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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 MI Southeast. This plan received an overall rating of 3 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:
Sign up for Aetna Medicare Chronic Care (HMO C-SNP)
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Drug Coverage
The Aetna Medicare Chronic Care (HMO C-SNP) plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you pay no copay when using a preferred pharmacy or preferred mail-order service, while standard pharmacies charge a small copay starting at $2 for a one-month supply. Tier 2 generic drugs are also highly affordable, with copays starting at $5 at preferred pharmacies and $12 at standard pharmacies for a one-month supply. For higher-tier medications, costs shift to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with Tier 5 coverage limited to a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care (HMO C-SNP) plan offers comprehensive medical coverage with no copay for primary care visits, annual physicals, and home health services. For specialized care, members pay a copay of up to $25 for specialist visits and no copay for routine vision and hearing exams. Inpatient hospital stays require daily copays for the first seven days with no coinsurance, while emergency room visits carry a $130 copay. This plan features robust supplemental benefits, including preventive dental care with no copay and comprehensive dental coverage up to a $1,500 annual limit with 20% to 50% coinsurance. Members also benefit from a $200 annual eyewear allowance and up to $750 per ear annually for prescription hearing aids with no copays. Additionally, the plan provides a monthly $15 allowance for over-the-counter items and covers diabetic equipment with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Chronic Care (HMO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $400 daily copay for days 1 through 7 of acute stays and a $325 daily copay for days 1 through 7 of psychiatric stays, with no copays for days 8 through 90. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $400 copay and observation services with a $400 copay per stay. Ambulatory surgical center and blood services are covered with no copay or coinsurance, while outpatient substance abuse individual and group sessions require a $25 copay.
Partial Hospitalization See details
Partial hospitalization services are covered under the Aetna Medicare Chronic Care (HMO C-SNP) plan with no coinsurance, though prior authorization is required. Depending on the specific service, patients will pay a copay of either $60.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers ambulance services with a $300 copay for ground transport and a 20% coinsurance for air transport, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $130 to $300, up to a maximum plan benefit of $250,000.
Primary Care See details
Aetna Medicare Chronic Care (HMO C-SNP) features primary care physician and podiatry services with no copay and no coinsurance, while specialists, physical therapy, and mental health services have copays up to $25 and no coinsurance. Chiropractic services are partially covered because routine and other chiropractic care are not covered, and telehealth benefits carry a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers preventive services with no copay and no coinsurance for annual physical exams, health education, and screenings, though kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered as several supplemental services 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 covered by Aetna Medicare Chronic Care (HMO C-SNP), featuring a $25 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to $750 per ear annually, though 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 deductible and no coinsurance, featuring no copay for annual routine eye exams and follow-up diabetic exams, and a copay of up to $25 for Medicare-covered exams. Covered eyewear, including lenses, frames, and contacts, also has no copay and is subject to a $200 annual maximum limit.
Dental Services See details
Dental services are partially covered by Aetna Medicare Chronic Care (HMO C-SNP), offering preventive services like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental with a $25 copay and no coinsurance. Comprehensive services such as restorative care, endodontics, periodontics, prosthodontics, and oral surgery are covered up to a $1,500 annual limit with no copay and 20% to 50% coinsurance, while fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
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 chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from no coinsurance up to 20%, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Chronic Care (HMO C-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment is covered under Aetna Medicare Chronic Care (HMO C-SNP) with no copays, though prior authorization is required. Durable medical equipment and medical supplies have a 0% to 20% coinsurance, prosthetic devices have a 20% coinsurance, and diabetic equipment is covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Chronic Care (HMO C-SNP) with prior authorization, featuring no copay or coinsurance for lab services and diagnostic test copays ranging from $0 to $20 with no coinsurance. Outpatient X-rays require a $20 copay and coinsurance, while therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Chronic Care (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance and no copayment, but in practice, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Chronic Care (HMO C-SNP) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Chronic Care (HMO C-SNP) offers partially covered Other Services, with acupuncture and meal benefits not covered. Covered benefits, including annual wellness exams, additional gFOBT and FIT screenings, and up to $15 per month in over-the-counter (OTC) items, are provided with no copay and no coinsurance.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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