Aetna Medicare Assure (HMO D-SNP)

Medicare Plan Details (2022 Plan)


Monthly Premium

 

by Aetna Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C) with Prescription Drug (Part D)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D

 

$0
$0
$0
$0
$7,550 In-network
No
Yes
Yes
Yes

Doctor Services

$0 copay
$0 copay

Tests, labs, & imaging

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Hospital Services

$0 copay
$0 copay

Skilled nursing facility

$0 copay

Preventive services

$0 copay

Ambulance

$0 copay

Therapy services

$0 copay
$0 copay

Mental health services

$0 copay
$0 copay
$0 copay
$0 copay

Opioid treatment services

Covered

Other services

$0 copay
$0 copay
$0 copay

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$5.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$3.95 copay or 5% (whichever costs more)

Brand-name drugs :
$9.85 copay or 5% (whichever costs more)

Generic$10.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug25%
Specialty Tier26%

Part B Drugs

$0 copay
$0 copay

Hearing

$0 copay
$0 copay
$0 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Vision

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 3.5
 3
 4
 3
 3
No Rating
 4
 5
 3
 4
 4

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