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Aetna Medicare FIDE (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare FIDE (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare FIDE (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare FIDE (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in New Jersey Counties: All. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare FIDE (HMO D-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 FIDE (HMO D-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 FIDE (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.
For Aetna Medicare FIDE (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $54.20. 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 FIDE (HMO D-SNP) plan features an annual prescription drug deductible of $615. This deductible is the amount you must pay out-of-pocket for your covered medications before your plan begins to pay its share. Specific drug tier details, including individual copayments and coinsurance percentages, are not currently available for this plan. To determine your exact out-of-pocket costs, you should consult the plan's formulary or contact the provider directly to verify how your specific prescriptions are covered after the deductible is met.
Additional Benefits
The Aetna Medicare FIDE (HMO D-SNP) plan offers comprehensive coverage for essential healthcare needs, featuring no copay and no coinsurance for primary care visits and home health services. For inpatient hospital stays, members pay a set copay per stay with no coinsurance, while outpatient services generally require a 20% coinsurance with no copay. Emergency care is available with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. Specialist visits, diagnostic tests, and durable medical equipment typically require a 20% coinsurance and no copay. Preventive care, annual physicals, and hearing exams are fully covered with no copays or coinsurance, and the plan provides up to $255 monthly for over-the-counter item reimbursements. Skilled nursing facility care is also highly affordable, offering no copay for the first 20 days of your stay.
Inpatient Hospital See details
Aetna Medicare FIDE (HMO D-SNP) partially covers inpatient hospital services with prior authorization required, offering acute care with no coinsurance and a $2,190 copay per stay, and psychiatric care with no coinsurance and a $2,080 copay per stay. Additional days, non-Medicare-covered stays, and acute upgrades are not covered.
Outpatient Services See details
Aetna Medicare FIDE (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, outpatient substance abuse, and outpatient blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible for the first three pints of blood.
Partial Hospitalization See details
Aetna Medicare FIDE (HMO D-SNP) covers partial hospitalization services with prior authorization required. Depending on the service, you will either pay no copay with a 20% coinsurance or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare FIDE (HMO D-SNP) covers ground and air ambulance services with a 35% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare FIDE (HMO D-SNP) covers emergency services 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 copay or coinsurance.
Primary Care See details
Aetna Medicare FIDE (HMO D-SNP) covers primary care physician services and telehealth benefits with no copay and no coinsurance, while other services like specialist visits, mental health, and physical therapy require no copay and a 20% coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare FIDE (HMO D-SNP), featuring no copay and no coinsurance for annual physicals, personal emergency response systems, and memory fitness benefits. Other covered benefits, such as kidney disease education, glaucoma screenings, and diabetes self-management training, have no copay but require a 20% coinsurance. However, the plan does not cover health education, in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, home safety modifications, or counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare FIDE (HMO D-SNP), offering covered hearing exams with no copay, no deductible, and no coinsurance. Routine hearing exams, fitting and evaluation services, prescription hearing aids, and over-the-counter hearing aids are not covered.
Vision Services See details
Vision Services under Aetna Medicare FIDE (HMO D-SNP) cover some services with no copay and a 20% coinsurance, although routine eye exams, contact lenses, and eyeglasses are not covered. There is no deductible for these services.
Dental Services See details
Dental services are partially covered under the Aetna Medicare FIDE (HMO D-SNP) plan, which offers covered Medicare dental services with no copay and a 20% coinsurance, subject to prior authorization. Other routine and comprehensive dental services, including oral exams, cleanings, x-rays, fluoride, restorative care, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare FIDE (HMO D-SNP) with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy and radiation drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare FIDE (HMO D-SNP) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare FIDE (HMO D-SNP) with no copays, though prior authorization is required for these services. While diabetic supplies feature no coinsurance, a 20% coinsurance applies to durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare FIDE (HMO D-SNP) with prior authorization required and no copays. There is a 20% coinsurance for diagnostic procedures, lab services, therapeutic radiological services, and outpatient X-rays, while diagnostic radiological services have no coinsurance.
Home Health Services See details
Aetna Medicare FIDE (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare FIDE (HMO D-SNP) with no copay, though only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by Aetna Medicare FIDE (HMO D-SNP) with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a three-day prior inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare FIDE (HMO D-SNP) partially covers other services with no copay and no coinsurance, including chronic illness meals, wellness exams, and up to $255 monthly in over-the-counter item reimbursements. Acupuncture is not covered under this plan.
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