Aetna Assure Premier Plus (HMO D-SNP)
Aetna Assure Premier Plus (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H6399-001
HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Aetna Assure Premier Plus (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H6399-001
HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Aetna Assure Premier Plus (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H6399-001
HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Monthly Deductible | $0 |
| Out of Pocket Max |
In-Network: $-1 Out-of-Network: N/A |
| Initial Coverage Limit | $5030 |
| Catastrophic Coverage Limit | $8,000 |
| Primary Care Doctor Visit | $0 |
| Specialty Doctor Visit | $0 |
| Inpatient Hospital Care | $0 |
| Urgent Care | Copayment for Urgent Care $0.00 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $0.00 |
| Emergency Room Visit | $0 |
| Ambulance Transportation | $0 |
Health Care Services and Medical Supplies
Aetna Assure Premier Plus (HMO D-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
| Coverage | Cost |
|---|---|
| Chiropractic Services | In-Network: Copayment for Medicare-covered Chiropractic Services $0.00 Prior Authorization Required for Chiropractic Services Prior authorization required |
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | 0% |
| Durable Medical Eqipment (DME) | $0 |
| Diagnostic Tests, Lab and Radiology Services, and X-Rays | Lab Services: $0, for more information see Evidence of Coverage Diagnostic Procedures: $0 Imaging: Xray: $0 | CT Scans: $0 | Diagnostic Radiology other than CT Scans: $0| Diagnostic Radiology Mammogram: $0 |
| Home Health Care | 0% |
| Mental Health Inpatient Care | In-Network: Psychiatric Hospital Services: Copayment for Psychiatric Hospital Services per Stay $0.00 Prior Authorization Required for Psychiatric Hospital Services Prior authorization required |
| Mental Health Outpatient Care | $0 for Mental Health Group and Individual Sessions, for more information see Evidence of Coverage |$0 for Psychiatric Services Group and Individual Sessions, for more information see Evidence of Coverage |
| Outpatient Services / Surgery | Ambulatory Surgical Center: $0 |
| Outpatient Substance Abuse Care | In-Network: Copayment for Medicare-covered Individual Sessions $0.00 Copayment for Medicare-covered Group Sessions $0.00 Prior Authorization Required for Outpatient Substance Abuse Services Prior authorization required |
| Over-the-counter (OTC) Items | Over the counter (OTC) items are covered under the Extra Benefits Card, for more information see Evidence of Coverage|Nicotine Replacement Therapy(NRT) offered as a Part C OTC benefit, for more information see Evidence of Coverage |
| Podiatry Services | In-Network: Copayment for Medicare-Covered Podiatry Services $0.00 |
| Skilled Nursing Facility Care | $0, for more information see Evidence of Coverage. |
Dental Benefits
The following dental services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Dental Care | $0, for more information see the Evidence of Coverage. |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | $0, for more information see the Evidence of Coverage. |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | $0, for more information see the Evidence of Coverage. |
Preventive Services and Health/Wellness Education Programs
The following services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Preventive Services and Health/Wellness Education Programs | $0 copay for all covered preventive services |
Prescription Drug Costs and Coverage
The Aetna Assure Premier Plus (HMO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year.
| Coverage |
Cost
|
|---|---|
|
Coverage & Cost
|
|
| Annual Drug Deductible | $0 |
| Preferred Generic |
|
| Generic |
|
| Preferred Brand |
|
| Non-Preferred Drug |
|
| Specialty Tier |
|
| Annual Drug Deductible | $0 |
| Preferred Generic |
|
| Generic |
|
| Preferred Brand |
|
| Non-Preferred Drug |
|
| Specialty Tier |
|
| Annual Drug Deductible | $0 |
| Preferred Generic |
|
| Generic |
|
| Preferred Brand |
|
| Non-Preferred Drug |
|
| Specialty Tier |
|
