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Aetna Medicare Dual Classic (PPO D-SNP) H1608-062
The Centers for Medicare & Medicaid Services (CMS) publishes annual Star Ratings that reflect how each Medicare Advantage plan performs across a range of metrics, using a system of one to five stars.
$0.00
Monthly Premium
Aetna Medicare Dual Classic (PPO D-SNP) H1608-062 is a PPO D-SNP plan offered by Aetna Inc.
Plan ID: H1608-062
HelpAdvisor Editorial Team analysis of data from the 2027 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.
Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.
Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.
Learn more about Medicare Advantage plans such as Aetna Medicare Dual Classic (PPO D-SNP) H1608-062 - H1608-062 by Aetna Inc. as well as other Medicare Advantage plans available in your area.
$0.00
Monthly Premium
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Drug Deductible | $700 |
| Out of Pocket Max | In-Network: $9850 Out-of-Network: 0 |
| Initial Coverage Limit | $0 |
| Catastrophic Coverage Limit | $2100 |
| Primary Care Doctor Visit | In-Network $0 Out-of-Network $0 -$ 30% based on level of Medicaid eligibility |
| Specialty Doctor Visit | In-Network $0 Out-of-Network $0 -$ 30% based on level of Medicaid eligibility |
| Inpatient Hospital Care | In-Network $0 Out-of-Network $0 - $2050 per stay based on level of Medicaid eligibility |
| Urgent Care | Urgent Care: Copayment for Urgent Care $0 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $0 Maximum Plan Benefit of $250,000 |
| Emergency Room Visit | $0 - $115 based on level of Medicaid eligibility. Cost share applies even if visit requires an admission to the hospital. |
| Ambulance Transportation | In-Network $0 Out-of-Network $0 -$ 20% based on level of Medicaid eligibility |
Health Care Services and Medical Supplies
Aetna Medicare Dual Classic (PPO D-SNP) H1608-062 covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).
| Coverage | Cost |
|---|---|
| Diabetes Supplies, Training, Nutrition Therapy and Monitoring | In-Network 0% for blood glucose monitors (BGM) and continuous glucose monitors (CGM) Out-of-Network 0% for Accu-Chek/Roche and TRUE/Trividia blood glucose meters (BGM) and medical diabetic supplies $0 - 20% based on level of Medicaid eligibility for blood glucose meters (BGM) and supplies manufactured by providers other than Accu-Chek/Roche and TRUE/Trividia with an approved prior authorization $0 - 20% based on level of Medicaid eligibility for continuous glucose monitors (CGM) |
| Durable Medical Equipment (DME) | In-Network $0 Out-of-Network $0 - 20% based on level of Medicaid eligibility |
| Diagnostic Tests, Lab and Radiology Services, and X-Rays | Lab Services: In-Network $0 Out-of-Network $0 - 30% based on level of Medicaid eligibility Diagnostic Procedures: In-Network $0 Out-of-Network $0 - 30% based on level of Medicaid eligibility Imaging: In-Network Xray: $0 CT Scans: $0 Diagnostic Radiology other than CT Scans: $0 Diagnostic Radiology Mammogram: $0 Out-of-Network $0 - 30% based on level of Medicaid eligibility |
| Home Health Care | In-Network $0 Out-of-Network $0 - 0% based on level of Medicaid eligibility |
| 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 Out-of-Network $0 - 30% for Mental Health Services- Group Sessions based on level of Medicaid eligibility $0 - 30% for Mental Health Services - Individual Sessions based on level of Medicaid eligibility $0 - 30% for Psychiatric Services - Group Sessions based on level of Medicaid eligibility $0 - 30% for Psychiatric Services - Individual Sessions based on level of Medicaid eligibility |
| Outpatient Services / Surgery | Ambulatory Surgical Center: In-Network $0 Out-of-Network $0 - 30% based on level of Medicaid eligibility |
| Outpatient Substance Abuse Care | Out-of-Network: Outpatient Substance Abuse Services: Coinsurance for Medicare Covered Individual Sessions 0% or 30% Coinsurance for Medicare Covered Group Sessions 0% or 30% 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 (OTC) Items | Over-the-Counter (OTC) Wallet with a $90 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 | Out-of-Network: Podiatry Services: Coinsurance for Medicare Covered Podiatry Services 0% or 30% In-Network: Podiatry Services: Copayment for Medicare-Covered Podiatry Services $0 Copayment for Routine Foot Care $0
|
| Skilled Nursing Facility Care | In-Network $0 Out-of-Network $0 - $0 per day, days 1-20; $221 per day, days 21-100 based on level of Medicaid eligibility |
Dental Benefits
The following dental services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Dental Care | In-Network Preventive dental services: $0 for oral exams $0 for cleanings $0 for fluoride treatment $0 for x-rays $0 for other diagnostic dental services $0 for other preventive dental services Comprehensive dental services: $0 for restorative services $0 for endodontic services $0 for periodontic services $0 for removeable prosthodontics $0 for fixed prosthodontics $0 for oral and maxillofacial surgery $0 for adjunctive services Out-of-Network Preventive dental services: $0 for oral exams $0 for cleanings $0 for fluoride treatments $0 for x-rays $0 for other diagnostic dental services $0 for other preventive dental services Comprehensive dental services: $0 for restorative services $0 for endodontic services $0 for periodontic services $0 for removeable prosthodontics $0 for fixed prosthodontics $0 for oral and maxillofacial surgery $0 for adjunctive services $1,000 benefit amount (allowance) every year in and out-of-network for covered preventive and comprehensive dental services combined. Frequencies and medical necessity requirements vary by covered dental service. ADA recognized dental services are covered up to the benefit amount excluding implants and implant related services, orthodontics, cosmetic services, those considered medical in nature, and administrative charges. See EOC for a full list of exclusions. |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | In-Network Eye Exams: 0% for Medicare-covered eye exams $0 for non-Medicare covered routine eye exam with an EyeMed network provider Eyewear: 0% for Medicare-covered prescription eyewear $175 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 Out-of-Network Eye Exams: 0%-30% based on level of Medicaid eligibility for Medicare-covered eye exams $0 for non-Medicare covered routine eye exam (out of network covered up to $50) Eyewear: 0%-30% based on level of Medicaid eligibility for Medicare-covered prescription eyewear $175 annual benefit amount (allowance) for non-Medicare covered prescription eyewear $0 for Contacts $0 for Eyeglass Frames $0 for Eyeglass Lenses $0 for Eyeglass Lenses and Frames $0 for Upgrades Maximum one non-Medicare covered routine eye exam every calendar year in or out-of-network. Maximum one annual benefit amount for non-Medicare covered prescription eyewear in or out-of-network. |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | 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 in or out-of-network) $0 for fitting/evaluation for hearing aids (Maximum one hearing aid fitting/evaluation every year) Hearing Aids: $0 for hearing aids $500 benefit amount (allowance) per ear, every year for hearing aids (Maximum two hearing aids every year) Out-of-Network: Hearing Exams: 0%-30% based on level of Medicaid eligibility for Medicare-covered hearing exams $0 for non-Medicare covered hearing exams (Maximum one non-Medicare covered hearing exam every year in or out-of-network Hearing Aids: You must purchase hearing aids through NationsHearing |
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 | In-Network $0 for all preventive services covered under Original Medicare Out-of-Network $0 based on level of Medicaid eligibility for all preventive services covered under Original Medicare |
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