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Aetna Medicare FL Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare FL 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 FL Select (HMO) in 2025, please refer to our full plan details page.
Aetna Medicare FL 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 out of 5 stars in 2025.
It's important to know that Aetna Medicare FL 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 FL 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 FL 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 $1500.00 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 FL Select (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay either a copay or coinsurance depending on the drug tier and pharmacy used. For preferred generic drugs, you have no copay at preferred pharmacies and mail order, while standard pharmacies have a $12 copay. Standard generic drugs have a 25% coinsurance. Preferred brand drugs have a 35% coinsurance, and non-preferred drugs have a 33% coinsurance.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers comprehensive coverage, including inpatient and outpatient hospital services with varying copays, and no copays for many preventive services. The plan includes coverage for emergency services, ambulance services, and transportation to health-related locations, as well as hearing, vision, and dental services with copays or coinsurance. The plan offers additional benefits like home health services, home infusion, and skilled nursing facility stays.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $45 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you will also pay a $45 copay for days 1-6, and no copay for days 7-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional Days for Inpatient Hospital Psychiatric and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $150, Observation Services have a $45 copay, Ambulatory Surgical Center (ASC) Services have no copay, Individual Sessions for Outpatient Substance Abuse have a $10 copay, Group Sessions for Outpatient Substance Abuse have a $5 copay, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan, with a $15 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground ambulance services with a $225 copay, and air ambulance services with 20% coinsurance. Transportation Services to a plan-approved health-related location has no copay, with up to 48 one-way trips per year, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, including Worldwide Emergency Services and Urgently Needed Services, are covered. Emergency Services and Worldwide Emergency Coverage and Urgent Coverage have a $140 copay, while Worldwide Emergency Transportation has a $225 copay; Urgently Needed Services have no copay, and there is no coinsurance for any of these services.
Primary Care See details
The Aetna Medicare FL Select (HMO) plan covers primary care physician services with no copay, chiropractic services with a $5 copay, occupational therapy with a $5 copay, and physician specialist services with a copay between $0 and $5. The plan also covers mental health specialty services, podiatry services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services with a $5 copay, additional telehealth benefits with a 20% coinsurance and a copay between $0 and $10, and opioid treatment program services. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include annual physical exams with no copay, and additional preventive services that may have a copay. Kidney Disease Education Services have a 20% coinsurance. Other preventive services include glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit, all with no copay. Additional services, such as In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, and others, are not covered.
Hearing Services See details
Hearing services include hearing exams with a $5 copay, routine hearing exams with no copay for one visit per year, and fitting/evaluation for hearing aids with no copay for one visit per year. Prescription hearing aids (all types) are covered, with a maximum plan benefit of $1,000 every year, and no copay for two visits per year. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams with a copay of $0-$5, and eyewear with a $0 copay and a combined maximum of $300 per year. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, while eyeglass lenses and frames are not covered.
Dental Services See details
The Aetna Medicare FL Select (HMO) plan covers Medicare Dental Services with a $5 copay, and other dental services with a $3,000 maximum benefit per year. Oral exams, dental X-rays, other diagnostic dental services, prophylaxis (cleaning), restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay, while fluoride treatment, 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 and Other Medicare Part B Drugs are also covered with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered, but require prior authorization. The plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical equipment is covered, including durable medical equipment (DME) with a coinsurance between 0% and 20%, and prosthetics, medical supplies, and diabetic equipment. Diabetic supplies have a coinsurance between 0% and 20%, and medical supplies have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with a doctor referral and prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $25, and Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $50, while Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare FL Select (HMO) plan with no copay and no coinsurance. 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 FL Select (HMO) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. A doctor's referral is required for covered services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare FL Select (HMO) plan, but require prior authorization. You will have no 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
The Aetna Medicare FL Select (HMO) plan covers acupuncture with a $5 copay, and also covers over-the-counter (OTC) items with no copay, up to $120 every three months. The plan also includes a meal benefit with no copay, and covers annual wellness exams, screening mammography, and gFOBT/FIT with no copay. Some services are covered, but Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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