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Aetna Medicare Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Select (HMO). 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) in 2025, please refer to our full plan details page.
Aetna Medicare Select (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in GA. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Select (HMO) 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).
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), 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 $7900.00 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) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. After the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail order. Standard generic drugs have 24% coinsurance regardless of the pharmacy.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers a wide range of benefits. This plan covers inpatient hospital stays with a copay, as well as outpatient services with varying copays. The plan also includes coverage for ambulance, emergency, and primary care services. Additional benefits include preventive, hearing, vision, and dental services, with specific copays and maximums. The plan also covers home infusion, dialysis, medical equipment, and diagnostic services, often with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $380 copay for days 1-7, and no copay for days 8-90; and for Inpatient Hospital Psychiatric, you will pay a $407 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include outpatient hospital services with a copay between $0 and $380, observation services with a $380 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a $30 copay for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Select (HMO) plan, and requires prior authorization. The copay for this benefit is $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Select (HMO). Ground ambulance services have a $250 copay, while air ambulance services have 20% coinsurance. 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) plan. Emergency Services have a $110 copay, and Urgently Needed Services have a $45 copay, while Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, and Worldwide Emergency Transportation has a $250 copay.
Primary Care See details
The Aetna Medicare Select (HMO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, physician specialist services with a copay between $0 and $40, mental health specialty services with a $30 copay, other health care professional services with a copay between $0 and $40, psychiatric services with a $30 copay, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits with a 20% coinsurance and a copay between $0 and $45, and opioid treatment program services with a $30 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Aetna Medicare Select (HMO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, such as health education, wigs for hair loss, and remote access technologies, are covered with no copay, and kidney disease education services are covered with 20% coinsurance. Other services like in-home safety assessments, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Hearing services include hearing exams with a $40 copay, and routine hearing exams and fitting/evaluation for hearing aids with no copay. Prescription hearing aids (all types) are covered with no copay, and a maximum benefit of $500 per ear every year. However, prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Aetna Medicare Select (HMO) covers vision services, including eye exams with a copay of $0-$40, routine eye exams with no copay, and other eye exam services with no copay. Eyewear benefits are also covered, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, all with no copay, and a combined maximum benefit of $200 per year.
Dental Services See details
Dental services are covered, with a $1,200 annual maximum benefit. Medicare dental services have a $40 copay, while oral exams, dental X-rays, other diagnostic dental services, prophylaxis, fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered with 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) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Select (HMO) plan, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance, while Prosthetics/Medical Supplies have a 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $95, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a maximum copay of $300, therapeutic radiological services with a coinsurance of at least 20%, and outpatient X-ray services with no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Select (HMO) 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 by the Aetna Medicare Select (HMO) plan, but the specific services including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. The plan has a copay for some Cardiac and Pulmonary Rehabilitation Services, but the exact amount is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered under the Aetna Medicare Select (HMO) plan, with a $0 copay for days 1-20, and a $214 copay for days 21-100. 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 1 and Other 2 services 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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