Aetna Medicare Partial Dual Care (HMO D-SNP) in Karnes County, Texas — 2026 plan details

Last updated Jul 18, 2026

Reviewed by Jason Burns, Editorial Steward

Published by Senior Direct Answers · Licensed under Citation License 1.0

Aetna Medicare Partial Dual Care (HMO D-SNP) (H4523-041) is a $5-premium Medicare Advantage HMO D-SNP from CVS Health Corporation available in Karnes County, Texas in 2026, with a 4.0-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.

Plan facts (CMS CY2026 Landscape file)

OrganizationCVS Health Corporation
Plan nameAetna Medicare Partial Dual Care (HMO D-SNP)
Contract IDH4523
Plan ID041
Segment ID0
Contract year2026
Contract categorySNP
Plan typeHMO D-SNP
SNPYes — Dual-Eligible
Monthly consolidated premium$4.60
Part C premium$0.00
Part D basic premium$4.60
Part D total premium$4.60
Annual Part D deductible$615.00
Maximum out-of-pocket (in-network)$9250.00
Overall star rating4.0

How this plan is structured

  • $5 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
  • HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
  • $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
  • Service area = Karnes County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.

How it compares in Karnes County

The CMS CY2026 Landscape file lists 46 Medicare Advantage plans in Karnes County, Texas, of which 10 carry a 5.0-star overall rating and 26 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $110.00 per month, and in-network out-of-pocket maximums range from $3400.00 to $9250.00.

Other 5.0-star Medicare Advantage plans in Karnes County (first three alphabetically):

PlanOrganizationPremiumMOOP
DEVOTED C-SNP 046 TX (HMO C-SNP)Devoted Health, Inc.$0.00$4450.00
DEVOTED C-SNP PLUS 033 TX (HMO C-SNP)Devoted Health, Inc.$4.80$9250.00
DEVOTED CORE 003 TX (HMO)Devoted Health, Inc.$0.00$3900.00

For the full county plan directory, see all Medicare plans in Karnes County, Texas.

How to verify your doctors take this plan

Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:

  1. Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H4523-041.
  2. Call the plan (CVS Health Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
  3. Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.

What H4523-041 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4523-041, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 4523 are the contract number issued to the organization, and the three-digit 041 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).

Frequently asked questions

Is Aetna Medicare Partial Dual Care (HMO D-SNP) an HMO or PPO?

Aetna Medicare Partial Dual Care (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.

Does Aetna Medicare Partial Dual Care (HMO D-SNP) include prescription drug coverage?

Yes — Aetna Medicare Partial Dual Care (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.

What is the maximum out-of-pocket cost for Aetna Medicare Partial Dual Care (HMO D-SNP)?

The 2026 in-network maximum out-of-pocket limit for Aetna Medicare Partial Dual Care (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.

What counties offer Aetna Medicare Partial Dual Care (HMO D-SNP) (H4523-041)?

Aetna Medicare Partial Dual Care (HMO D-SNP) (H4523-041) is offered in 80 Texas counties: Aransas County, Atascosa County, Bandera County, Bee County, Bell County, Bexar County, Bowie County, Brooks County, Burleson County, Burnet County, Caldwell County, Calhoun County, Cameron County, Cass County, Cherokee County, Colorado County, Comal County, Comanche County, Coryell County, DeWitt County, Duval County, Ector County, El Paso County, Erath County, Falls County, Fayette County, Goliad County, Gonzales County, Gregg County, Guadalupe County, Hamilton County, Harrison County, Henderson County, Hidalgo County, Houston County, Jackson County, Jasper County, Jim Hogg County, Jim Wells County, Karnes County, Kendall County, Kenedy County, Kleberg County, Lamar County, Lampasas County, Lavaca County, Lee County, Leon County, Live Oak County, Lubbock County, Madison County, Marion County, Maverick County, Medina County, Midland County, Milam County, Morris County, Nacogdoches County, Newton County, Nueces County, Panola County, Potter County, Rains County, Randall County, Red River County, Refugio County, Robertson County, Rusk County, San Augustine County, Smith County, Starr County, Titus County, Tom Green County, Tyler County, Upshur County, Van Zandt County, Webb County, Willacy County, Wilson County, and Wood County.

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