A non-government entity
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 2026 to people living in Central 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 $29.70. 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:
Sign up for Aetna Medicare Chronic Care Value (HMO 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 Aetna Medicare Chronic Care Value (HMO C-SNP) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, members pay no copay for one-month, two-month, or three-month supplies filled through standard pharmacies or standard mail order. Tier 2 generic drugs are also highly affordable, with a low copay of $5 for a one-month supply and up to $15 for a three-month supply at standard pharmacies, or up to $10 for a three-month supply via standard mail order. For brand-name and specialty medications, the plan transitions to a coinsurance model. Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs all require a 25% coinsurance for standard pharmacy and standard mail order fills. This 25% coinsurance applies to all available supply lengths, helping you easily plan your out-of-pocket costs for higher-tier medications.
Additional Benefits
The Aetna Medicare Chronic Care Value (HMO C-SNP) plan offers robust coverage with a focus on minimizing out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, routine podiatry, and preventive screenings. Specialist visits, physical therapy, and Medicare-covered dental and hearing exams require a low copay of up to $15 with no coinsurance. For inpatient hospital stays, members pay a $475 daily copay for the first five days, followed by no copay for days six through 90. Members also enjoy valuable supplemental benefits, including routine vision and hearing exams with no copay, alongside annual allowances of $250 for eyewear and $500 for prescription hearing aids. Preventive dental care features no copay, while comprehensive dental services require 20% to 50% coinsurance up to a $1,000 yearly limit. Additionally, the plan provides a $50 monthly allowance for over-the-counter items and up to six free one-way trips per year to plan-approved locations.
Inpatient Hospital See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, you pay a $475 daily copay for days 1 to 5 and no copay for days 6 to 90, while psychiatric stays cost a $265 daily copay for days 1 to 5 and no copay for days 6 to 90. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay of $0 to $475, observation services require a $475 copay per stay, and outpatient substance abuse sessions have a $15 copay.
Partial Hospitalization See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers partial hospitalization services with a copayment of either $55.00 or $110.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP), featuring a $325 copay for ground ambulance services and a 20% coinsurance for air ambulance services. Transportation services are partially covered with no copay or coinsurance for up to 6 one-way trips per year to plan-approved locations, but transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $40 copay with no coinsurance, and worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $325.
Primary Care See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers primary care and routine podiatry services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a copay of up to $15 and no coinsurance. Additional telehealth services are available with a $0 to $40 copay and 20% coinsurance, but routine chiropractic care is not covered.
Preventive Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers preventive services, including annual physical exams and diabetes training, with no copay and no coinsurance. Kidney disease education is covered with no copay and 20% coinsurance, while additional preventive services are only partially covered, excluding items such as in-home safety assessments, personal emergency response systems, and nutritional therapy.
Hearing Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) offers hearing services, including Medicare-covered exams for a $15 copay and no coinsurance, alongside annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 annually, but OTC hearing aids and inner ear, outer ear, or 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, offering eye exams with a $0 to $15 copay and eyewear with no copay. Covered benefits include one routine eye exam per year, follow-up diabetic eye exams, and up to a $250 annual maximum allowance for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan, with Medicare-covered dental requiring a $15 copay and no coinsurance. Preventive cleanings and exams are available with no copay and no coinsurance, while covered comprehensive services carry no copay and 20% to 50% coinsurance up to a $1,000 yearly limit. Fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs have 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 under the Aetna Medicare Chronic Care Value (HMO C-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Chronic Care Value (HMO C-SNP) covers durable medical equipment and prosthetics with no copay and 0% to 20% coinsurance (20% for prosthetic devices), requiring prior authorization. Diabetic supplies and therapeutic shoes from specified manufacturers are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Chronic Care Value (HMO C-SNP) with prior authorization required. Diagnostic tests, lab services, and diagnostic radiological services feature no copay and no coinsurance, while outpatient x-rays carry a $20 copay plus coinsurance and therapeutic radiological services require a 20% coinsurance plus a copay.
Home Health Services See details
Home health services are covered under the Aetna Medicare Chronic Care Value (HMO C-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Chronic Care Value (HMO C-SNP) with no copay and no coinsurance, although in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Chronic Care Value (HMO 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 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Chronic Care Value (HMO C-SNP) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items up to $50 monthly, annual wellness exams, and additional gFOBT and FIT. 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