A non-government entity
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 2026, 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 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 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2900.00 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 offers prescription drug coverage with no annual drug deductible, allowing your benefits to begin immediately. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, copays start at just $2 for Tier 1 and $12 for Tier 2. For brand-name and specialty medications, the plan uses coinsurance instead of copays. Tier 3 preferred brand drugs require a 21% coinsurance, while Tier 4 non-preferred drugs require a 33% coinsurance across all pharmacy and mail-order options. Tier 5 specialty drugs also have a 33% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers robust coverage with no copays and no coinsurance for primary care, specialist visits, preventive services, and home health care. For hospital care, inpatient stays require a $125 daily copay for the first five days and no copay thereafter, while outpatient hospital services carry a copay ranging from $0 to $125 with no coinsurance. Emergency care is covered with a $150 copay, which is waived if you are admitted, while urgent care services require no copay. This plan also features comprehensive dental, vision, and hearing benefits with no copays or coinsurance, including up to a $2,500 annual dental maximum, a $1,000 annual hearing aid allowance per ear, and a $100 annual allowance for eyewear. Additionally, durable medical equipment, dialysis, and Part B drugs generally carry a 0% to 20% coinsurance with no copays. Skilled nursing facility care is also covered with no copay for the first 20 days of your stay.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Select (HMO) with no coinsurance, requiring a $125 daily copay for days 1 through 5 and no copay for days 6 through 90 per stay. While unlimited additional days are covered for acute care, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Select (HMO) with no coinsurance for all services and no deductible for blood services. While ambulatory surgical center, outpatient substance abuse, and blood services have no copay, outpatient hospital and observation services require a copay ranging from $0 to $125.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Select (HMO) with a copay ranging from $5.00 to $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered under Aetna Medicare Select (HMO) because transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $90 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for both.
Emergency Services See details
Aetna Medicare Select (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with no copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum with no coinsurance, requiring a $90 copay for transportation and a $150 copay for emergency and urgent care.
Primary Care See details
Aetna Medicare Select (HMO) primary care benefits are partially covered, offering no copay and no coinsurance for primary care, specialist, therapy, podiatry, and mental health services, while routine and other chiropractic services are not covered. Additional telehealth benefits are also covered with no copay and a 20% coinsurance.
Preventive Services See details
Preventive Services under Aetna Medicare Select (HMO) are partially covered, with most services like annual physicals, glaucoma screenings, and fitness benefits featuring no copay and no coinsurance. Kidney disease education requires a referral and has no copay but carries a 20% coinsurance, while sub-services such as weight management, nutritional therapy, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Select (HMO), featuring no copay, coinsurance, or deductible for routine exams, fitting evaluations, and prescription hearing aids up to $1,000 per ear annually. However, over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Select (HMO) with no copay, no coinsurance, and no deductible, although eyeglass lenses and eyeglass frames are not covered. Covered benefits include annual routine eye exams, unlimited diabetic eye exams, and up to $100 per year for contact lenses and up to two pairs of eyeglasses.
Dental Services See details
Dental services are partially covered by Aetna Medicare Select (HMO) with no copay and no coinsurance for covered services, up to a maximum annual benefit of $2,500. While oral exams, cleanings, and restorative care are covered, this plan does not cover fluoride treatments, other preventive dental services, maxillofacial prosthetics, implants, or orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are partially covered by Aetna Medicare Select (HMO) with no copay, excluding Part D home infusion drugs as part of the bundle, and prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other Part B drugs, including chemotherapy, have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Select (HMO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Select (HMO) covers medical equipment with no copays for durable medical equipment, prosthetics, and diabetic shoes, though prior authorization is required. Coinsurance ranges from 0% to 20% for durable medical equipment and diabetic supplies, while prosthetic devices require a 20% coinsurance and medical supplies have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Select (HMO) covers diagnostic and radiological services, requiring referrals and prior authorization. Diagnostic tests have no coinsurance and a copay of $0 to $25, lab services and outpatient X-rays have no copay, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Select (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Select (HMO) with no copay and no coinsurance, though a referral is required. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Select (HMO) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered period are not covered.
Other Services See details
Aetna Medicare Select (HMO) partially covers Other Services with no copay and no coinsurance, which includes chronic illness meals, annual wellness exams, and a $30 quarterly allowance for over-the-counter items. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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