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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 Central 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:
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Drug Coverage
The Aetna Medicare Dual Select (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications filled at standard pharmacies or through standard mail order for up to a three-month supply. This makes managing everyday prescriptions highly affordable with zero out-of-pocket costs for generic drugs. For higher-tier medications, cost sharing is based on coinsurance rather than set copays. You will pay a 22% coinsurance for Tier 3 (Preferred Brand) drugs and a 25% coinsurance for Tier 4 (Non-Preferred) drugs, applicable to standard retail and mail-order fills. Tier 5 (Specialty) drugs also require a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers comprehensive coverage with many essential services available at no cost to you. You will pay no copay and no coinsurance for primary care, specialist visits, home health services, medical equipment, and routine dental, vision, and hearing care. For hospital stays, inpatient care requires a $180 daily copay for the first five days and no copay thereafter, while outpatient hospital services range from no copay up to a $175 copay. Emergency services are covered with a $115 copay, which is waived if you are admitted, and the plan includes up to 48 free one-way transportation trips per year. You also benefit from a monthly $170 over-the-counter allowance and no copay for laboratory services. Specialty services like dialysis and chemotherapy drugs carry no copay but require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) provides partially covered inpatient hospital services with no coinsurance, requiring a $180 daily copay for days 1 to 5 and no copay for days 6 and beyond. Prior authorization is required, and 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 no copay for ambulatory surgical center visits, outpatient substance abuse sessions, and outpatient blood services. Outpatient hospital services have a copay of $0.00 to $175.00, and observation services require a $180.00 copay per stay, with prior authorization required for several of these benefits.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Dual Select (HMO D-SNP) with no coinsurance, though prior authorization is required. Depending on the service, you will pay either no copay or a $110 copay.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ground ambulance services with a $275 copay and coinsurance, and air ambulance services with a 20% coinsurance and a copay, both requiring prior authorization. The plan also partially covers transportation services, offering up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, while 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 and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $250,000 maximum benefit.
Primary Care See details
Aetna Medicare Dual Select (HMO D-SNP) covers primary care, specialist visits, mental health, and therapy services with no copays and no coinsurance. Chiropractic care is partially covered, offering up to 24 routine visits per year with no copay or coinsurance, though other chiropractic services are not covered. Additional telehealth benefits are also available with a 20% coinsurance and a copay ranging from $0 to $40.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) partially covers preventive services with no copay and no coinsurance for annual exams, fitness benefits, and screenings, though kidney disease education requires a 20% coinsurance and no copay. Uncovered sub-services include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, caregiver support, enhanced disease management, telemonitoring, and counseling services.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay, no coinsurance, and no deductible for routine exams, fitting evaluations, and up to two prescription hearing aids per year with a $1,000 maximum benefit per ear. However, OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), offering no copays, no coinsurance, and no deductibles for covered exams and eyewear. While routine exams, contact lenses, and eyeglasses (lenses and frames) are covered up to a $300 annual limit, separate eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partially covered dental services with no copay and no coinsurance, up to a maximum annual benefit of $2,000. While many preventive and comprehensive services are covered, fluoride treatments, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
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 have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, is covered by Aetna Medicare Dual Select (HMO D-SNP) 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 and radiological services, though prior authorization and referrals are required. Diagnostic tests and procedures carry a $0 to $50 copay with no coinsurance, lab services are available with no copay or coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Aetna Medicare Dual Select (HMO D-SNP) does not cover Cardiac Rehabilitation Services, meaning there is no coverage or benefits for cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) for peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no coinsurance, featuring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 Medicare-covered days are not covered.
Other Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partially covered other services with no copay and no coinsurance, including chronic illness meals, select wellness screenings, and a monthly $170 over-the-counter allowance. Acupuncture is not covered under these benefits.
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