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Aetna Medicare Dual Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Dual Select (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Dual Select (HMO D-SNP) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Dual Select (HMO D-SNP) is a HMO D-SNP plan offered by Aetna Health Inc. (FL) available for the 2026 plan year to people living in South FL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Dual Select (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Aetna Medicare Dual Select (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Dual Select (HMO D-SNP).
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 Dual Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $3.90. 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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 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 Dual Select (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through standard mail order. For higher-tier prescription drugs, standard pharmacy and standard mail-order fills require a 22% coinsurance for Tier 3 (Preferred Brand) drugs and a 25% coinsurance for Tier 4 (Non-Preferred) drugs. Tier 5 (Specialty) medications also carry a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers comprehensive coverage with no copays and no coinsurance for many essential services, including primary care, specialist visits, outpatient services, and home health care. Members also benefit from no copays or coinsurance for preventive care, routine dental up to a $3,000 annual limit, routine vision with a $300 eyewear allowance, and hearing aids up to $1,000 per ear. Additionally, the plan includes a $140 monthly over-the-counter allowance and up to 48 one-way routine transportation trips per year at no cost. For hospital and specialized care, inpatient hospital stays require a $150 daily copay for days 1 through 5, with no copay for days 6 through 90. Skilled nursing facility stays have no copay for the first 20 days and a $218 daily copay for days 21 through 100. Other key costs include a $115 emergency room copay, a $100 ground ambulance copay, and a 20% coinsurance for dialysis, air ambulance, and therapeutic radiology services.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $150 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers outpatient services, including outpatient hospital, ambulatory surgical center, substance abuse, and blood services, with no copay and no coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Dual Select (HMO D-SNP) with either no copay or a $110 copay, and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ground ambulance services with a $100 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance, offering up to 48 one-way trips per year to plan-approved health-related locations, while trips to any health-related location are not covered.
Emergency Services See details
Emergency services for Aetna Medicare Dual Select (HMO D-SNP) are covered with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance, up to a maximum plan benefit of $250,000.
Primary Care See details
Aetna Medicare Dual Select (HMO D-SNP) provides primary care benefits with no copayments and no coinsurance for most services, including primary care provider visits, specialist care, physical therapy, and mental health services. Chiropractic services are partially covered, offering up to 24 routine visits per year with no copay or coinsurance while excluding other chiropractic services, and telehealth benefits are available with no copay and a 20% coinsurance.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partially covered preventive services, featuring no copays and no coinsurance for annual physical exams, though kidney disease education requires a 20% coinsurance with no copay. Several sub-services are not covered, including medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, in-home support, and counseling.
Hearing Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers annual routine hearing exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum per ear per year, but inner ear, outer ear, and over the ear prescription aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Aetna Medicare Dual Select (HMO D-SNP) provides partially covered vision services with no copays, no coinsurance, and no deductibles, including one annual routine eye exam and follow-up diabetic eye exams. Covered eyewear includes contact lenses and up to two pairs of eyeglasses per year with a $300 annual limit, though individual eyeglass lenses and individual eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance up to a $3,000 annual maximum, although prior authorization is required for several services. Fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Part B chemotherapy, radiation, and other drugs have a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Dual Select (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copay and no coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers diagnostic and radiological services with no copays or coinsurance for lab services, diagnostic tests, diagnostic radiology, and outpatient X-rays. Therapeutic radiological services require a 20% coinsurance, and prior authorization and referrals are required for all of these services.
Home Health Services See details
Home health services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, provided you have a referral. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Dual Select (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Patients pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, including a $140 monthly over-the-counter allowance, chronic illness meal benefits, annual wellness exams, and additional colorectal screenings. Acupuncture and highly integrated dual-eligible SNP services are not covered under this benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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