A non-government entity
Aetna Medicare FL Dual Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare FL 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 FL Dual Select (HMO D-SNP) in 2025, please refer to our full plan details page.
Aetna Medicare FL 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 out of 5 stars in 2025.
It's important to know that Aetna Medicare FL 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 FL 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 FL 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 FL Dual Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $20.30. 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 $590.00 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 $4150.00 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 FL 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 FL Dual Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. After the deductible is met, you will pay the costs for your drugs based on the tier and pharmacy you use. The plan has a defined standard for drug coverage. If you qualify for the low-income subsidy (LIS), your Part D premium will be $20.30. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with a focus on low-cost care. Many services have no copay, including primary care, outpatient services, preventive services, and home health services. The plan also covers dental, vision, and hearing services with varying levels of cost sharing, and has a maximum benefit for hearing aids and dental services. Hospital stays and ambulance services have copays, while some services like dialysis and some drugs have coinsurance. Emergency services have a copay, but urgent and worldwide emergency services have no copay. The plan also includes additional benefits like acupuncture, over-the-counter items, and medical equipment with no copay, making it a comprehensive option for many healthcare needs.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For the first 5 days of Inpatient Hospital-Acute or Inpatient Hospital Psychiatric, the copay is $110 per day, and there is no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, but Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Inpatient Hospital Psychiatric does not cover additional days or non-Medicare covered stays.
Outpatient Services See details
Outpatient services, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services are covered. Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center Services, and Outpatient Blood Services have no copay. Outpatient Substance Abuse Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan with no copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $100 copay, while air ambulance services have a 20% coinsurance, and transportation services to a plan-approved health-related location have no copay.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered. For emergency services, you will pay a $140 copay, but there is no coinsurance. For Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation, you will have no copay and no coinsurance.
Primary Care See details
Primary Care services, including Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy, Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services, are covered with a $0 copay for most services. Routine Chiropractic Care has a limit of 24 visits per year, and some services require a referral or prior authorization.
Preventive Services See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers preventive services, including annual physical exams with no copay. Additional preventive services are covered, and the plan also covers wigs for hair loss related to chemotherapy, with no copay and a maximum benefit of $400 per year. Kidney disease education services are covered with 20% coinsurance. Other preventive services, like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, are covered with no copay.
Hearing Services See details
Hearing services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids, with no copay for exams and evaluations. Prescription hearing aids have a maximum plan benefit coverage of $1250.00 per year, and the plan does not cover OTC hearing aids, or prescription hearing aids for the inner ear, outer ear, or over the ear.
Vision Services See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers vision services including eye exams and eyewear. There is no copay for eye exams, routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), and upgrades. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. This plan covers oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventive dental services with no copay, but coverage is limited to one visit per service. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and orthodontics are covered with no copay, but coverage is limited to one visit per service. Maxillofacial prosthetics and implant services are not covered. The plan has a maximum benefit of $3,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while 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 under the Aetna Medicare FL Dual Select (HMO D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan, with no copay and no coinsurance for Durable Medical Equipment. Prosthetic Devices have no copay, while Medical Supplies have no coinsurance. Diabetic Supplies have no coinsurance, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Diagnostic Procedures/Tests have no copay, and Lab Services have no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a maximum copay of $0, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with a doctor's referral, but the plan does not cover any specific cardiac rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the cost sharing is not described. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture with no copay, limited to 20 treatments per year, and over-the-counter items with no copay and a maximum benefit of $255.00 every month. The plan also covers meal benefits and other services, but does not cover Dual Eligible SNPs with Highly Integrated Services, 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.
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