Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026
Aetna Medicare Full Dual Extra Care, 2027
H4523Contract034Plan
HMO D-SNP · special needs plan, dual-eligible · 98 counties in Texas
Run by Aetna Health Inc. (TX) (contract H4523), sold as Aetna Medicare, owned by CVS Health Corporation
Aetna Medicare Full Dual Extra Care (H4523-034) 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 Full Dual Care. It leaves 11 counties it served in 2026, where 347 of its members lived; they choose another plan for 2027 (the counties are listed below).
What changes from 2026 to 2027?
| What you pay or get | 2026 | 2027 | Change |
|---|---|---|---|
| Plan name | Aetna Medicare Full Dual Care | Aetna Medicare Full Dual Extra Care | renamed |
| In-network out-of-pocket limit | $9,250 | $9,850 | ▲up $600 |
| Drug deductible | $615 | $700 | ▲up $85 |
| Part B premium reduction, monthly | $2 | none | ▼dropped |
| Hospital stay, in network | $1,700 a stay | $1,975 a stay | ▲up $275for a 5-day stay |
| Skilled nursing facility, in network | not filed | $0 a day for days 1–20, then $221 a day for days 21–100 | changed |
| Eyewear, yearly limit | $350 a year | $400 a year | ▲up $50 |
| Hearing aids, yearly limit for both ears | $2,000 a year | $1,500 a year | ▼down $500 |
| Over-the-counter items, yearly | $1,920 a year | $2,280 a year | ▲up $360 |
| Counties served | 83 | 98 | ▲up 15 |
| Drug tier 2, generic | $10 | $0 | ▼down $10 |
| Drug tier 3, preferred brand | 22% of the cost | 9% of the cost | ▼down 13 points |
| 10 lines do not change | |||
| Monthly premium | $0 | $0 | no change |
| Primary care visit | $0 copay | $0 copay | no change |
| Specialist visit | $0 copay | $0 copay | 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 |
| Drug tier 1, preferred 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 | $10 | $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, 77 dual-eligible special needs plans are sold for 2027, this one included. Against the others, 8 plans have a lower out-of-pocket limit, 68 the same. On the premium, 69 the same, 7 a higher one.
Out-of-pocket limits of the 77 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?
It stops serving 11 counties it served in 2026 (listed in the next section).
The premium and the out-of-pocket limit are the same in all 98 counties: $0 a month and $9,850.
Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).
What if you live in a county it leaves?
Its 2026 members in the 11 counties listed below cannot stay in it for 2027; each county page lists the 2027 plans sold there.
- Your coverage
- This plan ends for you on December 31, 2026, because it is no longer sold where you live.
- October 15 to December 7, 2026
- Open enrollment: join another Medicare Advantage plan, or Original Medicare with a drug plan. Coverage starts January 1, 2027.
- December 8, 2026 to the end of February 2027
- A special enrollment period because the plan is leaving: you can still join a plan, but coverage starts the first day of the month after you join, so choose by December 31 to have no gap.
- If you do nothing
- You are enrolled in Original Medicare when the plan ends, and because you have Medicaid, Medicare enrolls you in a drug plan.
- If you choose Original Medicare
- You have a guaranteed right to buy Medigap Plan A, B, C, D, F, G, K or L sold in your state by any insurance company; if you were new to Medicare on or after January 1, 2020, Plans D and G take the place of C and F. Apply from 60 days before to 63 days after the plan ends; the policy starts once your Medicare Advantage coverage ends. Other Medigap plans are not covered by this right.
- If you have Medicaid or Extra Help
- You can switch to a different drug plan, or leave a Medicare Advantage plan for Original Medicare with a drug plan, once a calendar month; the change starts the first day of the next month.
| County | Members, Sept. 2026 |
|---|---|
| Travis, TX | 133 |
| Smith, TX | 42 |
| Hays, TX | 35 |
| Williamson, TX | 33 |
| Bowie, TX | 32 |
| Randall, TX | 32 |
| Henderson, TX | 21 |
| Cherokee, TX | 19 |
| Colorado, TX | fewer than 11 |
| DeWitt, TX | fewer than 11 |
| Hamilton, TX | fewer than 11 |
Source: CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11); Medicare.gov, “Special enrollment periods” and “When can I buy Medigap?” (read Oct. 7, 2026).
Who runs this plan?
- Plan ID
- H4523-034
- Legal name of the contract
- Aetna Health Inc. (TX)
- Sold as
- Aetna Medicare
- Parent company
- CVS Health Corporation
- Plan type
- HMO D-SNP
- 2026 star rating of the contract
- 4 of 5 overall; health plan 4 of 5, drug plan 3.5 of 5
- Members, September 2026
- 2,564
- 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 Bexar, TXWhere 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 23 plans of contract H4523Same 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.