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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 Southwest 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) 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 drugs filled at standard pharmacies or through standard mail order. This benefit applies to one-month, two-month, and three-month supplies, helping you save on essential medications. For brand-name and specialty prescriptions, cost-sharing is structured as coinsurance. You will pay a 22% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for both Tier 4 non-preferred drugs and Tier 5 specialty tier drugs.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers robust medical coverage featuring no copay for primary care visits, routine preventive care, and home health services. For inpatient hospital stays, members pay a $180 daily copay for the first seven days with no coinsurance, followed by no copay for additional days. Outpatient specialist visits and mental health services require low copays between $15 and $20, while emergency room visits have a $115 copay that is waived if you are admitted. Supplemental benefits are highly accessible, offering routine dental, vision, and hearing care with no copay or coinsurance. This includes a $1,000 annual dental limit, a $400 annual eyewear allowance, and up to $1,250 per ear for hearing aids. Members also benefit from up to 48 free one-way transportation trips annually, durable medical equipment with no copay, and a generous $185 monthly over-the-counter reimbursement.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no coinsurance, requiring a $180 daily copay for days 1 through 7 and no copay for days 8 and beyond. While unlimited additional days are covered for acute stays, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers outpatient services with no coinsurance, featuring outpatient hospital copays from no copay up to $175 and a $180 copay per stay for observation services. Ambulatory surgical and blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $15 to $20 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Dual Select (HMO D-SNP) covers partial hospitalization services with a copayment of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ambulance services with a $250 copay (and no coinsurance) for ground transport and a 20% coinsurance (and no copay) for air transport. Transportation services are partially covered, providing up to 48 one-way trips per year to plan-approved locations with no copay and no 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, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $20 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Dual Select (HMO D-SNP) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, and mental health services require copays ranging from $15 to $20 and no coinsurance. Chiropractic care is partially covered, offering up to 24 routine visits per year with no copay and no coinsurance, though other chiropractic services are not covered. Telehealth benefits are also available with a copay of $0 to $20 and 20% coinsurance.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers preventive services, such as annual physicals, health education, and glaucoma screenings, with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered because 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 services, and counseling services are not covered.
Hearing Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers hearing exams with a $20 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay and no coinsurance up to $1,250 per ear annually, although inner ear, outer ear, over-the-ear, and over-the-counter (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 for covered benefits, including a $400 annual limit for eyewear. Routine eye exams, contact lenses, and eyeglasses (lenses and frames) are covered with no copay, but individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), offering a $1,000 annual maximum with no copay and no coinsurance for most covered diagnostic, preventive, and comprehensive services, while Medicare-covered dental services require a $20 copay and no coinsurance. However, fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay, although prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy, radiation, and miscellaneous drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required before receiving these services.
Medical Equipment See details
Aetna Medicare Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay 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 with prior authorization and referrals required. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $50 copay for tests, while outpatient X-rays have no copay and therapeutic radiological services require 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under the Aetna Medicare Dual Select (HMO D-SNP) plan, as all individual sub-services are excluded. While the benefit technically features no copay and no coinsurance with a referral, none of the specific cardiac, pulmonary, or SET for PAD rehabilitation services are actually 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 but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partial coverage for additional services with no copay and no coinsurance, including a $185 monthly over-the-counter reimbursement, chronic illness meals, and extra wellness screenings. Acupuncture is not covered under this plan.
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