A non-government entity
Aetna Medicare Assure (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Assure (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 Assure (HMO D-SNP) in 2025, please refer to our full plan details page.
Aetna Medicare Assure (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in South FL. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Assure (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 Assure (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 Assure (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 Assure (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.20. 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:
Sign up for Aetna Medicare Assure (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Assure (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy, your monthly premium for Part D is $16.20. During the initial coverage phase, you will pay the costs for your drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare Assure (HMO D-SNP) plan offers comprehensive coverage with no copays for many services. This includes inpatient hospital stays, outpatient services, primary care, preventive services, hearing and vision exams, dental cleanings, medical equipment, and home health services. Emergency Services have a $140 copay, and air ambulance services have a 20% coinsurance. The plan also provides coverage for prescription hearing aids, eyeglasses, and a $3,000 annual maximum for dental services. Additionally, it includes benefits like home infusion services, and over-the-counter items with a monthly maximum of $150. Note that some services like dialysis and air ambulance services have coinsurance, while others like cardiac rehabilitation services, additional days for SNF, and certain other services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. There is no copay for a Medicare-covered stay. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center Services, and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have no copay for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by Aetna Medicare Assure (HMO D-SNP), and requires prior authorization. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Assure (HMO D-SNP). Ground ambulance services have no copay, while air ambulance services have a 20% coinsurance. Transportation Services have no copay for plan-approved health-related locations, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare Assure (HMO D-SNP) plan. Emergency Services have a $140 copay and no coinsurance, while Urgently Needed Services have no copay and no coinsurance. Worldwide Emergency Services have a $0 copay for Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, with no coinsurance for any of these services.
Primary Care See details
The Aetna Medicare Assure (HMO D-SNP) plan covers primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, podiatry 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, physical therapy, speech-language pathology, and additional telehealth benefits have no copay. Mental health specialty services, podiatry services, other health care professional services, psychiatric services, and opioid treatment program services have a $0 minimum and maximum copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services with varying copays. Other covered preventive services include glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids (all types) are covered with no copay, but inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay. Eyeglasses (lenses and frames) are covered, with a maximum of 3 pairs per year, and contact lenses are covered, with no limit. Eyeglass lenses and frames are not covered.
Dental Services See details
Dental services are covered, with a maximum plan benefit of $3,000 per year. Preventive services such as oral exams, dental x-rays, and cleanings have no copay, while other services like maxillofacial prosthetics and implant services 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 and Other Medicare Part B Drugs are also covered, with a coinsurance between 0% and 20%. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Assure (HMO D-SNP) plan, but require prior authorization. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment is covered by the Aetna Medicare Assure (HMO D-SNP) plan, with no copay and no coinsurance for Durable Medical Equipment. Prosthetic Devices and Medical Supplies are covered with no copay and no coinsurance for Medical Supplies. Diabetic Supplies have no coinsurance, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with no copay, lab services with no copay, diagnostic radiological services with a maximum copay of $0, therapeutic radiological services with a maximum copay of $0, and outpatient X-ray services with no copay. Prior authorization and a doctor referral are required.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Assure (HMO D-SNP) with no copay and no coinsurance, although 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 Assure (HMO D-SNP) plan. The plan does not cover intensive cardiac rehabilitation services, pulmonary rehabilitation services, or SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the specific cost-sharing details are not provided. Additional days beyond Medicare-covered SNF and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Aetna Medicare Assure (HMO D-SNP) plan covers acupuncture with no copay, over-the-counter (OTC) items with no copay and a maximum benefit of $150.00 per month, meal benefits with no copay, and other services with no copay. Other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others, are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved