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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 Cincinnati Dayton OH 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 $36.00. 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 $4150.00 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. The plan has a deductible of $590. Once you meet your deductible, you will pay a copay or coinsurance for your prescriptions depending on the drug tier and pharmacy. For preferred generic drugs, you have no copay at preferred pharmacies or preferred mail order. For standard generic drugs, preferred and standard pharmacies and mail order options have 22% coinsurance. For preferred brand drugs, you pay 25% coinsurance at all pharmacies.
Additional Benefits
The Aetna Medicare Select (HMO-POS) plan offers a variety of benefits with varying costs. This plan includes coverage for inpatient and outpatient hospital services, with copays ranging from $0 to $350 depending on the service. It also covers a wide range of services such as primary care, preventive care, hearing, vision, and dental services, with many services incurring no copay or low copays. Additional benefits include ambulance services, emergency services, and home health services with no copays. The plan also provides coverage for medical equipment, diagnostic and radiological services, and skilled nursing facility stays with varying costs. However, some services like cardiac rehabilitation, certain hearing aids, and specific dental procedures are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Aetna Medicare Select (HMO-POS) plan. For Inpatient Hospital-Acute, you'll pay a $350 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you'll also pay a $350 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, and outpatient substance abuse services, are covered under this plan. Outpatient hospital services have a copay of $0-$285, while observation services have a $350 copay. Ambulatory Surgical Center (ASC) Services and outpatient blood services have no copay, while individual and group sessions for outpatient substance abuse have a copay of $35.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Select (HMO-POS) plan. There is a $40 copay for this benefit, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground and air ambulance services have a $290 copay, and transportation services to a plan-approved health-related location have no copay, with a limit of 12 one-way trips per year using rideshares, bus/subway, or medical transport.
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, Urgently Needed Services have a $40 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, while Worldwide Emergency Transportation has a $290 copay.
Primary Care See details
The Aetna Medicare Select (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, and specialist services with a $35 copay. Mental health, podiatry, other health care professional, psychiatric, and opioid treatment services are covered, but have varying copays depending on the specific service, and additional telehealth benefits are covered with a 20% coinsurance and a copay between $0 and $40. Physical therapy and speech-language pathology services have a $25 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, as well as additional preventive services which include Health Education, Nutritional/Dietary Benefit, and Wigs for Hair Loss Related to Chemotherapy, all with no copay. Kidney disease education services have a 20% coinsurance, and other preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay.
Hearing Services See details
Hearing services include hearing exams with a $35 copay, and Routine Hearing Exams and Fitting/Evaluation for Hearing Aid with no copay. Prescription Hearing Aids (all types) are covered, with a maximum copay of $1700. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, Prescription Hearing Aids - Over the Ear, and OTC Hearing Aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams and eyewear. Eye exams have a copay of $0-$35, while routine eye exams and other eye exam services have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, are covered with no copay and a combined maximum benefit of $175 per year.
Dental Services See details
Dental Services includes coverage for Medicare dental services with no copay, as well as other dental services with a $1,000 maximum benefit per year, with no copay for 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. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, Medicare Part B Chemotherapy/Radiation Drugs with a 0-20% coinsurance, and Other Medicare Part B Drugs with a 0-20% coinsurance. Prior authorization is required for this benefit.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered, including durable medical equipment with a coinsurance between 0% and 20%, prosthetics/medical supplies with a coinsurance, and diabetic equipment with a coinsurance between 0% and 20% and potential copays. Durable medical equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $150, lab services with no copay, and radiological services with a copay of at most $175 and coinsurance of at most 20% for therapeutic radiological services and no copay for outpatient X-ray services. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Select (HMO-POS) plan with no copay and no coinsurance; however, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Select (HMO-POS) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Select (HMO-POS) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services include coverage for over-the-counter (OTC) items and meal benefits with no copay, and other services such as annual wellness exams and screening mammography, and gFOBT and FIT with no copay. Acupuncture, 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, 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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