A non-government entity
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 Southwest 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 $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 FL Select (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay varying copays or coinsurance amounts depending on the drug tier and pharmacy type. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail order, while standard generic drugs have 25% coinsurance at all pharmacies. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. This plan may have a reduced premium if you qualify for the low-income subsidy.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of health benefits with varying costs. Inpatient hospital stays have a $160 copay for the initial days, while outpatient services may have copays from $0 to $150. You'll find no copays for many services, including primary care visits, preventive services like annual exams, and many dental services. The plan includes coverage for ambulance services, with a $250 copay for ground transport. Emergency, urgent, and worldwide emergency services come with copays, while hearing and vision services include exams and coverage for hearing aids and eyewear. The plan also covers home health, durable medical equipment, and offers an over-the-counter allowance of $75 every three months, and a meal benefit with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered under the Aetna Medicare FL Select (HMO) plan. For Inpatient Hospital-Acute, you will pay a $160 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a $160 copay for days 1-7, and no copay for days 8-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay for Inpatient Hospital-Acute and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered. Outpatient Hospital Services have a copay between $0-$150, Observation Services have a $160 copay, Ambulatory Surgical Center (ASC) Services have no copay, and Outpatient Blood Services have no copay. Individual Sessions for Outpatient Substance Abuse have a $20 copay, and Group Sessions for Outpatient Substance Abuse have a $15 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services include coverage for ground ambulance services with a $250 copay, and air ambulance services with 20% coinsurance. Transportation services to plan-approved health-related locations are covered with no copay, and up to 24 one-way trips per year using rideshare services, bus/subway, van, or medical transport. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare FL Select (HMO) plan. Emergency Services have a $140 copay, Urgently Needed Services have a $10 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, while Worldwide Emergency Transportation has a $250 copay.
Primary Care See details
The Aetna Medicare FL Select (HMO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy services with a $20 copay, and physician specialist services with a $15 copay. The plan also covers mental health specialty services with a copay of $20 for individual sessions and $15 for group sessions, podiatry services with a $15 copay, other health care professional services with a copay between $0 and $15, psychiatric services with a copay of $20 for individual sessions and $15 for group sessions, physical therapy and speech-language pathology services with a $20 copay, additional telehealth benefits with a 20% coinsurance and a copay between $0 and $20, and opioid treatment program services with a $20 copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive Services include annual physical exams with no copay, and additional preventive services which may have a copay. Kidney Disease Education Services have a 20% coinsurance. Additional services such as In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing Services include hearing exams with a $15 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $1,000 per year, but specific types of prescription hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a copay of $0-$15, and eyewear with no 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 eyeglass frames are not covered.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $15 copay, 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. The plan has a maximum benefit of $3,000 per year.
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 for this service.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetic Devices with no copay and Medical Supplies with no coinsurance. Diabetic Equipment is covered, including Diabetic Supplies with 0-20% coinsurance and Diabetic Therapeutic Shoes/Inserts with no copay, and some services require prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay ranging from $0 to $50, and lab services with no copay. Diagnostic radiological services have a copay of at most $95, and 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 by Aetna Medicare FL Select (HMO) 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, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. A doctor's referral is required.
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. For days 1-20, there is no copay, and for days 21-100, the copay is $214. 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 (OTC) items with no copay, a maximum benefit coverage amount of $75 every three months. The plan also covers a meal benefit with no copay, as well as other services such as annual wellness exams and screening mammography, and gFOBT and FIT, all with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, 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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