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Aetna Medicare Chronic Care Value (HMO C-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Chronic Care Value (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 Value (HMO C-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Chronic Care Value (HMO C-SNP) is a HMO C-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 Medicare Chronic Care Value (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 Value (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 Value (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 Value (HMO C-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $32.70. 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 Value (HMO C-SNP) plan features an annual drug deductible of $615. Under this plan, you will enjoy no copay for Tier 1 preferred generic drugs filled through standard pharmacies or standard mail order. For Tier 2 generic drugs, copays are $5 for a one-month supply, with standard mail order offering a cost-saving $10 copay for both two-month and three-month supplies. For higher-tier medications, including Tier 3 preferred brand, Tier 4 non-preferred, and Tier 5 specialty drugs, you will pay a 25% coinsurance at standard pharmacies and through standard mail order. This 25% coinsurance rate applies to all available supply lengths, though Tier 5 specialty drugs are restricted to a one-month supply.
Additional Benefits
The Aetna Medicare Chronic Care Value (HMO C-SNP) provides robust medical coverage with no copay and no coinsurance for many essential services, including primary care visits, home health care, and routine dental and vision exams. For specialized medical care, members can expect predictable copays, such as $0 to $20 for specialist visits, $115 for emergency care, and daily copayments for inpatient hospital stays. Diagnostic lab services and diabetic supplies are also covered with no copay and no coinsurance. The plan features valuable extra benefits, including a monthly over-the-counter allowance of up to $55 with no copay, as well as annual allowances for prescription hearing aids and eyewear. While many benefits have no coinsurance, select services like dialysis and durable medical equipment require a 20% coinsurance. Skilled nursing facility care is also highly accessible, featuring no copay for the first 20 days of your stay.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the Aetna Medicare Chronic Care Value (HMO C-SNP) with no coinsurance, though prior authorization is required. Acute stays require a $480 daily copay for days 1 to 5 and no copay for days 6 to 90, while psychiatric stays require a $385 daily copay for days 1 to 5 and no copay for days 6 to 90, but additional days, non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services under the Aetna Medicare Chronic Care Value (HMO C-SNP) are covered with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Patients will pay a copay of $0 to $480 for outpatient hospital services, a $480 copay per stay for observation services, and a $20 copay for outpatient substance abuse group or individual sessions, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers ambulance services with prior authorization, requiring a $285 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers emergency services with a $115 copay (waived if admitted within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum limit with a $115 copay ($285 for worldwide emergency transportation) and no coinsurance.
Primary Care See details
Aetna Medicare Chronic Care Value (HMO C-SNP) provides primary care physician services and routine podiatry visits with no copay and no coinsurance, while specialist visits require a $0 to $20 copay and no coinsurance. Physical, occupational, and mental health therapies have copays ranging from $20 to $25 with no coinsurance, though some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) offers partially covered preventive services, including annual physical exams, health education, and glaucoma screenings with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, though supplemental services like in-home safety assessments and weight management are not covered.
Hearing Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers hearing services with no deductible and no coinsurance, though some services are not covered. Medicare-covered exams require a $20 copay, while routine exams and fitting evaluations have no copay (limited to one of each per year). Prescription hearing aids are covered up to $500 per ear annually with no copay, but OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers vision services with no coinsurance and no deductibles, including one routine eye exam per year and follow-up diabetic exams with no copay. Medicare-covered eye exams have a copay ranging from $0 to $20, and eyewear like contacts and eyeglasses has no copay up to a $150 annual maximum.
Dental Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers Medicare-covered dental services for a $20 copay and no coinsurance, alongside preventive services like exams and cleanings for no copay and no coinsurance. Comprehensive services are partially covered with no copay and 20% to 50% coinsurance up to a $750 annual limit, excluding fluoride, implants, maxillofacial prosthetics, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with no copay and no coinsurance, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and clinical drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers medical equipment, offering durable medical equipment and medical supplies with no copay and 0% to 20% coinsurance, and prosthetic devices with no copay and 20% coinsurance. Diabetic equipment, including supplies and therapeutic shoes, is covered with no copay and no coinsurance, though manufacturer limitations and prior authorization requirements apply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan, with prior authorization required for both. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $15 copay, while radiological services require a $10 copay and coinsurance for X-rays, a minimum $0 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) features cardiac rehabilitation services with no copay and no coinsurance, but only some services are covered as standard cardiac, intensive cardiac, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Chronic Care Value (HMO C-SNP), offering no copay and no coinsurance for over-the-counter items up to $55 monthly, annual wellness exams, and select screenings, while acupuncture and meal benefits are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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