In-network
Aetna Medicare Value Plus (PPO)
Emergency transport
Ambulance
Emergency services
Emergency room
$130 copay
Waived if admitted within 24 hours
Medical maximum
Maximum out-of-pocket
Skilled care at home
Home health
Monthly cost
Premium & giveback
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Primary care physician
In: $0 copay · Out: 40% coinsurance
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Specialist
In: $0–$65 copay · Out: 40% coinsurance
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Preventive care
In: $0 copay · Out: 0%–40% coinsurance
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Diagnostic procedures & tests
In: $0–$40 copay · Out: 40% coinsurance
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Laboratory services
In: $0 copay · Out: 40% coinsurance
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X-rays & standard imaging
In: $0–$325 copay · Out: 40% coinsurance
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MRI, CT & PET imaging
In: 20% coinsurance · Out: 40% coinsurance
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Urgent care
In: Cost share not reported · Out: Not separately reported
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Emergency room
In: $130 copay · Out: Not separately reported
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Ground ambulance
In: $340 copay · Out: $340 copay
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Air ambulance
In: 20% coinsurance · Out: 20% coinsurance
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Outpatient hospital
In: $0–$350 copay · Out: 40% coinsurance
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Outpatient surgery / ASC
In: $0–$300 copay · Out: 40% coinsurance
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Home health
In: $0 copay · Out: 40% coinsurance
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Skilled nursing facility
In: Cost share not reported · Out: Not separately reported
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Cardiac & pulmonary rehabilitation
In: $20 copay · Out: 40% coinsurance
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Occupational therapy
In: $50 copay · Out: 40% coinsurance
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Physical & speech therapy
In: $50 copay · Out: 40% coinsurance
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Mental health services
In: $70 copay · Out: 40% coinsurance
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Substance use treatment
In: $145 copay · Out: 40% coinsurance
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Podiatry
In: $65 copay · Out: 40% coinsurance
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Chiropractic
In: $15 copay · Out: 40% coinsurance
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Dental
In: $65 copay · Out: 40% coinsurance
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Vision
In: $0 copay · Out: $0 copay
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Hearing
In: $0 copay · Out: 40% coinsurance
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Transportation
Not reported in this CMS export
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Fitness & wellness
In: $0 copay · Out: $0 copay
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Over-the-counter allowance
Not reported in this CMS export
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Meals
In: $0 copay · Out: $0 copay
Plan details
All plan benefits
No benefits match that search.
Medical care3 benefits
Primary care physician
Specialist
Preventive care
Diagnostics & imaging4 benefits
Diagnostic procedures & tests
Laboratory services
X-rays & standard imaging
MRI, CT & PET imaging
Urgent & hospital care6 benefits
Urgent care
Emergency room
Ground ambulance
Air ambulance
Outpatient hospital
Outpatient surgery / ASC
Recovery & therapy5 benefits
Home health
Skilled nursing facility
Cardiac & pulmonary rehabilitation
Occupational therapy
Physical & speech therapy
Behavioral health2 benefits
Mental health services
Substance use treatment
Specialty care2 benefits
Podiatry
Chiropractic
Supplemental benefits7 benefits
Dental
Vision
Hearing
Transportation
Not reported in this CMS exportNot reported in this CMS export
Fitness & wellness
Over-the-counter allowance
Not reported in this CMS exportNot reported in this CMS export
Meals
Plan costs & rulesCoverage overview
Premium & Part B giveback
$0 Part C premium / month · Part B giveback not separately reported
Maximum out-of-pocket (MOOP)
Medical deductibles
Network & referrals
Local PPO · Referrals: Not required · Out-of-network coverage: Yes
Prescription drugs5 tiers
Part D deductible
Not reported
Drug tier 1
$2 retail copay · 30-day supply
Drug tier 2
$12 retail copay · 30-day supply
Drug tier 3
22% retail coinsurance · 30-day supply
Drug tier 4
25% retail coinsurance · 30-day supply
Drug tier 5
25% retail coinsurance · 30-day supply
Using this plan
Understand H3288-018-000
Plain-language context built from this plan’s 2026 CMS record. It is a guide to the reported benefits, not a personalized cost estimate.
Plan at a glance
A quick read on this plan
Aetna Medicare Value Plus (PPO) is a 2026 Local PPO offered by Aetna Medicare in Southeast Non-Metro Counties. The CMS record indicates out-of-network coverage, although member costs may differ from in-network care. The plan record does not require referrals. Its listed inpatient copay stages total $2,640 across 6 charged days.
Common benefit costs
What you may pay
These are individual in-network benefit amounts. A real visit may involve more than one separately billed service.
Routine care
- Primary care physician
- $0 copay
- Specialist
- $0–$65 copay
- Laboratory services
- $0 copay
Separate visits or services; costs are not added together.
Tests & outpatient care
- Diagnostic procedures & tests
- $0–$40 copay
- MRI, CT & PET imaging
- 20% coinsurance
- Outpatient hospital
- $0–$350 copay
The service setting and billing details can change what you pay.
Emergency & hospital care
- Emergency room
- $130 copay
- Listed inpatient stages
- $2,640 total
6 charged inpatient days are included in the calculated total. Actual costs depend on the care received and plan rules.
Helpful context
Terms worth knowing
Maximum out-of-pocket (MOOP)
This is the most you generally pay during the plan year for covered Part A and Part B medical services under the applicable network limit. Premiums and prescription drug costs generally do not count toward it.
Availability
Who can enroll
- Service area
- Southeast Non-Metro Counties (TX)
- Plan type
- Local PPO
- Contract / plan
- H3288-018
- Coverage year
- 2026
Enrollment generally requires Medicare eligibility and residence in the plan's service area. Confirm eligibility and the exact service area with the plan before enrolling.
Supplemental coverage
Extra benefits reported
Availability is summarized here; allowances, frequency limits, networks, and prior-authorization rules may apply.
Plan-specific answers
Frequently asked questions
Where is H3288-018-000 available?
Aetna Medicare Value Plus (PPO) is listed for Southeast Non-Metro Counties (TX). Enrollment generally requires Medicare eligibility and residence in the plan's service area.
What is the in-network maximum out-of-pocket limit for H3288-018-000?
The 2026 CMS record lists an in-network medical maximum out-of-pocket limit of $6,750. Prescription drug spending generally does not count toward this medical limit.
What is the monthly plan premium for H3288-018-000?
The listed consolidated Part C and Part D premium is $4.80 per month. This does not replace the standard Medicare Part B premium.
What does an emergency room visit cost on H3288-018-000?
The plan record lists $130 copay, waived when an admission meets the plan's stated timing rule.
Does H3288-018-000 report extra benefits?
Yes. CMS reports dental, vision, hearing, fitness & wellness, meals. See the detailed benefit rows and official plan documents for limits and conditions.
Carrier-hosted source material
Official plan documents
An exact direct document has not been verified for this plan yet. Use the carrier's document finder and confirm H3288-018-000 before relying on a document.
Source trail
Official CMS, Contract Year 2026
Plan identity and benefits come from CMS PBP data. Premium and MOOP figures are cross-checked against the August 2026 Landscape release; county identity is sourced from segment-level Landscape rows and stable codes are enriched from the aligned MA contract service-area release where matched. Quick-reference values should be confirmed in 2026 official plan documents.
Plan context
Where H3288-018-000 fits
- Full CMS plan ID
H3288-018-000- Contract
H3288- Base plan code
H3288-018- Segment
000- Carrier
- Aetna Medicare
- Plan type
- Local PPO
- Service area
- Southeast Non-Metro Counties (TX)
County/service-area foundation
CMS service-area entries
Named county entries are tied to this exact contract, plan, and segment in CMS Landscape data. County codes are enriched from the aligned CMS contract service-area release where a match exists.
- Austin, TX
- Brazoria, TX
- Brazos, TX
- Chambers, TX
- Colorado, TX
- Fort Bend, TX
- Grimes, TX
- Hardin, TX
- Jasper, TX
- Jefferson, TX
- Liberty, TX
- Madison, TX
10 additional service-area entries are retained in the data record.
About this code
What H3288-018-000 identifies
H3288-018-000 is a Contract Year 2026 Medicare plan segment code. Searches written as H3288-018, H3288 018, or the compact full CMS ID H3288018000 refer to this plan or its base plan code.
Medicare Plan Lookup uses official CMS data as a quick reference. Benefit details, eligibility, service-area rules, and cost sharing should be confirmed in the current Summary of Benefits or Evidence of Coverage.