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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 Southwest 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:
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Drug Coverage
The Aetna Medicare FL Dual Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. After you meet the deductible, you pay the costs for your drugs based on their tier. Once your total drug costs reach $2000, you will enter the next coverage phase. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for your Part D covered drugs.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with no copay, including primary care visits, outpatient services, preventive services, hearing exams, vision exams, and many dental services. The plan also covers inpatient hospital stays with a $120 copay for the first seven days, with no copay for the remainder of the stay. The plan also covers ambulance services, with a $200 copay for ground ambulance and 20% coinsurance for air ambulance. This plan provides coverage for home infusion services, dialysis services, and medical equipment with varying cost-sharing, such as a $35 copay for Medicare Part B Insulin Drugs. Diagnostic and radiological services, home health services, and other services like acupuncture and over-the-counter items are also covered with no copay. However, some services like cardiac rehabilitation and additional hours of home health care are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered with a $120 copay for days 1-7 and no copay for days 8-90. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient hospital-acute, and additional days and non-Medicare-covered stays for inpatient hospital psychiatric are not covered.
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. There is no copay for outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services. There is also no copay for individual and group sessions for outpatient substance abuse.
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. Ground ambulance services have a $200 copay, while air ambulance services have a 20% coinsurance. Transportation services to a plan-approved health-related location have no copay, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan with a $140 copay; however, if admitted to the hospital within 24 hours, the copay is waived. Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have no copay, and no coinsurance.
Primary Care See details
Primary care services include no copay for primary care physician services, chiropractic services, occupational therapy, 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. Routine chiropractic care, individual and group sessions for mental health and psychiatric services, and routine foot care have a $0 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other preventive services, such as glaucoma screenings, with no copay. Additional preventive services such as in-home safety assessments, personal emergency response systems, and counseling services are not covered. Kidney Disease Education Services are covered with 20% coinsurance.
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, and prescription hearing aids have a maximum plan benefit coverage of $1250 per year. Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, OTC Hearing Aids, are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, including routine eye exams and other eye exam services. Eyewear has no copay and includes contact lenses, eyeglasses (lenses and frames), and upgrades, with a combined maximum plan benefit of $400 every year. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental Services are covered, with a maximum plan benefit of $3,000 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, 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, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required for these services.
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 benefits include Durable Medical Equipment (DME) with no copay and no coinsurance, and Prosthetic Devices with no copay, and Medicare-covered Medical Supplies with no coinsurance. Diabetic Equipment includes Diabetic Supplies with no coinsurance, and Diabetic Therapeutic Shoes/Inserts with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Diagnostic Procedures/Tests and Lab Services have no copay, while Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services also 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 not covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, and Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, though the plan does not cover additional days beyond Medicare coverage or non-Medicare-covered stays. Prior authorization is required, and the copay information is available elsewhere in the plan details.
Other Services See details
Other services include acupuncture with no copay, and a limit of 24 treatments per year, over-the-counter items with no copay and a maximum benefit of $255 per month, and a meal benefit with no copay for a chronic illness. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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