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 an "Enhanced Alternative" drug benefit. There is no deductible for prescription drugs. In the initial coverage phase, you will pay no copay for preferred generic drugs at preferred pharmacies and mail order pharmacies. For standard generic drugs, you pay 25% coinsurance, and for preferred brand drugs, you pay 35% coinsurance. Non-preferred drugs have a 33% coinsurance.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $100 copay for the first four days, and then no copay for the rest of the stay. Outpatient services have copays ranging from $0 to $100, and emergency services have a $140 copay. This plan also covers a wide array of services with varying costs. Primary care visits have no copay, while specialist visits have copays between $0 and $15. Hearing and vision services have no copays for routine exams, but may have copays for hearing aids and eyewear. Dental services have no copay for many services, but there is a $3,000 maximum benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For days 1-4, there is a $100 copay, and for days 5-90, there is no copay. Additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $75, and observation services with a $100 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have copays between $15 and $20 for individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan, with a $25 copay. Prior authorization is required.
Ambulance and Transportation Services See details
The Aetna Medicare FL Select (HMO) plan covers ambulance and transportation services, with a $250 copay for ground ambulance services and a 20% coinsurance for air ambulance services. Transportation services to plan-approved health-related locations are covered with no copay, up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Aetna Medicare FL Select (HMO). Emergency Services and Worldwide Emergency Coverage have a $140 copay, Urgently Needed Services has a $25 copay, and Worldwide Emergency Transportation has a $250 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 $10 copay, physician specialist services with a $0-$15 copay, mental health specialty services with a $20 copay for individual sessions and a $15 copay for group sessions, podiatry services with a $15 copay, other health care professional services with a $0-$15 copay, psychiatric services with a $20 copay for individual sessions and a $15 copay for group sessions, physical therapy and speech-language pathology services with a $10 copay, additional telehealth benefits with a 20% coinsurance and a $0-$25 copay, and opioid treatment program services with a $20 copay. Routine chiropractic care is not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services that may have a copay. Kidney disease education services have a 20% coinsurance, while other preventive services such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit have no copay.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are covered with a maximum benefit of $1000 per year, and prescription hearing aids (all types) are covered with no copay. OTC hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered.
Vision Services See details
Vision Services includes coverage for eye exams with a copay of $0-$15, and routine eye exams with no copay. Eyewear benefits are covered with no copay, including contact lenses, eyeglasses (lenses and frames), and upgrades. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare FL Select (HMO) covers Medicare Dental Services with a $15 copay, and other dental services including 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, all with no copay. Fluoride Treatment, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered, and there is a $3,000 maximum plan benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare FL Select (HMO) plan, 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 under the Aetna Medicare FL Select (HMO) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Aetna Medicare FL Select (HMO) plan covers Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetic Devices and Medical Supplies with no copay or coinsurance for medical supplies. This plan also covers Diabetic Equipment, with a coinsurance between 0% and 20% for diabetic supplies, and no copay for Diabetic Therapeutic Shoes/Inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures and tests with a copay between $0 and $50, and lab services with no copay. Radiological services include coverage for diagnostic radiological services with a copay up to $100, therapeutic radiological services with 20% coinsurance, and outpatient X-ray services with 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 Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. A doctor referral is required, and there is a copay for some services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare FL Select (HMO) plan, with prior authorization required. There is 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 (OTC) items with no copay, and a maximum benefit coverage amount of $120 every three months. The plan also covers a meal benefit with no copay, and other services including annual wellness exams, screening mammography, and gFOBT, FIT with no copay. Acupuncture, 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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