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 Panhandle/Northwest 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 $3400.00 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 will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred and mail order pharmacies, while standard generic drugs have 25% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs. If you qualify for the low-income subsidy (LIS), you may have your premium reduced. Please refer to the plan's formulary for specific drug coverage details.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of benefits with varying costs. For inpatient hospital stays, you'll pay a copay of $245 for days 1-6, with no copay for the remaining days. Outpatient services and primary care visits have no copay. The plan also covers emergency services, hearing, vision, and dental services, with copays ranging from $0 to $250 depending on the service. Additionally, you can receive coverage for ambulance services, home health, and skilled nursing facilities, along with other services such as over-the-counter items and meal benefits.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you pay a $245 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you pay a $245 copay for days 1-6, and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, and all other sub-services are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $200, observation services with a $245 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services include individual sessions with a $20 copay and group sessions with a $15 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare FL Select (HMO) plan, but requires prior authorization. You will have a $35 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services includes coverage for ground ambulance services with a $250 copay, and air ambulance services with 20% coinsurance. Transportation Services to a plan-approved health-related location is covered, with a limit of 24 one-way trips per year, with no copay.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay, and Urgently Needed Services have a $25 copay. Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, and Worldwide Emergency Transportation has a $250 copay. There is no coinsurance for any of these services.
Primary Care See details
Primary Care Physician Services have no copay. Chiropractic Services have a $20 copay, but routine care is not covered. Occupational Therapy Services have a $25 copay. Physician Specialist Services have a $20 copay. Individual and Group Sessions for Mental Health Specialty Services have a copay of $20 and $15, respectively. Podiatry Services are not covered. Other Health Care Professional services have a copay between $0 and $20. Individual and Group Sessions for Psychiatric Services have a copay of $20 and $15, respectively. Physical Therapy and Speech-Language Pathology Services have a $25 copay. Additional Telehealth Benefits have a 20% coinsurance and a copay between $0 and $25. Opioid Treatment Program Services have a $20 copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and additional preventive services. Additional preventive services may have a copay, and some services like In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees are not covered. The plan also covers wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, fitness benefits (memory fitness), remote access technologies, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit with no copay.
Hearing Services See details
Hearing exams are covered with a $20 copay, routine hearing exams and fitting/evaluation for hearing aids are also covered with no copay. Prescription hearing aids are covered with a plan-specified amount of $1000 per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have a copay of $0-$20, with routine eye exams covered with no copay, and other eye exam services covered with no copay. Eyewear, including contact lenses and eyeglasses (lenses and frames) are covered with no copay, and a combined maximum of $300 per year; eyeglass lenses and frames are not covered.
Dental Services See details
The Aetna Medicare FL Select (HMO) plan covers Medicare Dental Services with a $20 copay, and other dental services with a $3,000 maximum benefit per year. 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 are covered with no copay. However, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare FL Select (HMO) plan, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have 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 these services.
Medical Equipment See details
Medical Equipment benefits include coverage for Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, Prosthetics/Medical Supplies with a coinsurance, and Diabetic Equipment. The plan does not cover Durable Medical Equipment for use outside the home. Diabetic Therapeutic Shoes/Inserts have a $10 copay, and Diabetic Supplies have a coinsurance between 0% and 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $100, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $125, and Outpatient X-Ray Services with no copay. Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare FL Select (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover any of the sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services. A doctor 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. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items with no copay, and a maximum plan benefit of $75 every three months, and a Meal Benefit 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, 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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