Aetna Medicare Partial Dual Care (HMO D-SNP) in Polk 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) (H4523-043) is a $5-premium Medicare Advantage HMO D-SNP from CVS Health Corporation available in Polk 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 ID043
Segment ID0
Contract year2026
Contract categorySNP
Plan typeHMO D-SNP
SNPYes — Dual-Eligible
Monthly consolidated premium$4.80
Part C premium$0.00
Part D basic premium$4.80
Part D total premium$4.80
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 = Polk 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 Polk County

The CMS CY2026 Landscape file lists 45 Medicare Advantage plans in Polk County, Texas, of which 0 carry a 5.0-star overall rating and 27 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.

For the full county plan directory, see all Medicare plans in Polk 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 — H4523-043.
  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 H4523-043 means

CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H4523-043, 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 043 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) (H4523-043)?

Aetna Medicare Partial Dual Care (HMO D-SNP) (H4523-043) is offered in 19 Texas counties: Austin County, Brazoria County, Brazos County, Chambers County, Fort Bend County, Grimes County, Hardin County, Harris County, Jefferson County, Liberty County, Matagorda County, Montgomery County, Polk County, San Jacinto County, Victoria County, Walker County, Waller County, Washington County, and Wharton County.

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