A non-government entity
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 Alameda, San Francisco and San Mateo 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2500.00 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:
Sign up for Aetna Medicare Select (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Select (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $5 copay at preferred pharmacies. After your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. Those who qualify for the low-income subsidy will have their premiums reduced.
Additional Benefits
The Aetna Medicare Select (HMO-POS) plan offers a variety of benefits, including inpatient and outpatient hospital services, with varying copays. The plan also covers ambulance and transportation services, emergency services, and a wide range of primary care services with no copay for many services. Preventive, hearing, vision, and dental services are also covered, with no copays for eye exams, eyewear, and a $1,000 annual maximum benefit for dental services. Additionally, the plan provides coverage for home infusion, dialysis services, medical equipment, diagnostic and radiological services, home health services, and skilled nursing facility services. The plan also covers acupuncture and over-the-counter items, and includes no copays for services like annual physical exams, hearing exams, and fitting/evaluation for hearing aids.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-5, the copay is $245, and for days 6-90, there is no copay. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $125, observation services with no copay, ambulatory surgical center services with no copay, individual and group sessions for outpatient substance abuse with a $40 copay, and outpatient blood services with no copay. Prior authorization is required for many services.
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 $295 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location have no copay for up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $140 copay, Worldwide Emergency Transportation has a $295 copay, and Urgently Needed Services have no copay. There is no coinsurance for these services.
Primary Care See details
Under the Aetna Medicare Select (HMO-POS) plan, primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, opioid treatment program services, and additional telehealth benefits are covered. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, and other health care professional services have no copay, and mental health specialty services, psychiatric services, and opioid treatment program services have a $40 copay, with the exception of group sessions, which have a $0 copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional preventive services, such as health education, wigs for hair loss related to chemotherapy, smoking cessation, and fitness benefits, with a $0 copay. Kidney disease education services have a 20% coinsurance. Other preventive services, such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, are covered with no copay.
Hearing Services See details
The Aetna Medicare Select (HMO-POS) plan covers hearing exams and routine hearing exams with no copay. Fitting/Evaluation for Hearing Aids is also covered with no copay. Prescription hearing aids are covered with a $1,250 maximum plan benefit per year, but hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay, while a combined maximum of $275 is covered annually for eyewear.
Dental Services See details
Dental services are covered, with a $1,000 annual maximum benefit. Preventive and diagnostic services, including oral exams, dental x-rays, and cleanings, have no copay. Other services, including maxillofacial prosthetics, implant services, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Aetna Medicare Select (HMO-POS) plan, with prior authorization required. For Medicare Part B Insulin Drugs, there is a $35 copay, while other Medicare Part B drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. There is a 20% coinsurance for this benefit.
Medical Equipment See details
The Aetna Medicare Select (HMO-POS) plan covers medical equipment, including Durable Medical Equipment (DME) with 0-20% coinsurance and no copay, and Medicare-covered prosthetic devices with 20% coinsurance. Medical supplies have no coinsurance, and diabetic equipment is covered with varying coinsurance and copays depending on the service.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests, lab services, diagnostic radiological services, therapeutic radiological services, and outpatient X-ray services, are covered. Lab Services, Diagnostic Radiological Services, and Outpatient X-Ray Services have no copay, while Therapeutic Radiological Services have a $60 copay.
Home Health Services See details
Home Health Services are covered under 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. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Select (HMO-POS) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Select (HMO-POS), but require prior authorization. You will have no copay for days 1-20, and a $75 copay for days 21-100.
Other Services See details
The Aetna Medicare Select (HMO-POS) plan covers acupuncture and over-the-counter (OTC) items. Acupuncture has no copay, and OTC items have no copay, with a maximum coverage amount of $75 every three months. Other services like meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and many others are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved