A non-government entity
Allina Health Aetna Medicare Chronic (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Chronic (PPO C-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Allina Health Aetna Medicare Chronic (PPO C-SNP) in 2026, please refer to our full plan details page.
Allina Health Aetna Medicare Chronic (PPO C-SNP) is a PPO C-SNP plan offered by Allina Health and Aetna Insurance Holding Company available for enrollment in 2026 to people living in Twin Cities Metro. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Allina Health Aetna Medicare Chronic (PPO C-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Allina Health Aetna Medicare Chronic (PPO 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 Allina Health Aetna Medicare Chronic (PPO 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 Allina Health Aetna Medicare Chronic (PPO 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 combined Maximum Out-Of-Pocket cost of $8900.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Allina Health Aetna Medicare Chronic (PPO 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 Allina Health Aetna Medicare Chronic (PPO C-SNP) plan has an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay when using preferred pharmacies or preferred mail order, while standard pharmacies charge a small copay starting at $2. Tier 2 generic drugs feature a $5 copay for a one-month supply at preferred locations and a $12 copay at standard locations. Higher-tier medications are covered through coinsurance rather than flat copays. Tier 3 preferred brand drugs require 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance across all pharmacy and mail order options.
Additional Benefits
The Allina Health Aetna Medicare Chronic (PPO C-SNP) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, routine annual physicals, and home health services. For specialized medical needs, members pay no coinsurance, but face copays such as $400 daily for the first few days of inpatient hospital stays and $130 for emergency room visits, which is waived if admitted. Outpatient services and specialist visits are highly accessible, with specialist copays ranging from no copay up to $35 and outpatient procedures requiring copays up to $400 with no coinsurance. This Medicare plan also provides valuable supplemental benefits, including routine hearing and vision exams with no copay and no coinsurance, alongside a $250 annual eyewear allowance and a $500 annual hearing aid allowance. Preventive dental care features no copay, while comprehensive dental services require a 20% to 50% coinsurance up to a $1,500 annual limit. Additionally, members benefit from a $40 monthly over-the-counter reimbursement and no copays for diabetic supplies, durable medical equipment, and prosthetics, though coinsurance up to 20% may apply to some equipment.
Inpatient Hospital See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) partially covers inpatient hospital services with no coinsurance, requiring a $400 daily copay for days 1 to 6 of acute stays and days 1 to 5 of psychiatric stays, with no copay for remaining days up to day 90. Prior authorization is required, and additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers outpatient services with no coinsurance, although prior authorization is required for most services. Outpatient hospital and observation copays range from $0 to $400, substance abuse sessions cost a $35 copay, and ambulatory surgical center and blood services have no copay.
Partial Hospitalization See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers partial hospitalization with a copay of either $60.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers ground ambulance services with a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. For transportation benefits, some services are covered, but transportation to plan-approved or any other health-related locations is not covered.
Emergency Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $45 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 lifetime limit with no coinsurance and copays ranging from $130 to $300.
Primary Care See details
Primary care services under the Allina Health Aetna Medicare Chronic (PPO C-SNP) plan feature no copay and no coinsurance for primary care doctor visits and routine podiatry, though chiropractic services are not covered. Specialist visits, mental health, and physical therapies require copays ranging from $0 to $35 with no coinsurance, while telehealth benefits are available with a $0 to $45 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under the Allina Health Aetna Medicare Chronic (PPO C-SNP) plan, with most covered services, including annual physical exams, health education, and fitness benefits, featuring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but sub-services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs for hair loss, 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 and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing services covered by Allina Health Aetna Medicare Chronic (PPO C-SNP) include Medicare-covered exams for a $35 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual limit, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Members receive coverage for one routine eye exam per year up to a $50 maximum, alongside a $250 combined annual limit for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental Services are partially covered by Allina Health Aetna Medicare Chronic (PPO C-SNP), featuring Medicare-covered dental for a $35.00 copay and no coinsurance, and preventive care with no copay and no coinsurance. Covered comprehensive services have no copay and 20% to 50% coinsurance up to a $1,500 annual maximum, while other diagnostic services, fluoride, other preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Allina Health Aetna Medicare Chronic (PPO 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
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, and diabetic supplies. Coinsurance ranges from 0% to 20% for DME and medical supplies, is 20% for prosthetics, and there is no coinsurance for diabetic equipment, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Allina Health Aetna Medicare Chronic (PPO C-SNP) with prior authorization required. Diagnostic procedures require a $0 to $20 copay and lab services have no copay, with no coinsurance for either service. Radiological services feature a $20 copay for X-rays, diagnostic radiology copays starting at $0, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Allina Health Aetna Medicare Chronic (PPO C-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, but 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
Allina Health Aetna Medicare Chronic (PPO C-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 copay for days 1 to 20, a $218 copay for days 21 to 50, and no copay for days 51 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Allina Health Aetna Medicare Chronic (PPO C-SNP) with no copay and no coinsurance for eligible benefits, which include a $40 monthly over-the-counter (OTC) reimbursement, an annual wellness exam, screening mammographies, and additional colorectal screenings. 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