Aetna Community HealthChoices (HMO D-SNP)

Aetna Community HealthChoices (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Southeastern Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2026.

It's important to know that Aetna Community HealthChoices (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Aetna Community HealthChoices (HMO D-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.

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:

Drug Coverage

The Aetna Community HealthChoices (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, policyholders benefit from no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order for up to a three-month supply. This makes everyday generic prescriptions highly affordable for members looking to manage their healthcare costs. For brand-name and specialty medications, members pay a percentage of the drug costs instead of a flat copay. Tier 3 preferred brand drugs require a 22% coinsurance for up to a three-month supply at standard pharmacies and mail order services. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with specialty prescriptions limited to a one-month supply.

Additional Benefits

The Aetna Community HealthChoices (HMO D-SNP) plan offers comprehensive medical coverage with many services featuring no copayments, though some require coinsurance. For instance, primary care, home health, and preventive services are covered with no copay, while outpatient services, dialysis, and medical equipment typically require a 20% coinsurance. Inpatient hospital stays require a copay of up to $2,230 with no coinsurance, and skilled nursing facility care features no copay for the first 20 days. This plan also provides valuable supplemental benefits, including dental, vision, and hearing coverage with no deductibles. Routine dental services are covered with no copay or coinsurance up to a $1,000 annual maximum, and prescription hearing aids are covered up to $1,500 per ear with no copay. Additionally, members benefit from emergency services with a $115 copay, up to 24 one-way transportation trips with no copay, and a $220 monthly over-the-counter allowance.