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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.
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 Central. 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:
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Drug Coverage
The Aetna Medicare Chronic Care Total (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for up to a three-month supply at standard pharmacies and through standard mail order. Tier 2 generic drugs require a copay starting at $5 for a one-month supply, with standard mail order options capping at a $10 copay for a three-month supply. For higher-tier medications, including Tier 3 preferred brand and Tier 4 non-preferred drugs, members pay a 25% coinsurance for standard pharmacy and mail-order fills. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care Total (HMO C-SNP) plan offers comprehensive medical coverage with no copays or coinsurance for primary care visits, home health services, and routine preventive exams. For inpatient hospital stays, members pay a copay of $2,230 for acute care or $2,080 for psychiatric care per stay, while outpatient hospital services require no copay but carry a 0% to 20% coinsurance. Emergency care is accessible with a $115 copay, which is waived upon hospital admission, and urgent care visits require a $40 copay. Specialty care, diagnostic labs, and medical equipment feature no copays, though coinsurance typically ranges from 0% to 20%. Dental, vision, and hearing benefits are highly covered, featuring no copays and generous allowances, including up to a $2,250 annual dental maximum and a $350 annual limit for eyewear. Additionally, the plan covers skilled nursing facilities with no copay for the first 20 days and provides up to an $88 monthly reimbursement for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Chronic Care Total (HMO C-SNP) offers partially covered inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required for these services, while 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 coinsurance apply to most benefits. Outpatient hospital, ambulatory surgical center, and outpatient substance abuse services require a 0% to 20% coinsurance, while outpatient blood services are fully covered with no copay and no coinsurance.
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 receive these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) partially covers ambulance and transportation services, offering ground and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services to plan-approved or 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, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care is covered with a $40 copay and no coinsurance, while worldwide emergency services are covered up to $250,000 with a $115 copay and no coinsurance for care, and a 20% coinsurance with no copay for emergency transportation.
Primary Care See details
Primary care benefits under the Aetna Medicare Chronic Care Total (HMO C-SNP) plan feature no copay and no coinsurance for primary care doctor visits and podiatry services. Specialist visits, physical therapy, occupational therapy, and mental health services require no copay and 0% to 20% coinsurance, while chiropractic services are not covered in practice.
Preventive Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) offers annual physical exams, health education, and select preventive services with no copay and no coinsurance. Other covered services, including kidney disease education and glaucoma screenings, have no copay but require a 20% coinsurance. The benefit is partially covered, excluding services such as in-home safety assessments, personal emergency response systems, weight management programs, and medical nutrition therapy.
Hearing Services See details
Hearing services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no deductible, featuring annual routine exams for a 20% coinsurance and no copay, and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear yearly (excluding inner ear, outer ear, and over the ear types), but OTC hearing aids 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 0% to 20% coinsurance, and follow-up diabetic eye exams with no copay. Eyewear, including contacts, eyeglasses, frames, and upgrades, is also covered with no copay or coinsurance up to a $350 annual maximum.
Dental Services See details
Aetna Medicare Chronic Care Total (HMO C-SNP) offers partially covered dental services with a $2,250 annual maximum, featuring no copay and no coinsurance for most preventive and comprehensive care. Medicare-covered dental services require no copay and a 20% coinsurance, while 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. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while 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, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Chronic Care Total (HMO C-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay. Coinsurance ranges from 0% to 20% depending on the specific item, and prior authorization is required for these services.
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 copays. There is no coinsurance for diagnostic procedures, lab services, and diagnostic radiological services, while therapeutic radiological services 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. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are provided by Aetna Medicare Chronic Care Total (HMO C-SNP), and while some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered. For these services, there is no copay for cardiac and intensive cardiac rehabilitation, and a 20% coinsurance applies to pulmonary rehabilitation and supervised exercise therapy.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Chronic Care Total (HMO C-SNP) with no coinsurance, requiring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, a three-day prior hospital stay is not required for admission, and additional days beyond the Medicare-covered period 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, and up to $88 monthly in over-the-counter item reimbursements. Acupuncture and meal benefits are not covered.
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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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