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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 Central 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 $15.50. 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:
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Drug Coverage
The Aetna Medicare FL Dual Select (HMO D-SNP) plan has a $590.00 deductible for prescription drugs. After the deductible, you will pay the costs for your prescriptions according to the plan's formulary. Once your total drug costs reach $2000.00, you enter the Catastrophic Coverage Phase, where you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy, you may have a reduced premium.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with a focus on low out-of-pocket costs. Many services have no copay, including outpatient services, preventive services like annual physicals, hearing and vision exams, and dental services. You'll also find no copays for primary care visits, physical therapy, and telehealth. For services that do have cost-sharing, the plan includes a $90 copay for inpatient hospital stays (days 1-5), a $140 copay for emergency services, and a $100 copay for ground ambulance services. Prescription hearing aids are covered with a maximum annual benefit, and you'll also find coverage for home infusion services with varying coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a $90 copay for days 1-5 and no copay for days 6-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute is covered with no copay. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center Services, and Outpatient Blood Services have no copay, while Outpatient Substance Abuse Services have no copay for individual and group sessions.
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, including ground and air ambulance services, and transportation services to plan-approved health-related locations. Ground ambulance services have a $100 copay, while air ambulance services have 20% coinsurance. Transportation Services to a plan-approved health-related location have no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan, with a $140 copay for emergency services. Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care includes coverage for 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 and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. You will pay no copay for Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits.
Preventive Services See details
Preventive services, including annual physical exams, are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. The annual physical exam has no copay. Additional services include health education, wig for hair loss related to chemotherapy, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefit, remote access technologies, and home and bathroom safety devices and modifications.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids have no copay. Prescription hearing aids have a maximum plan benefit coverage of $1250.00 per year, and prescription hearing aids (all types) have no copay. OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams, including routine eye exams and other eye exam services, have no copay. Eyewear includes contact lenses, eyeglasses (lenses and frames), and upgrades, all with no copay; eyeglass lenses and frames are not covered.
Dental Services See details
Dental services are covered, with a maximum of $3,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, and other preventative dental services are covered with no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and orthodontics are covered with no copay. Maxillofacial prosthetics and implant services are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. This includes Medicare Part B Insulin Drugs with a $35 copay, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan, but require prior authorization. This plan has a coinsurance of 20% for dialysis services.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME) with no copay and no coinsurance. Prosthetic Devices have no copay, and Medical Supplies have no coinsurance. Diabetic Equipment includes Diabetic Supplies with no coinsurance, and Diabetic Therapeutic Shoes/Inserts with no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services, are covered. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan with no copay and no coinsurance. However, 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 of the listed sub-services. As a result, this benefit is not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the plan does not provide Skilled Nursing Facility Services as a supplemental benefit under Part C. There is a copay for SNF services, but no other cost-sharing information is provided.
Other Services See details
Other Services includes acupuncture, over-the-counter (OTC) items, a meal benefit, and other services with no copay. Acupuncture has a limit of 20 treatments per year, and OTC items have a maximum benefit coverage amount of $225 per month. The plan does not cover several other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services.
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