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 West 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 a $200.00 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 $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 features an annual drug deductible of $200. 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, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For brand-name and specialty medications, your costs are based on coinsurance regardless of the pharmacy you choose. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred and Tier 5 specialty drugs carry a 30% coinsurance. Specialty drugs under this plan are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers affordable healthcare coverage with no copay for primary care doctor visits and low copays of up to $20 for specialist visits. Inpatient hospital stays require a $160 daily copay for the first five days and no copay for days six through 90, while emergency room visits carry a $150 copay. Most outpatient services and home health care visits are highly affordable, requiring no coinsurance and often no copay. This plan also features robust supplemental benefits, including routine dental and vision care with no copay and annual allowances of $1,500 for dental services and $200 for eyewear. Additionally, members receive no copay for routine hearing exams, a $1,000 annual allowance per ear for prescription hearing aids, and a $30 quarterly over-the-counter item reimbursement. Skilled nursing facility stays are also covered with no copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Select (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $160 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Select (HMO) outpatient services are covered with no coinsurance, offering no copays for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $150 for outpatient hospital services, $160 per stay for observation services, and $10 to $15 for outpatient substance abuse sessions, with prior authorization required for most services.
Partial Hospitalization See details
Aetna Medicare Select (HMO) covers partial hospitalization services with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Select (HMO) covers ground ambulance services with a $225 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services are not covered.
Emergency Services See details
Aetna Medicare Select (HMO) emergency services are covered with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $150 to $225.
Primary Care See details
Primary Care benefits under Aetna Medicare Select (HMO) feature no copay and no coinsurance for primary care physician visits, while specialist visits require a referral and have a $0 to $20 copay with no coinsurance. Other covered services like therapy, podiatry, and mental health sessions carry copays ranging from $5 to $20 with no coinsurance, though routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered by Aetna Medicare Select (HMO) with no copay and no coinsurance for annual physicals, fitness benefits, and most screenings, though kidney education services require a 20% coinsurance with no copay. Additional preventive benefits are partially covered, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling services.
Hearing Services See details
Hearing services are covered by Aetna Medicare Select (HMO) with no coinsurance, requiring a $20 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay up to a $1,000 maximum per ear yearly, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Select (HMO) provides partially covered vision services with no copay, no coinsurance, and no deductible, including annual routine eye exams and eyewear up to a $200 yearly limit. Covered options include contact lenses and up to two pairs of eyeglasses (lenses and frames) per year, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered under Aetna Medicare Select (HMO), with Medicare-covered dental requiring a $20.00 copay and no coinsurance, and other covered dental services having no copay and no coinsurance up to a $1,500 annual maximum. Fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Select (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other Part B drugs require 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Select (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Select (HMO) with no copay and coinsurance ranging from no coinsurance to 20% for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices are covered with no copay and 20% coinsurance, and diabetic therapeutic shoes or inserts have no copay, with prior authorization required for most items.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Select (HMO), requiring prior authorization and referrals. Diagnostic tests have no coinsurance and a $0 to $40 copay (with no copay for lab services), while radiological services feature no copay for X-rays, a copay starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Select (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no copay and no coinsurance under Aetna Medicare Select (HMO), though a referral is required. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation 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, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Select (HMO) with no copay and no coinsurance for eligible benefits, including a chronic illness meal benefit, annual wellness exams, and up to $30 every three months in over-the-counter item reimbursements. Acupuncture is not covered under this plan.
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