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Aetna Medicare Chronic Care (HMO C-SNP) - H0523-096-000

3 out of 5 stars** for plan year 2027

$0.00

Monthly Premium

Aetna Medicare Chronic Care (HMO C-SNP) is a HMO C-SNP Medicare Advantage (Medicare Part C) plan offered by Aetna®

Plan ID: H0523-096-000

** Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0.00

Monthly Premium

If you have Medicare in California, you may want to review your coverage options. Medicare Advantage plans cover services that aren’t covered by Original Medicare (Part A and Part B).

Aetna Medicare Advantage plans may cover prescription drugs, and offer other benefits that Original Medicare doesn’t cover.

Compare Aetna Medicare Advantage plans today.

Speak with a licensed insurance agent.*

1-800-891-6309
|
(TTY: 711), 24/7

Aetna Medicare Chronic Care (HMO C-SNP) basic costs and coverage

Learn more about the costs, benefits and coverage of Aetna Medicare Chronic Care (HMO C-SNP) below:

Coverage Details
Monthly plan premium $0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible $700.00
Out-of-pocket maximum $299.00
Initial drug coverage limit $0.00
Catastrophic drug coverage limit $2,100.00
Primary care provider visit In-Network
$0
Specialty doctor visit In-Network
$0
Inpatient hospital care In-Network
$0 per stay
Urgent care
Urgent Care:
Copayment for Urgent Care $0

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $150
Maximum Plan Benefit of $250,000
Emergency room visit $150 If you are admitted to the hospital within 24 hours your cost share may be waived
Ambulance transportation In-Network
$275

Additional health services and supplies coverage

Aetna Medicare Chronic Care (HMO C-SNP) covers additional health services and medical supplies. Learn more below:

Coverage Details
Chiropractic services In-Network
$0

unlimited visits every year
Diabetes supplies, training, nutrition therapy and monitoring In-Network
0% for blood glucose monitors (BGM) and continuous glucose monitors (CGM)
Durable medical equipment (DME) In-Network
20%
Diagnostic tests, lab and radiology services, and X-rays Lab Services: In-Network
$0
Diagnostic Procedures: In-Network
$0
Imaging: In-Network
Xray: $0
CT Scans: $0
Diagnostic Radiology other than CT Scans: $0
Diagnostic Radiology Mammogram: $0
Home health care In-Network
$0
Mental health inpatient care In-Network:

Psychiatric Hospital Services:
Copayment for Psychiatric Hospital Services per Stay $0
Prior Authorization Required for Psychiatric Hospital Services
Mental health outpatient care In-Network
$0 for Mental Health - Group Sessions
$0 for Mental Health - Individual Sessions
$0 for Psychiatric Services - Group Sessions
$0 for Psychiatric Services - Individual Sessions
Outpatient services/surgery Ambulatory Surgical Center: In-Network
$0
Outpatient substance abuse care In-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $0
Copayment for Medicare-covered Group Sessions $0
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter items Over-the-Counter (OTC) Wallet with a $25 monthly benefit amount (allowance) on the Extra Benefits Card to help pay for approved OTC health and wellness products like first aid supplies, cold and allergy medicine, pain relievers, and more. Approved products can be purchased in-store at participating locations including CVS retail locations (excluding locations inside other stores), using the app, online or by phone through CVS Flex Benefits.

Qualifying members may be eligible for additional spending categories. See EOC for more information.
Podiatry services In-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $0
Copayment for Routine Foot Care $0
  • Maximum 6 visits every year
Referral Required for Podiatry Services
Skilled Nursing Facility (SNF) care In-Network
$0 per day, days 1-20; $50 per day, days 21-100

Dental benefit

Aetna Medicare Chronic Care (HMO C-SNP) offers the following dental benefit and coverage. There may be provider network restrictions. You can find more information about network restrictions in the plan’s Evidence of Coverage.

Coverage Details
Dental care In-Network

Preventive dental services:
$0 for oral exams
$0 for cleanings
$0 for x-rays

Comprehensive dental services:
50% for restorative services
50% for endodontic services
50% for periodontic services
50% for removeable prosthodontics
50% for fixed prosthodontics
50% for oral and maxillofacial surgery
50% for adjunctive services

$500 benefit amount (allowance) every year for covered comprehensive dental services. Frequencies and medical necessity requirements vary by covered dental service. Covered preventive dental services do not count towards your annual benefit amount. See EOC for additional details on exclusions and limitations.

Vision benefit

Aetna Medicare Chronic Care (HMO C-SNP) offers the following vision benefit. There may be provider network restrictions. You can find more information about network restrictions in the plan's Evidence of Coverage.

Coverage Details
Vision care In-Network

Eye Exams:
$0 for non-Medicare covered routine eye exam
Maximum one non-Medicare covered routine eye exam every calendar year with an EyeMed network provider

Eyewear:
$100 annual benefit amount (allowance) for non-Medicare covered prescription eyewear through an EyeMed network provider.
$0 for Contacts
$0 for Eyeglasses
$0 for Eyeglass Frames
$0 for Eyeglass Lenses
$0 for Upgrades

Hearing benefit

Aetna Medicare Chronic Care (HMO C-SNP) offers the following hearing benefit and coverage. There may be provider network restrictions. You can find more information about network restrictions in the plan’s Evidence of Coverage.

Coverage Details
Hearing care In-Network

Hearing Exams:
$0 for Medicare-covered hearing exams
$0 for non-Medicare covered hearing exams
(Maximum one non-Medicare covered hearing exam every year)
$0 for fitting/evaluation for hearing aids
(Maximum one hearing aid fitting/evaluation every year)

Hearing Aids:
$0 for hearing aids
$1,250 benefit amount (allowance) per ear, every year for hearing aids
(Maximum two hearing aids every year)

Preventive services and health/wellness education programs

Aetna Medicare Chronic Care (HMO C-SNP) offers the following preventive services, benefits and wellness programs. There may be provider network restrictions. You can find more information about network restrictions in the plan’s Evidence of Coverage.

Coverage Details
Preventive services and health/wellness education programs In-Network
$0 for all preventive services covered under Original Medicare

We can help you find out if your doctors are in a plan’s network when reviewing Aetna Medicare Advantage plans in California. We can also help you look for plans that cover your prescription drugs.

There may be other Aetna Medicare Advantage plans available in California. Call 1-800-891-6309 (TTY: 711), 24/7 to speak with a licensed TZ insurance agent* who can help you compare plans where you live.

Plan documents

Learn more about Aetna Medicare Chronic Care (HMO C-SNP) by reviewing the following documents:

Back to Aetna plans in California 

Find an Aetna Medicare Advantage plan today.

Speak with a licensed insurance agent*

1-800-891-6309
|
(TTY: 711), 24/7