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 Panhandle/Northwest 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 $3900.00 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 a drug deductible of $200. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail order. If you choose a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs are based on a percentage of the drug cost rather than flat copays. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty drugs also carry a 30% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits and a copay of up to $20 for specialist appointments. For hospital care, inpatient stays require a $300 daily copay for the first seven days followed by no copay, while outpatient and home health services are generally covered with no copay. Emergency services are available with a $150 copay, which is waived upon hospital admission, and urgent care visits require a $25 copay. This plan also features valuable supplemental benefits, including routine dental, vision, and hearing services with no copay for annual exams. Members benefit from a $1,000 annual hearing aid allowance per ear, a $150 annual eyewear allowance, and up to $1,500 in yearly dental coverage with no copay for preventive care. Additional perks include a $30 quarterly over-the-counter item allowance, no-cost fitness benefits, and no copay for skilled nursing facility stays for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization and a $300 daily copay for days 1 through 7, followed by no copay for days 8 through 90. Although unlimited additional acute days are covered with no copay, additional psychiatric days, room upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Select (HMO) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services and a $300 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse services require a $15 to $20 copay.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Select (HMO) with a copay of either $35.00 or $180.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Select (HMO) covers ambulance services with prior authorization, requiring a $250 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Select (HMO) with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $25 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum limit with no coinsurance and copays ranging from $150 to $250.
Primary Care See details
Aetna Medicare Select (HMO) provides primary care physician services with no copay and no coinsurance, while specialist visits require a $0 to $20 copay with no coinsurance. Covered therapy, psychiatric, and mental health services have copays ranging from $15 to $25 with no coinsurance, but chiropractic and podiatry services are not covered. Additional telehealth benefits are available with a $0 to $25 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Select (HMO), offering no copay and no coinsurance for annual physical exams, glaucoma screenings, and fitness benefits, while kidney disease education requires a 20% coinsurance and no copay. Several additional services are not covered under this plan, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and nutritional benefits.
Hearing Services See details
Aetna Medicare Select (HMO) hearing services are partially covered, offering routine exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $20 copay. Prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, but over-the-counter (OTC) hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Select (HMO) offers partially covered vision services with no copay, no coinsurance, and no deductible, which includes one routine eye exam and follow-up diabetic eye exams annually. Eyewear is covered with no copay or coinsurance up to a $150 annual maximum for contact lenses and up to two pairs of eyeglasses (lenses and frames), though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Select (HMO) provides partially covered dental services with an annual maximum of $1,500, featuring a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services. 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 insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Select (HMO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment covered by Aetna Medicare Select (HMO) features no copay and no coinsurance to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices require no copay and 20% coinsurance, while diabetic therapeutic shoes and inserts have a $10 copay and no coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Select (HMO), requiring referrals and prior authorization. Diagnostic services carry no coinsurance, featuring no copay for labs and a $0 to $100 copay for procedures, while radiological services range from no copay for X-rays and diagnostic imaging to a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home health services are covered by Aetna Medicare Select (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Select (HMO) with no copay and no coinsurance, though a referral is required. While some services are covered, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Select (HMO) with no coinsurance, requiring prior authorization and allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Select (HMO) provides coverage for select other services with no copay and no coinsurance, including a meal benefit for chronic illness, annual wellness exams, and a $30 quarterly over-the-counter item allowance. Acupuncture and certain other services are not covered under this plan.
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