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Allina Health Aetna Medicare Value (PPO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Value (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 Value (PPO C-SNP) in 2026, please refer to our full plan details page.
Allina Health Aetna Medicare Value (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 Value (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 Value (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 Value (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 Value (PPO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $41.50. 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 $10200.00 (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 $10200.00 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 Value (PPO C-SNP)
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Drug Coverage
The Allina Health Aetna Medicare Value (PPO C-SNP) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic drugs, members enjoy no copay for one-, two-, or three-month supplies filled through standard pharmacies or standard mail order. Tier 2 generic drugs require a $5 copay for a one-month supply, while a three-month supply costs $15 at standard pharmacies and $10 through standard mail order. Higher-tier medications under this plan transition from flat copays to a coinsurance model. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all carry a 25% coinsurance for standard pharmacy and standard mail-order fills. This 25% coinsurance applies to up to a three-month supply for Tiers 3 and 4, and a one-month supply for Tier 5 specialty prescriptions.
Additional Benefits
The Allina Health Aetna Medicare Value (PPO C-SNP) offers comprehensive coverage with a strong focus on affordable care, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits and outpatient services are also highly accessible, requiring low copays ranging from no copay to thirty dollars. For major medical needs, inpatient hospital stays require a daily copay of three hundred fifty dollars for the first six days, after which there is no copay, while emergency room visits carry a flat one hundred fifteen dollar copay. Enrollees also benefit from robust ancillary coverage, including routine dental cleanings, annual eye exams, and yearly hearing exams with no copays or coinsurance. The plan includes generous allowances for hardware, providing up to a two hundred dollar annual allowance for eyewear and up to seven hundred fifty dollars per ear for prescription hearing aids. Additionally, members can take advantage of a sixty-five dollar monthly reimbursement for over-the-counter items and a fitness benefit with no copay to support their daily wellness.
Inpatient Hospital See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers inpatient hospital services with no coinsurance, requiring a $350 daily copay for days 1 through 6 of acute stays (no copay for days 7 to 90) and days 1 through 5 of psychiatric stays (no copay for days 6 to 90). This benefit is partially covered, as upgrades, additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay and no coinsurance. Outpatient hospital services require a copay of $0 to $350, and outpatient substance abuse sessions have a $30 copay, both with no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Allina Health Aetna Medicare Value (PPO C-SNP) with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers ground ambulance services with a $275 copay and air ambulance services with a 20% coinsurance, with prior authorization required for both. Some transportation services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services under the Allina Health Aetna Medicare Value (PPO C-SNP) plan are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $275.
Primary Care See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers primary care and podiatry services with no copay and no coinsurance, while specialist, therapy, and mental health services require copays between $0 and $30 with no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, excluding routine and other chiropractic care. Additional telehealth benefits are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under the Allina Health Aetna Medicare Value (PPO C-SNP), offering annual physicals, diabetes training, and fitness benefits with no copay and no coinsurance, while kidney disease education requires no copay and 20% coinsurance. However, several services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, telemonitoring, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by the Allina Health Aetna Medicare Value (PPO C-SNP) plan, featuring no copay and no coinsurance for annual routine exams, fitting evaluations, and prescription hearing aids up to $750 per ear. Medicare-covered exams require a $30 copay and no coinsurance, while OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) offers vision services with no copay, no coinsurance, and no deductible for eye exams and eyewear. The plan covers one routine eye exam per year up to a $50 maximum, alongside a $200 annual combined maximum allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) dental services are partially covered, offering preventive care like exams and cleanings with no copay and no coinsurance, though fluoride, implants, and orthodontics are not covered. Medicare-covered dental requires a $30 copay and no coinsurance, while covered comprehensive services have no copay and 20% to 50% coinsurance up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Allina Health Aetna Medicare Value (PPO C-SNP) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers medical equipment with no copays, though prior authorization is required. Durable medical equipment and medical supplies incur a 0% to 20% coinsurance, prosthetic devices require a 20% coinsurance, and diabetic supplies and therapeutic shoes feature no coinsurance when sourced from specified manufacturers.
Diagnostic and Radiological Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services require no coinsurance, featuring no copay for lab services and a $0 to $15 copay for diagnostic procedures, while radiological services range from no copay for diagnostic radiology and a $10 copay for X-rays to a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by the Allina Health Aetna Medicare Value (PPO C-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Allina Health Aetna Medicare Value (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) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Allina Health Aetna Medicare Value (PPO 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. There is no copay for days 1 to 20 and days 55 to 100, a $218 daily copay for days 21 to 54, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Allina Health Aetna Medicare Value (PPO C-SNP) provides partially covered other services with no copay and no coinsurance, which includes a $65 monthly reimbursement for over-the-counter items, annual wellness exams, and additional colorectal screenings. Acupuncture and meal benefits are not covered under this plan.
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