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Aetna Medicare Dual Preferred (HMO D-SNP) H3239-007 Plan Details
4 out of 5 stars
Aetna Medicare Dual Preferred (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H3239-007
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$0.00
Monthly Premium
Aetna Medicare Dual Preferred (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H3239-007
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Get Medicare Help
Aetna Medicare Dual Preferred (HMO D-SNP) H3239-007 Plan Details
4 out of 5 stars
Aetna Medicare Dual Preferred (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H3239-007
Have Medicare questions?
Talk to a licensed agent today to find a plan that fits your needs.
Get Medicare Help
$0.00
Monthly Premium
Louisiana Counties Served
Vermilion Iberia Saint Landry Saint Martin Rapides Acadia Lafayette Natchitoches Ouachita Allen Beauregard Winn Evangeline Lincoln Avoyelles Jefferson Davis Sabine Calcasieu Vernon
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: |
| Emergency Room Visit | $0 |
| Ambulance Transportation | $0 |
Health Care Services and Medical Supplies
Aetna Medicare Dual Preferred (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:
Prior Authorization Required for Chiropractic Services |
| 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 |
| 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: |
| Over-the-counter (OTC) 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:
|
| 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|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 |$3,750 maximum benefit for preventive and comprehensive dental services combined - see Evidence of Coverage. |
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 $350 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%|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 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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