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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 2026 to people living in IL. The overall rating for this plan is not yet available for 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 $15.20. 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) prescription drug plan features an annual drug deductible of $615. Under this plan, members enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This coverage applies to one-month, two-month, and three-month supplies, offering excellent savings on everyday drugs. For higher-tier medications, costs are structured around coinsurance rather than flat copays. Members pay a 22% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply at standard retail or mail-order pharmacies.
Additional Benefits
The Aetna Medicare FIDE (HMO D-SNP) plan provides robust medical coverage with no copays for outpatient services, primary care, and specialist visits, which instead carry a 20% coinsurance. Inpatient hospital stays require a set copay of $2,200 for acute care or $2,080 for psychiatric care with no coinsurance. Emergency room visits have a $115 copay that is waived if you are admitted to the hospital within 24 hours. This plan also features excellent coverage for supplemental care, offering home health services and routine physicals with no copays and no coinsurance. Members can take advantage of valuable extra allowances, including up to $2,500 annually for dental care, $1,000 per ear for prescription hearing aids, and a $225 monthly reimbursement for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare FIDE (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,200 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required for these services, and while unlimited additional acute care days are covered with no copay, upgrades and non-Medicare-covered stays 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 blood services, with no copay and a 20% coinsurance. Prior authorization is required for most of these services, and the deductible is waived for the first three pints of blood.
Partial Hospitalization See details
Aetna Medicare FIDE (HMO D-SNP) covers partial hospitalization services, which require prior authorization. Depending on the service, you will either pay a 20% coinsurance with no copay, or a $110.00 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare FIDE (HMO D-SNP), with prior-authorized ground and air ambulance services requiring a 20% coinsurance and no copay. Although some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Aetna Medicare FIDE (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay 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 copays or coinsurance.
Primary Care See details
Aetna Medicare FIDE (HMO D-SNP) covers primary care, specialist visits, physical and occupational therapies, psychiatric care, and opioid treatment with no copay and 20% coinsurance. While some chiropractic services are covered, routine and other chiropractic services are not covered. Telehealth options are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare FIDE (HMO D-SNP) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, health education, and fitness benefits, while kidney disease education, glaucoma screenings, diabetes training, digital rectal exams, and post-welcome-visit EKGs have no copay and a 20% coinsurance. In-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Aetna Medicare FIDE (HMO D-SNP) covers hearing services with no deductible, offering routine exams with no copay and 20% coinsurance, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare FIDE (HMO D-SNP) vision benefits include one routine eye exam per year with no copay and a 20% coinsurance, and follow-up diabetic eye exams with no copay and no coinsurance. Covered eyewear has a $200 annual limit, featuring no copay and no coinsurance for eyeglasses, frames, lenses, and upgrades, while contact lenses require no copay and a 20% coinsurance.
Dental Services See details
Dental services are partially covered by Aetna Medicare FIDE (HMO D-SNP), featuring Medicare-covered dental care with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $2,500 annual limit. While many diagnostic and restorative services are included, prophylaxis (cleanings), maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare FIDE (HMO D-SNP) covers Home Infusion bundled Services with no copay, although prior authorization is required. Covered Part B chemotherapy, radiation, and other Part B drugs require a coinsurance of 0% to 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare FIDE (HMO D-SNP) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare FIDE (HMO D-SNP) covers medical equipment with no copays, though prior authorization is required. Members will pay a 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes, while diabetic supplies are covered with no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare FIDE (HMO D-SNP) with prior authorization required and no copays for all services. 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Aetna Medicare FIDE (HMO D-SNP) with no copay, though only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and instead require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare FIDE (HMO D-SNP) 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, followed by a $218 daily copay for days 21 through 100, while additional days beyond standard Medicare coverage are not covered.
Other Services See details
Aetna Medicare FIDE (HMO D-SNP) partially covers other services with no copay and no coinsurance, which includes chronic illness meal benefits, annual wellness exams, and a $225 monthly over-the-counter item reimbursement. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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