Aetna Medicare Assure (HMO D-SNP)

New York Medicare-Medicaid Dual Eligible D-SNP Plan (2025 Plan)


Monthly Premium

Your Cost
$0
by Aetna Medicare

Additional Coverage

HearingVisionDental

Overall Government Star Rating

(coming soon)

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Plan Name
Aetna Medicare Assure (HMO D-SNP)
Insurance Carrier
Aetna Medicare
Plan Type
Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Network Type
HMO

Aetna Medicare Assure (HMO D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in New York and offered by the health insurance company Aetna Medicare. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$9,350
Primary doctor visit
$0 copay
Specialist visit
$0 copay
ER visit
$0 copay
Ambulance
$0 copay

Aetna Medicare Assure (HMO D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $9,350 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Aetna Medicare Assure (HMO D-SNP) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Aetna Medicare Assure (HMO D-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Aetna Medicare Assure (HMO D-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Aetna Medicare Assure (HMO D-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$9,350 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
$0 copay

Tests, labs, & imaging

Diagnostic tests & procedures
$0 copay
Lab services
$0 copay
Diagnostic radiology services (like MRI)
$0 copay
Outpatient x-rays
$0 copay
Emergency care
$0 copay
Urgent care
$0 copay

Hospital Services

Inpatient hospital coverage
$0 copay
Outpatient hospital coverage
$0 copay

Skilled nursing facility

Skilled nursing facility
$0 copay

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$0 copay

Therapy services

Occupational therapy visit
$0 copay
Physical therapy & speech & language therapy visit
$0 copay

Mental health services

Outpatient group therapy with a psychiatrist
$0 copay
Outpatient individual therapy with a psychiatrist
$0 copay
Outpatient group therapy visit
$0 copay
Outpatient individual therapy visit
$0 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
$0 copay
Prosthetics (like braces, artificial limbs)
$0 copay
Diabetes supplies
$0 copay

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

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic


Generic drugs :
25% coinsurance

Brand-name drugs :
25% coinsurance


Generic drugs :
0% coinsurance

Brand-name drugs :
0% coinsurance

Generic
Preferred Brand
Non-Preferred Drug
Specialty Tier

Part B Drugs

Chemotherapy drugs
$0 copay
Other Part B drugs
$0 copay

Hearing

Hearing exam
$0 copay
Fitting/evaluation
$0 copay
Hearing aids - All types
$0-1,700 copay

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
In-network: $0 copay
Out-of-network: $0 copay
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
Not covered
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$0 copay

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