$0.00 Monthly Premium
Aetna Medicare Dual Complete Plan (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H8597-001-000
$0.00 Monthly Premium
Texas Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Texas Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Basic Costs and Coverage
Coverage | Details |
---|---|
Monthly plan premium | $0.00 |
Vision coverage | |
Dental coverage | |
Hearing coverage | |
Prescription drugs | |
Medical deductible | $0.00 |
Out-of-pocket maximum | $8,850.00 |
Initial drug coverage limit | $0.00 |
Catastrophic drug coverage limit | $8,000.00 |
Primary care doctor visit | $0 |
Specialty doctor visit | $0 |
Inpatient hospital care | $0 |
Urgent care | Urgent Care: Copayment for Urgent Care $0.00 Worldwide Coverage: |
Emergency room visit | $0 |
Ambulance transportation | $0 |
Health Care Services and Medical Supplies
Aetna Medicare Dual Complete Plan (HMO D-SNP) covers a range of additional benefits. Learn more about Aetna Medicare Dual Complete Plan (HMO D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Coverage | Details |
---|---|
Chiropractic services | In-Network: Chiropractic Services: |
Diabetes supplies, training, nutrition therapy and monitoring | 0% |
Durable medical equipment (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: |
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: Outpatient Substance Abuse Services: |
Over-the-counter 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: Podiatry Services:
|
Skilled Nursing Facility (SNF) care | $0, for more information see Evidence of Coverage. |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Dental care | In Network Dental Coverage|For covered services: ADA recognized dental services are covered excluding only cosmetic services, those considered medical in nature, and administrative changes.|Preventive dental services: |Oral exams: $0 copay |Cleanings: $0 copay |Fluoride treatment: $0 copay |Bitewing x-rays: $0 copay |Comprehensive dental services:|Non-routine services: $0 copay |Diagnostic services: $0 copay |Restorative services: $0 copay |Endodontics: $0 copay |Periodontics: $0 copay |Extractions: $0 copay |Prosthodontics and maxillofacial services: $0 copay |$4,000 maximum benefit for preventive and comprehensive dental services combined - see Evidence of Coverage. |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
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 $510 every year. See the Evidence of Coverage |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Hearing benefits | In-Network:|Hearing Exams:|Coinsurance for Medicare Covered Benefits 0%|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)|$1,250 per ear every year, for more information see the Evidence of Coverage |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Coverage | Details |
---|---|
Preventive services and health/wellness education programs | $0 copay for all preventive services covered under Original Medicare at zero cost sharing |
When reviewing Texas Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Texas that offer similar benefits at similar or lower prices than the plan above. Call 1-877-890-1409 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
Links to plan documents |
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Texas Counties Served
Aransas Bandera Bastrop Bee Bell Bexar Blanco Bowie Brooks Burleson Burnet Caldwell Calhoun Cameron Cass Cherokee Colorado Comal Comanche Coryell De Witt Dona Ana Duval Ector El Paso Erath Falls Fayette Gillespie Goliad Gonzales Gregg Guadalupe Hamilton Harrison Hays Henderson Hidalgo Houston Jackson Jasper Jim Hogg Jim Wells Karnes Kendall Kenedy Kleberg Lamar Lampasas Lavaca Lee Leon Live Oak Llano Lubbock Madison Marion Maverick Medina Midland Milam Morris Nacogdoches Newton Nueces Panola Potter Rains Randall Red River Refugio Robertson Rusk San Augustine Smith Starr Taylor Titus Tom Green Travis Tyler Upshur Van Zandt Webb Willacy Williamson Wilson Wood
Enrolling in H8597-001-000 Medicare Advantage Plans in Texas
Medicare beneficiaries from Texas may have access to Medicare Advantage plans from Aetna and other insurance companies.
Get help comparing your local plan options by calling to speak with a licensed insurance agent who can help you find out if your doctor and prescription drugs are covered by a Medicare Advantage plan in your area.
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
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