A non-government entity
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 West 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 $4.80. 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:
Sign up for Aetna Medicare Dual Select (HMO D-SNP)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Dual Select (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic medications when using standard pharmacies or standard mail order for one-month, two-month, or three-month supplies. For higher-tier medications, your costs are based on coinsurance rather than copays during the initial coverage phase. You will pay a 22% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for Tier 4 non-preferred drugs and Tier 5 specialty drugs through standard pharmacy or standard mail order channels.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers robust healthcare coverage with no copays or coinsurance for primary care doctor visits, routine physical exams, and home health services. Specialist visits and outpatient therapy require low copays ranging from $5 to $25, while inpatient hospital stays carry a $250 daily copay for the first six days and no copay for days 7 through 90. Emergency room visits require a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also features exceptional supplemental benefits, including routine dental care up to a $2,000 annual maximum and routine vision care with a $300 annual eyewear allowance, both with no copays. Additionally, members receive no-copay routine hearing exams, up to $1,000 per ear annually for hearing aids, and up to 48 one-way transportation trips to approved locations. You can also take advantage of a monthly allowance of up to $215 for over-the-counter items with no copay.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) inpatient hospital benefits are partially covered with no coinsurance, requiring a $250 daily copay for days 1 through 6 and no copay for days 7 through 90. 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, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services have a $0 to $250 copay, observation services require a $250 copay per stay, and outpatient substance abuse sessions have a copay of $10 for group or $15 for individual visits.
Partial Hospitalization See details
Aetna Medicare Dual Select (HMO D-SNP) covers partial hospitalization services with a copayment of either $25.00 or $110.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ground ambulance services with a $225 copay and air ambulance services with a 20% coinsurance. Transportation services are partially covered, offering no copay or 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
Emergency services are covered by Aetna Medicare Dual Select (HMO D-SNP) with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no copay and no coinsurance.
Primary Care See details
Primary care benefits under Aetna Medicare Dual Select (HMO D-SNP) feature no copay and no coinsurance for primary care doctor visits, while chiropractic services are partially covered with routine care covered at no copay and other chiropractic services not covered. Specialist visits, physical therapy, and mental health services require copays ranging from $5 to $25 with no coinsurance, whereas additional telehealth services carry a 20% coinsurance and copays up to $40.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), offering annual physical exams, health education, and screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered under this plan include in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Dual Select (HMO D-SNP), featuring Medicare-covered exams for a $25 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear annually, excluding inner ear, outer ear, over the ear, and OTC hearing aids which are not covered.
Vision Services See details
Aetna Medicare Dual Select (HMO D-SNP) vision services are covered with no copays, no coinsurance, and no deductibles, including one routine annual eye exam and unlimited diabetic eye exams. Eyewear is covered with no copay up to a $300 annual limit for contact lenses and up to two pairs of eyeglasses, though individual eyeglass lenses and frames are not covered.
Dental Services See details
Aetna Medicare Dual Select (HMO D-SNP) partially covers dental services up to a $2,000 annual maximum, featuring no copay and no coinsurance for most covered preventive and comprehensive services, and a $25 copay with no coinsurance for Medicare-covered dental. Fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Dual Select (HMO D-SNP) with no copays and no coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Dual Select (HMO D-SNP), with diagnostic tests carrying a $0 to $45 copay and no coinsurance, and lab services requiring no copay or coinsurance. Outpatient X-rays feature no copay but require coinsurance, while therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Dual Select (HMO D-SNP) 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, but intensive cardiac, pulmonary, and SET for PAD 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 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 Dual Select (HMO D-SNP) partially covers other services with no copay and no coinsurance, including a meal benefit for chronic illness, annual wellness exams, screening mammographies, additional gFOBT and FIT, and up to $215 monthly for over-the-counter items. Acupuncture is not covered under this benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved