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Aetna Medicare Dual Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Dual Select (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Dual Select (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Dual Select (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in South FL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Dual Select (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Aetna Medicare Dual Select (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Dual Select (HMO D-SNP).
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 Dual Select (HMO D-SNP), 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 $615.00 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 $9250.00 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 Dual Select (HMO D-SNP) prescription drug plan features an annual drug deductible of $615. Under this plan, Tier 1 preferred generic drugs have no copay for up to a three-month supply filled at standard pharmacies or through standard mail order. Tier 2 generic drugs require a copay of $10 for a one-month supply, $20 for a two-month supply, and $30 for a three-month supply. For brand-name and specialty medications, your costs are based on coinsurance at standard pharmacies and mail-order services. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. These clear cost-sharing tiers help you easily estimate your out-of-pocket prescription costs under this plan.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) plan offers comprehensive medical coverage with many essential healthcare services featuring no copays and no coinsurance. For example, members enjoy no copay for primary care, physical therapy, and mental health visits, while specialist office visits require a low $20 copay. Inpatient hospital stays require a $90 daily copay for the first five days and no copay for subsequent days, while emergency room visits carry a $115 copay that is waived if you are admitted. Supplemental benefits are equally robust, offering no copay or coinsurance for routine dental care up to a $2,000 annual maximum, routine eye exams with a $400 eyewear allowance, and hearing aids up to $1,500 per ear. Additionally, this plan features no copay or coinsurance for durable medical equipment, home health care, and a valuable $225 monthly over-the-counter reimbursement.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance and a $90 daily copay for days 1 through 5, followed by no copay for days 6 through 90. Prior authorization is required, and certain services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers outpatient services with no coinsurance, featuring a copay of $0 to $85 for outpatient hospital services and a $90 copay per stay for observation services. Ambulatory surgical center services, outpatient substance abuse treatment, and outpatient blood services are covered with no copays and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Dual Select (HMO D-SNP) covers partial hospitalization benefits with copays ranging from no copay up to $110 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Dual Select (HMO D-SNP), with ground ambulance services requiring a $200 copay and coinsurance, and air ambulance services requiring a 20% coinsurance and copay, both subject to prior authorization. Transportation services are partially covered with no copay and no coinsurance for up to 48 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers emergency services with a $115 copay—waived if admitted to the hospital within 24 hours—and urgently needed services with a $5 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum benefit with no copays and no coinsurance.
Primary Care See details
Aetna Medicare Dual Select (HMO D-SNP) covers primary care, physical and occupational therapy, podiatry, and mental health services with no copay and no coinsurance, while specialist visits require a $20 copay and no coinsurance. Chiropractic services are partially covered, offering up to 24 routine visits per year with no copay and no coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) partially covers preventive services, featuring no copay and no coinsurance for annual physicals and most supplemental benefits, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), featuring a $20 copay and no coinsurance for Medicare-covered exams, and no copays or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to $1,500 per ear yearly with no copay or coinsurance, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay, no coinsurance, and no deductible, though individual eyeglass lenses and eyeglass frames are not covered. The plan covers one routine eye exam yearly and offers a $400 annual maximum for eyewear, which includes contact lenses and up to three pairs of eyeglasses.
Dental Services See details
Dental services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), featuring a $20 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered dental services up to a $2,000 annual maximum. While many diagnostic, preventive, and restorative procedures are included, fluoride treatments, other preventive 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 Dual Select (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance and no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Dual Select (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these covered dialysis treatments.
Medical Equipment See details
Aetna Medicare Dual Select (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and no coinsurance. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers diagnostic procedures and tests with no coinsurance and a $0 to $25 copay, while lab services, diagnostic radiological services, and outpatient X-rays feature no copays. Therapeutic radiological services require a minimum 20% coinsurance, and prior authorization and referrals are required for all diagnostic and radiological services.
Home Health Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers some cardiac rehabilitation services with no copay and no coinsurance, though a referral is required. However, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Dual Select (HMO D-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring no prior three-day hospital stay but requiring prior authorization. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, though acupuncture is not covered. Covered benefits include a $225 monthly over-the-counter reimbursement, chronic illness meal benefits, annual wellness exams, screening mammographies, and additional colorectal cancer screenings.
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