Aetna Medicare Signature Extra (HMO) H0523-086
Plan information effective January 1, 2027.
Plan costs & ratings
Availability
Available in 2 California countiesLos Angeles County, CA, Orange County, CA
Available Cities
This plan is available in 147+ cities in California.
Benefits
In-Network $0
In-Network $190 per day, days 1-5; $0 per day, days 6-90
In-Network $20 per day, days 1-20; $218 per day, days 21-100
$150 If you are admitted to the hospital within 24 hours your cost share may be waived
In-Network: $0 copay for Medicare-covered urgently-needed-care visits.
In-Network $275
In-Network Preventive dental services: $0 for oral exams $0 for cleanings $0 for x-rays Frequencies vary by covered dental service.
In-Network Eye Exams: $0 for Medicare-covered eye exams $0 for non-Medicare covered routine eye exam Maximum one non-Medicare covered routine eye exam every calendar year with an EyeMed network provider Eyewear: $0 for Medicare-covered prescription eyewear $100 annual benefit amount (allowance) for non-Medicare covered prescription eyewear through an EyeMed network provider. $0 for Contacts $0 for Eyeglasses $0 for Eyeglass Frames $0 for Eyeglass Lenses $0 for Upgrades
In-Network Hearing Exams: $0 for Medicare-covered hearing exams $0 for non-Medicare covered hearing exams (Maximum one non-Medicare covered hearing exam every year) $0 for fitting/evaluation for hearing aids (Maximum one hearing aid fitting/evaluation every year) Hearing Aids: $0 for hearing aids $500 benefit amount (allowance) per ear, every year for hearing aids (Maximum two hearing aids every year)
In-Network: $275 copay
Fitness benefit that includes a basic membership to any SilverSneakers participating fitness facility. If you do not reside near a participating facility, or prefer to exercise at home, online classes and one at-home fitness kit per year are available through SilverSneakers at no additional cost to you.
Highlights
Notes
- Drug deductible details: $0 Deductible on Tier(s) 1, 2; $300 Deductible on Tier(s) 3, 4, 5
- No
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Network & documents
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