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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 Greater Central Ohio Area. This plan received an overall rating of 4 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 $32.00. 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 $5900.00 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. You must first pay a $590 deductible before your drug coverage begins. After your deductible is met, you will pay different amounts depending on the drug tier and pharmacy. For preferred generic drugs, you will have no copay at preferred pharmacies and preferred mail order, but a $12 copay at standard pharmacies and standard mail order. For other tiers, you will pay coinsurance of 24% or 25% depending on the drug and pharmacy. Once 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 range of benefits with varying costs. For inpatient hospital stays, you'll pay a copay of $325 for the first week, with no copay thereafter. Outpatient services have copays that vary by service, and many services, such as primary care visits, preventive services, and dental services, come with no copay. This plan also covers ambulance services, with a $290 copay for both ground and air transport, and emergency services with a $125 copay. Hearing and vision services are covered, with hearing exams at a $35 copay and eye exams with no copay. Additionally, the plan provides benefits for home health, skilled nursing, and home infusion services, with specific copays and coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both requiring prior authorization. For Inpatient Hospital-Acute, you pay a $325 copay for days 1-7, and no copay for days 8-90, while for Inpatient Hospital Psychiatric, the copay is also $325 for days 1-7 and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay, but additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $375, Observation Services with a $325 copay, Ambulatory Surgical Center Services with no copay, Outpatient Substance Abuse Services with a $40 copay for both individual and group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Select (HMO-POS) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Select (HMO-POS). Ground and air ambulance services each have a $290 copay, with no 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 the Aetna Medicare Select (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, while Worldwide Emergency Transportation has a $290 copay, and there is no coinsurance for any of these services. Urgently Needed Services have a $45 copay with no coinsurance.
Primary Care See details
Primary Care services include no copay for Primary Care Physician Services, a $20 copay for Chiropractic Services, and a $35 copay for Occupational Therapy Services. Physician Specialist Services have a $35 copay, and Physical Therapy and Speech-Language Pathology Services have a $35 copay. Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services all have a $40 copay for individual and group sessions. Additional Telehealth Benefits have a 20% coinsurance with a copay between $0 and $45.
Preventive Services See details
Preventive Services include an annual physical exam with no copay. Additional preventive services include health education, wigs for hair loss related to chemotherapy, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, and fitness benefits with no copay, as well as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit with no copay. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing Services include hearing exams with a $35 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay, all with a limit of one visit per year. Prescription hearing aids are covered with a maximum copay of $1,700, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, nor are OTC hearing aids.
Vision Services See details
The Aetna Medicare Select (HMO-POS) plan covers vision services, including eye exams with a copay of $0-$35, and eyewear with no copay and a combined maximum benefit of $200 per year. Routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are covered with no copay.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with no copay, as well as 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, each with no copay. This plan has a $1,000 maximum for Other Dental Services, per year. 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, 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 the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered. Durable Medical Equipment (DME) has no copay and a coinsurance between 0% and 20%, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a coinsurance between 0% and 20%. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests, lab services, and radiological services. Diagnostic procedures/tests have a copay between $0 and $100, and lab services have no copay. Diagnostic radiological services have a copay up to $200, therapeutic radiological services have 20% coinsurance, and outpatient X-ray services have a $10 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. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but the plan does not cover specific sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, and Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services. There is a copay for some cardiac and pulmonary rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items, Meal Benefit, Other 1 (annual wellness exam and screening mammography), and Other 2 (gFOBT, FIT), each with no copay. Acupuncture, 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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