Aetna Medicare Preferred Plan (HMO D-SNP)
Aetna Medicare Preferred Plan (HMO D-SNP) H4982-009 Plan Details
Aetna Medicare Preferred Plan (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H4982-009
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Talk to a licensed agent today to find a plan that fits your needs.
$0.00
Monthly Premium
Aetna Medicare Preferred Plan (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H4982-009
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Aetna Medicare Preferred Plan (HMO D-SNP) H4982-009 Plan Details
Aetna Medicare Preferred Plan (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H4982-009
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
$0.00
Monthly Premium
Basic Costs and Coverage
| Coverage | Cost |
|---|---|
| Monthly Deductible | $0 |
| Out of Pocket Max |
In-Network: $8850 Out-of-Network: N/A |
| Initial Coverage Limit | $0 |
| 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 Medicare Preferred Plan (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 Copayment for Routine Care $0.00 Prior Authorization Required for Chiropractic Services Referral 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 | In Network: |Over-the-counter (OTC) items:|$50 monthly amount (allowance) to purchase approved OTC health and wellness products like first aid supplies, cold and allergy medicine, pain relievers and more. Approved items can be purchased online, in store, or by phone. |Be sure to use the full benefit amount monthly, because any unused amount will not rollover.|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 Copayment for Routine Foot Care $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 | In Network Dental Coverage|Preventive dental services: |Oral exams: $0 copay |Comprehensive dental services:|Restorative services: $0 copay (see Evidence of Coverage)|Prosthodontics and maxillofacial services: $0 copay (see Evidence of Coverage)|Preventive and comprehensive dental services are not covered out-of-network. |
Vision Benefits
The following vision services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Vision Benefits | In-Network:|Eye Exams:|Coinsurance for Medicare Covered Benefits 0%|Copayment for Routine Eye Exams $0 |(Maximum one exam every year)|Eyewear:|Coinsurance for Medicare Covered Benefits 0%|Copayment for Contacts $0|Copayment for Eyeglasses $0|Copayment for Eyeglass Frames $0|Copayment for Eyeglass Lenses $0|Copayment for Upgrades $0|Maximum Plan Allowance for all Non-Medicare covered Eyewear $400 every year. See the Evidence of Coverage |
Hearing Benefits
The following hearing services are covered from in-network providers.
| Coverage | Cost |
|---|---|
| Hearing Benefits | In-Network:|Hearing Exams:|Coinsurance for Medicare Covered Benefits 0%|Referral Required for Hearing Exams|Copayment for Routine hearing Exams $0|(Maximum one exam every year)|Copayment for Fitting/Evaluation for Hearing Aid $0|(Maximum one hearing aid fitting/evaluation every year)|Hearing Aids:|Copayment for Hearing Aids $0|(Maximum two hearing aids every year)|$2,500 per ear every year, 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 preventive services covered under Original Medicare at zero cost sharing |
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