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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 Fresno County. 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 $2900.00 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 a $590 deductible for prescription drugs. After meeting your deductible, you'll pay a copay or coinsurance depending on the drug tier and where you fill your prescriptions. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail order. In the initial coverage phase, you'll pay 24% coinsurance for standard generic drugs, 25% coinsurance for preferred brand and non-preferred drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Medicare Select (HMO-POS) plan offers a wide range of benefits with varying cost-sharing. Many services, such as primary care visits, preventive services, and outpatient services, have no copay. The plan also covers inpatient hospital stays, emergency services, and ambulance services, with copays and coinsurance amounts depending on the specific service. Other covered services include hearing, vision, and dental, with specific limits and cost-sharing. The plan also covers home health services, dialysis, and medical equipment, with some services requiring prior authorization and coinsurance. Overall, the plan provides a comprehensive set of benefits with a mix of no copay, copay, and coinsurance expenses depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, there is a $475 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, there is a $360 copay for days 1-7, and no copay for days 8-90. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $200, observation services with no copay, ambulatory surgical center services with no copay, individual and group sessions for outpatient substance abuse with a $10 copay, and outpatient blood services with no copay. Prior authorization is required for some services.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Select (HMO-POS) plan, with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $150 copay, while air ambulance services have a 20% coinsurance; transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by Aetna Medicare Select (HMO-POS). Emergency Services and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, and Worldwide Emergency Transportation has a $150 copay; there is no coinsurance for any of these services. Urgently Needed Services have no copay and no coinsurance.
Primary Care See details
The Aetna Medicare Select (HMO-POS) plan covers 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, additional telehealth benefits and opioid treatment program services. Primary care physician services, chiropractic services, physician specialist services, and physical therapy and speech-language pathology services have no copay, while individual and group mental health and psychiatric sessions have a $10 copay. Additional telehealth benefits have a 20% coinsurance with a copay between $0 and $10, while opioid treatment program services have a $10 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional services like health education, wigs for hair loss, and fitness benefits with no copay. Kidney disease education services have a 20% coinsurance, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit have no copay. Some services like in-home safety assessment, personal emergency response system, medical nutrition therapy, and others are not covered.
Hearing Services See details
Aetna Medicare Select (HMO-POS) covers hearing exams with no copay and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a plan-specified amount of $2,000 per year, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, including routine eye exams once per year and other eye exam services, such as follow up diabetic eye exams, with no copay. Eyewear is not covered, including contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental services include a $1,000 maximum plan benefit per year, and cover oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay; however, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. Medicare Part B Insulin Drugs have a $35 copay. 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 under the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Select (HMO-POS), including Durable Medical Equipment (DME) with 0% to 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with no coinsurance. Diabetic Equipment is covered, including Diabetic Supplies with 0% to 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with no copay, Lab Services with no copay, and Outpatient X-Ray Services with no copay. Diagnostic Radiological Services have a copay of at most $50, and Therapeutic Radiological Services have coinsurance of at most 20%.
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.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with a doctor referral, but the specific services of Medicare-covered Intensive Cardiac Rehabilitation, Medicare-covered Pulmonary Rehabilitation, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD), and Additional Cardiac Rehabilitation Services are not covered. There is a copay for some services, but the specific copay information is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. For days 1-20, the copay is $20, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for Skilled Nursing Facility (SNF) are not covered.
Other Services See details
Other Services include acupuncture, and other services. Acupuncture has no copay, while other services include annual wellness exams and screening mammography, and gFOBT and FIT, all with no copay. Over-the-counter items, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, private duty nursing services, case management (long term care), institution for mental disease services for individuals 65 or older, services in an intermediate care facility for individuals with intellectual disabilities, case management, tobacco cessation counseling for pregnant women, freestanding birth center services, respiratory care services, family planning services, nursing home services, home and community based services, personal care services, and self-directed personal assistance services are not covered.
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