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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 North FL, Treasure Coast 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 $3300.00 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. During the initial coverage phase, you'll pay either a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail order pharmacies, while standard generic drugs have 25% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy (LIS), your premium may be reduced. Be sure to check the plan's formulary for specific drug coverage details.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of benefits with varying costs. You can expect no copay for primary care physician services, preventive services, and many dental and vision services. Hospital stays have a copay of $150 for the first five days, and then no copay for the remaining days. The plan also provides coverage for outpatient services, with copays ranging from $0 to $175, and covers emergency services with a $140 copay. Additional benefits include hearing exams, eyewear, and certain medical equipment with no or low copays. The plan also covers home health services with no copay, and skilled nursing facility services with no copay for the first 20 days.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you pay a $150 copay for days 1-5, and no copay for days 6-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you pay a $150 copay for days 1-5, and no copay for days 6-90; additional days are not covered. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including hospital services, are covered by Aetna Medicare FL Select (HMO). Outpatient Hospital Services have a copay between $0 and $175, Observation Services have a $150 copay, Ambulatory Surgical Center (ASC) Services have no copay, Outpatient Substance Abuse Services have a copay of $20 for individual sessions and $15 for group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare FL Select (HMO), including ground and air ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location are covered, with 24 one-way trips per year and no copay, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including urgently needed services and worldwide emergency services, are covered by the Aetna Medicare FL Select (HMO) plan. Emergency services have a $140 copay, urgently needed services have a $15 copay, worldwide emergency coverage and worldwide urgent coverage have a $140 copay, and worldwide emergency transportation has a $250 copay.
Primary Care See details
Primary care physician services have no copay, while chiropractic services have a $20 copay. Occupational therapy services and physical therapy/speech-language pathology services have a $20 copay. Physician specialist services have a $0-$10 copay, while mental health specialty services have a $20 copay for individual sessions and a $15 copay for group sessions. Podiatry services and other health care professional services have a $10 copay. Psychiatric services have a $20 copay for individual sessions and a $15 copay for group sessions. Additional telehealth benefits have a 20% coinsurance and a $0-$20 copay, and opioid treatment program services have a $20 copay.
Preventive Services See details
Preventive services, including annual physical exams, are covered with no copay. Additional preventive services may have a copay. Kidney disease education services are covered with a 20% coinsurance, and other preventive services have no copay for glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit. Some preventive services, such as In-Home Safety Assessments, are not covered.
Hearing Services See details
Hearing exams are covered under the Aetna Medicare FL Select (HMO) plan with a $10 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids (all types) are covered, but inner ear, outer ear, and over the ear prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a copay between $0 and $10, and eyewear with no copay. Routine eye exams are covered with no copay for one visit every year, and other eye exam services are covered with no copay. Contact lenses and eyeglasses (lenses and frames) are covered with no copay, and upgrades are covered with no copay. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services include coverage for Medicare dental services with a $10 copay, and 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 with no copay. 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 a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare FL Select (HMO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
The Aetna Medicare FL Select (HMO) plan covers medical equipment, including Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, and Prosthetics/Medical Supplies with no copay and coinsurance for Medicare-covered devices and supplies. Diabetic equipment is covered, including Diabetic Supplies with 0-20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts with a $10 copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests, lab services, and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $75, and lab services have no copay. Diagnostic Radiological Services have a copay up to $100, while Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare FL Select (HMO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with a doctor's referral, but the plan does not cover any of the sub-services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by 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 and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare FL Select (HMO) plan covers over-the-counter items with no copay, up to $45 every three months. The plan also covers a meal benefit with no copay, and other services including annual wellness exams and screening mammography, and gFOBT/FIT with no copay. Acupuncture, Dual Eligible SNPs, 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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