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 either a copay or coinsurance depending on the drug tier and pharmacy type. For example, preferred generic drugs have no copay at preferred pharmacies and mail order, while standard pharmacies charge a $12 copay. The coinsurance for standard generic drugs, preferred brand drugs, and non-preferred drugs are 25%, 35%, and 33% respectively. After your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers comprehensive coverage with a variety of benefits. This plan includes no copay for primary care visits, preventive services, routine eye exams, and many dental services. It also offers coverage for inpatient and outpatient services, with varying copays depending on the specific service. This plan provides additional coverage for hearing aids, vision care, and dental services, with no copay for hearing exams and routine eye exams. Emergency services, ambulance services, and transportation to health-related locations are also covered, with copays and coinsurance varying based on the specific service. Other benefits include coverage for home health services, skilled nursing facilities, and home infusion bundled services.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $190 for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered with no copay, but non-Medicare-covered stays and upgrades are not covered for either service.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with a copay between $0 and $175, observation services with a $190 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $20 copay for individual sessions and a $15 copay for group sessions, and outpatient blood services with no copay. This plan also waives the three-pint deductible for blood services.
Partial Hospitalization See details
Partial hospitalization is covered by the Aetna Medicare FL Select (HMO) plan. This benefit has a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare FL Select (HMO), with prior authorization required for all ambulance services; ground ambulance services have a $205 copay, while air ambulance services have 20% coinsurance. Transportation Services to plan-approved health-related locations are covered with no copay, with a limit of 24 one-way trips per year using rideshare services, bus/subway, van, or medical transport; transportation to any health-related location is 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 has a $140 copay, Urgently Needed Services has a $10 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, while Worldwide Emergency Transportation has a $205 copay; all have no coinsurance.
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 $15 copay, and specialist visits with a $10 copay. Mental health services, psychiatric services, and opioid treatment program services have copays between $15 and $20, depending on the service type. Physical therapy and speech-language pathology services have a $15 copay, while additional telehealth benefits have a 20% coinsurance and a copay between $0 and $20.
Preventive Services See details
Preventive Services include an annual physical exam with no copay. Other preventive services include no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $10 copay, while routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids have a maximum plan benefit of $1000 per year, and all types of prescription hearing aids are covered with no copay, although inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
The Aetna Medicare FL Select (HMO) plan covers eye exams with a copay between $0 and $10, with routine eye exams covered with no copay, and other eye exam services covered with no copay. Eyewear benefits include contact lenses, eyeglasses (lenses and frames), and upgrades with no copay, with a combined maximum benefit of $300 every year, but eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services include a $10 copay for Medicare dental services, and no copay for 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. 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, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare FL Select (HMO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. DME has a coinsurance of 0-20%, while Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a 0-20% coinsurance. Diabetic Supplies have a 0-20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures/tests and lab services, are covered with a copay between $0 and $100. Diagnostic radiological services have a copay up to $100, and 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. 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 Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. A doctor referral is required.
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. There is no copay for days 1-20, but there is a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
Other services include coverage for over-the-counter items and meal benefits 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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