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Aetna Medicare QMB Only Extra Care (HMO D-SNP) (2027)

Dual Special Needs Plan (Medicare Advantage) from Aetna Medicare, plan ID H4523-041-000. Sold in 98 counties in Texas.

★★★★★3.0

Who can join

Only for people who have both Medicare and Medicaid.

2027 costs

Monthly premium$0
Drug deductible$700
Medical deductible$0
Out-of-pocket maximum (in network)$9,850
Plan typeDual Special Needs Plan (Medicare Advantage), HMO
Referral needed to see a specialistYes
Plan IDH4523-041-000

With a Medicare Advantage plan you also keep paying your Medicare Part B premium, unless Medicaid pays it for you.

What this plan would cost for your prescriptions

Add your prescriptions to see this plan's estimated yearly cost for them, which of them are on its drug list, and how each compares with Cost Plus Drugs prices.

See this plan with my prescriptions

What you pay for medical care

Primary care visit$0
Specialist visit$0
Preventive care$0
Urgent care$40
Emergency room$115
Hospital stay$0
Outpatient surgery20%
Lab tests20%
X-rays and scans20%
Mental health visit$0
Physical therapy$0
Medical equipment20%
TelehealthCovered

In-network amounts. A range means it depends on the service or provider.

Extra benefits

DentalCovered — up to $1250 allowance
VisionCovered — up to $300/yr allowance
HearingCovered — up to $2000/yr allowance
Over-the-counter itemsCovered — up to $110/mo allowance
FitnessCovered
Rides to appointmentsCovered — 12 one-way trips/yr

Drug costs by tier

Tier30 days, standard pharmacy30 days, preferred pharmacy90 days by mail
1 Preferred Generic$0$0$0
2 Generic$0$0$0
3 Preferred Brand9%9%9%
4 Non-Preferred Drug25%25%25%
5 Specialty Tier25%25%N/A

A percentage is coinsurance: your share of the drug's price. The drug deductible may apply first, depending on the tier. Your Part D out-of-pocket costs are capped at $2,400 for 2027.

Where it's sold

Texas (98 counties)

Other 2027 Aetna Medicare plans in Texas

Plan costs and benefits are from CMS's 2027 Medicare plan data (data as of October 27, 2026). Star ratings are CMS's 2027 Star Ratings. Every year, Medicare evaluates plans based on a 5-star rating system. Benefits, premiums and copays can change from year to year; check the plan's Evidence of Coverage, call the plan, or use Medicare.gov before you enroll.