Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Aetna Medicare Full Dual, 2027
H1692Contract005Plan
HMO D-SNP · special needs plan, dual-eligible · 55 counties in West Virginia
Run by Coventry Health Care of West Virginia, Inc. (contract H1692), sold as Aetna Medicare, owned by CVS Health Corporation
Aetna Medicare Full Dual (H1692-005) costs $0 a month in 2027, the same as in 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026). In 2026 it was called Aetna Medicare Advantra Dual. Some of its 2026 members move to H1692-010 instead (CMS crosswalk).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Plan name | Aetna Medicare Advantra Dual | Aetna Medicare Full Dual | renamed |
| In-network out-of-pocket limit | $9,250 | $9,850 | ▲up $600 |
| Drug deductible | $615 | $700 | ▲up $85 |
| Hospital stay, in network | $1,865 a stay | $2,060 a stay | ▲up $195for a 5-day stay |
| Skilled nursing facility, in network | $0 a day for days 1–20, then $218 a day for days 21–100 | $0 a day for days 1–20, then $221 a day for days 21–100 | ▲up $30for a 30-day stay |
| Eyewear, yearly limit | $300 a year | $250 a year | ▼down $50 |
| Over-the-counter items, yearly | $2,100 a year | $2,220 a year | ▲up $120 |
| Counties served | 49 | 55 | ▲up 6 |
| Drug tier 3, preferred brand | 22% of the cost | 9% of the cost | ▼down 13 points |
| 13 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Part B premium reduction, monthly | none | none | no change |
| Primary care visit | 20% of the cost | 20% of the cost | no change |
| Specialist visit | 0% of the cost | 0% of the cost | no change |
| Emergency room | $115 copay | $115 copay | no change |
| Medical deductible, in network | none | none | no change |
| Ground ambulance, in network | 20% of the cost | 20% of the cost | no change |
| Comprehensive dental, yearly limit | not offered | not offered | no change |
| Hearing aids, yearly limit for both ears | $500 a year | $500 a year | no change |
| Drug tier 1, preferred generic | $0 | $0 | no change |
| Drug tier 2, generic | $0 | $0 | no change |
| Drug tier 4, non-preferred drug | 25% of the cost | 25% of the cost | no change |
| Drug tier 5, specialty tier | 25% of the cost | 25% of the cost | no change |
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.
What will prescriptions cost?
| Tier | What the tier holds | 2026 | 2027 |
|---|---|---|---|
| Tier 1 | Preferred Generic | $0 | $0 |
| Tier 2 | Generic | $0 | $0 |
| Tier 3 | Preferred Brand | 22% of the cost | 9% of the cost |
| Tier 4 | Non-Preferred Drug | 25% of the cost | 25% of the cost |
| Tier 5 | Specialty Tier | 25% of the cost | 25% of the cost |
Source: CMS plan benefit package files, 2027 and 2026. Insulin is capped at $35 a month by law. A drug's tier is set by the plan's formulary.
How does it compare with plans sold where it is?
In the counties it serves, 15 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 3 plans have a lower out-of-pocket limit, 11 the same. On the premium, 10 the same, 4 a higher one.
Out-of-pocket limits of the 15 dual-eligible special needs plans
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where is it sold, and what does it cost there?
The premium and the out-of-pocket limit are the same in all 55 counties: $0 a month and $9,850.
West Virginia
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
Where do its 2026 members go?
The CMS crosswalk moves the members of the 2026 plan into 2 plans for 2027. It names the plans but not which member goes to which; the counties show where each 2027 plan is sold, and the plan's Annual Notice of Change says which one is yours.
| 2027 plan | Sold in | Members in those counties, Sept. 2026 | Premium 2027 | Limit 2027 |
|---|---|---|---|---|
| Stays in this plan | 49 of its 49 2026 counties, in West Virginia | 11,046 | $0 | $9,850 |
| Aetna Medicare Partial DualH1692-010 | 49 of its 49 2026 counties, in West Virginia | 11,046 | $0 | $9,850 |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11).
Who runs this plan?
- Plan ID
- H1692-005
- Legal name of the contract
- Coventry Health Care of West Virginia, Inc.
- Sold as
- Aetna Medicare
- Parent company
- CVS Health Corporation
- Plan type
- HMO D-SNP
- 2026 star rating of the contract
- 3.5 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
- Members, September 2026
- 11,086
- Plan website, as filed with CMS
- www.aetna.com/medicare
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.
What else should you check?
- Other 2027 plans in Kanawha, WVWhere most of its members live; premiums and limits side by side
- Every Aetna Medicare plan for 2027Its contracts, counties and plans that end
- The other 6 plans of contract H1692Same company, same contract
- Is your prescription covered?Coverage share and tier for 2,259 drugs
Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.