Aetna Medicare Assure Plan (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H3146-003-000
North Carolina 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 North Carolina Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
|Monthly plan premium||$0.00|
|Initial drug coverage limit||$0.00|
|Catastrophic drug coverage limit||$7,400.00|
|Primary care doctor visit||$0|
|Specialty doctor visit||$0|
|Inpatient hospital care||$0|
Copayment for Urgent Care $0.00
Copayment for Worldwide Urgent Coverage $0.00
Maximum Plan Benefit of $250000.00
|Emergency room visit||$0|
Aetna Medicare Assure Plan (HMO D-SNP) covers a range of additional benefits. Learn more about Aetna Medicare Assure Plan (HMO D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Copayment for Medicare-covered Chiropractic Services $0.00
Prior Authorization Required for 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:
Copayment for Psychiatric Hospital Services per Stay $0.00
Prior Authorization Required for 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:
Copayment for Medicare-covered Individual Sessions $0.00
Copayment for Medicare-covered Group Sessions $0.00
Prior Authorization Required for Outpatient Substance Abuse Services
|Over-the-counter items||Included in Extra Benefits Card, for more information see Evidence of Coverage|
Copayment for Medicare-Covered Podiatry Services $0.00
Copayment for Routine Foot Care $0.00
|Skilled Nursing Facility (SNF) care||$0, for more information see Evidence of Coverage.|
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
|Dental care||$4,000 maximum benefit for preventive and comprehensive dental services combined - see Evidence of Coverage.|
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
|Vision benefits||$300 every year, see the Evidence of Coverage|
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
|Hearing benefits||$2,500 per ear every year, for more information see the Evidence of Coverage|
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
|Preventive services and health/wellness education programs||$0 copay for all preventive services covered under Original Medicare at zero cost sharing|
When reviewing North Carolina 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 North Carolina 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.
|Links to plan documents|
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