications cost a $5 copay for a one-month supply, with standard mail order capping three-month supplies at a $10 copay. For brand-name and specialty medications, the plan transitions to coinsurance costs. Tier 3 preferred brands, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance at standard pharmacies and through standard mail order. Specialty tier drugs are limited to a one-month supply at this 25% coinsurance rate.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) offers comprehensive medical coverage with no copay for primary care, podiatry, and home health services. For specialized care, beneficiaries pay no copay and up to 20% coinsurance for specialists, while outpatient hospital services also feature no copays and a 0% to 20% coinsurance. Inpatient hospital stays require a copay of $2,230 per acute admission and $2,080 per psychiatric admission with no coinsurance, while emergency room visits carry a $115 copay. This plan also includes robust supplemental benefits, featuring no copays or coinsurance for routine dental and vision services up to annual limits, alongside a $1,000 per ear allowance for prescription hearing aids. Skilled nursing facility stays have no coinsurance and no copay for the first 20 days, followed by a $218 copay for days 21 through 100. Additionally, members benefit from an $83 monthly reimbursement for over-the-counter items and no copays for diagnostic and laboratory services.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers inpatient hospital services with prior authorization and no coinsurance. Medicare-covered acute stays require a $2,230 copay per admission and psychiatric stays require a $2,080 copay per admission, while upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) with no copays for all services, though coinsurance and prior authorization requirements apply to most. Beneficiaries pay a 0% to 20% coinsurance for outpatient hospital and ambulatory surgical center services, a 20% coinsurance for outpatient substance abuse services, and no coinsurance for outpatient blood services.
Partial Hospitalization See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers partial hospitalization services with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP), featuring a 20% coinsurance and no copay for ground and air ambulance services, which require prior authorization. While transportation is technically covered, only some services are covered, and transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers emergency services with a $115 copay (waived if admitted within 24 hours) and no coinsurance, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are covered up to a $250,000 limit with a $115 copay and no coinsurance, while worldwide emergency transportation is covered with a 20% coinsurance.
Primary Care See details
Aetna Medicare Chronic Care Total (HMO C-SNP) provides primary care physician and podiatry services with no copay and no coinsurance, while specialist, therapy, psychiatric, and mental health services have no copay and up to 20% coinsurance. Chiropractic services are not covered, and additional telehealth benefits are available with a copay of $0 to $40 and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), offering annual physical exams, health education, and fitness benefits with no copay and no coinsurance. While kidney disease education and screenings like glaucoma or diabetes training have no copay, they carry a 20% coinsurance, and several services such as in-home safety assessments and personal emergency response systems are not covered.
Hearing Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers hearing services, excluding OTC hearing aids and prescription hearing aids for the inner ear, outer ear, or over the ear. Routine exams require a 20% coinsurance and no copay, while fitting evaluations and up to two annual prescription hearing aids (up to $1,000 per ear) are provided with no copay and no coinsurance.
Vision Services See details
Vision services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductibles, offering routine eye exams with no copay and 0% to 20% coinsurance, and follow-up diabetic eye exams with no copay. Eyewear, including contacts, lenses, and frames, is covered with no copay and no coinsurance up to a $350 combined annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care Total (HMO C-SNP), with maxillofacial prosthetics, implant services, and orthodontics excluded from coverage. Medicare-covered dental services require no copay and 20% coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,500 yearly maximum.
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 is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copays, while coinsurance ranges from no coinsurance to 20% depending on the item. Prior authorization is required for these services, and diabetic therapeutic shoes or inserts as well as prosthetic devices carry 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, subject to prior authorization. Diagnostic procedures, lab services, and diagnostic radiological services have no coinsurance, while therapeutic radiological services and outpatient X-rays require a 20% coinsurance.
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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers some cardiac rehabilitation services, but cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered. Pulmonary and SET for PAD services require a 20% coinsurance, while cardiac and intensive cardiac rehabilitation services have no copay.
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 but allowing admission without a prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 copay for days 21 through 100, 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 with no copay and no coinsurance, including annual wellness exams, screening mammography, additional gFOBT and FIT tests, and up to $83 monthly in over-the-counter item reimbursements. 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