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Aetna Medicare Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Select (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Select (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Select (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Sacramento, San Joaquin and Yolo Counties. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Aetna Medicare Select (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Select (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Aetna Medicare Select (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Aetna Medicare Select (HMO-POS) plan has an enhanced alternative drug benefit. Before your coverage begins, you must meet a $590 deductible. In the initial coverage phase, after your deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred and mail order pharmacies, and a $12 copay at standard pharmacies. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Select (HMO-POS) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a copay, but many services like outpatient, partial hospitalization, primary care, preventive, hearing, vision, and dental services have no copay. Emergency services, ambulance services, and other services have copays or coinsurance, depending on the specific service. The plan also covers home health, cardiac rehabilitation, and skilled nursing facility services, with some requiring prior authorization. Additional benefits include coverage for medical equipment, diagnostic and radiological services, and over-the-counter items. The plan provides coverage for many services, but some services have copays, coinsurance, and/or require prior authorization.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, with a $100 copay for days 1-5 and no copay for days 6-90; the plan does not cover Non-Medicare-covered Stay or Upgrades for Inpatient Hospital-Acute, and does not cover Additional Days or Non-Medicare-covered Stay for Inpatient Hospital Psychiatric. Additional days for Inpatient Hospital-Acute are covered with no copay.
Outpatient Services See details
Outpatient Services are covered by Aetna Medicare Select (HMO-POS), including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay of $0-$50, while observation services, ambulatory surgical center services, outpatient substance abuse individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Select (HMO-POS) plan, with prior authorization required. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground Ambulance Services have a $250 copay, while Air Ambulance Services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay, up to 12 one-way trips per year using rideshare services, bus/subway, or medical transport, and Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare Select (HMO-POS) plan. Emergency Services have a $140 copay and no coinsurance, Urgently Needed Services have a $10 copay and no coinsurance, Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay and no coinsurance, and Worldwide Emergency Transportation has a $250 copay and no coinsurance.
Primary Care See details
The Aetna Medicare Select (HMO-POS) plan covers primary care physician services, chiropractic services, occupational therapy, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy, speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, physical therapy, and speech-language pathology services have no copay. For additional telehealth benefits, there is a 20% coinsurance and a copay between $0 and $10.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and also cover additional services like health education, wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, fitness benefit, and remote access technologies, with no copay for those services. Other services like kidney disease education services have a 20% coinsurance. Some services like in-home safety assessment, personal emergency response systems, medical nutrition therapy, and others are not covered.
Hearing Services See details
Hearing services with Aetna Medicare Select (HMO-POS) include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a maximum benefit of $1,250 per year, and all types of prescription hearing aids have no copay.
Vision Services See details
The Aetna Medicare Select (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay. Eyewear has a combined maximum plan benefit of $275 every year.
Dental Services See details
Dental services are covered, with a maximum benefit of $750 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventative dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Select (HMO-POS), requiring prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Select (HMO-POS), but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered by Aetna Medicare Select (HMO-POS). Durable medical equipment has no copay and a coinsurance between 0% and 20%, while medical supplies have no coinsurance. Diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services, and all radiological services. Diagnostic Procedures/Tests and Lab Services have no copay, while Therapeutic Radiological Services have a copay of $60, and Diagnostic Radiological Services and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Select (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but no specific services are covered. A doctor referral is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Select (HMO-POS), but require prior authorization. For days 1-20, there is no copay, and for days 21-100, there is a $50 copay. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Under "Other Services", Aetna Medicare Select (HMO-POS) covers acupuncture with no copay, and over-the-counter (OTC) items with no copay up to $75 every three months. This plan does not cover meal benefits, and some other services like Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, Private Duty Nursing Services, and more are not covered.
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