A non-government entity
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 South 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:
Sign up for Aetna Medicare 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 Dual Select (HMO D-SNP) plan features a yearly prescription drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, there is no copay for one-, two-, or three-month supplies filled at standard pharmacies or through standard mail-order services. This makes the plan highly cost-effective for members who primarily rely on generic prescription drugs. For brand-name and specialty medications, costs are structured as coinsurance rather than a flat copayment. You will pay a 22% coinsurance for Tier 3 (Preferred Brand) drugs and a 25% coinsurance for Tier 4 (Non-Preferred) drugs. Additionally, Tier 5 (Specialty) medications require a 25% coinsurance for a one-month supply at standard pharmacies and through standard mail order.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers robust coverage with low out-of-pocket costs, featuring no copay and no coinsurance for primary care, specialist visits, and preventive services. For inpatient hospital stays, members pay no coinsurance and a $105 daily copay for the first six days, followed by no copay for days seven through 90. Outpatient services are also highly affordable, requiring no coinsurance and either no copay or low copays up to $100. This plan also provides excellent supplemental benefits, including no copay or coinsurance for routine dental, vision, and hearing services, alongside generous annual allowances like $3,000 for dental care and $300 for eyewear. Additionally, members benefit from up to 48 free one-way transportation trips per year, a $260 monthly over-the-counter reimbursement, and no copay or coinsurance for home health care and durable medical equipment.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no coinsurance, requiring a $105 daily copay for days 1 through 6 and no copay for days 7 through 90 for both acute and psychiatric stays. Although unlimited additional acute days are covered with no copay, 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, including ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services with no copays. Outpatient hospital services feature a copay of $0 to $100, while observation services require a $105 copay per stay, both with no coinsurance.
Partial Hospitalization See details
The Aetna Medicare Dual Select (HMO D-SNP) covers partial hospitalization services with either no copay or a $110 copay, and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ground ambulance services with a $225 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, 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 and worldwide emergency, urgent, and transportation services are covered with no copay and no coinsurance, up to a maximum plan benefit of $250,000.
Primary Care See details
Primary Care benefits under the Aetna Medicare Dual Select (HMO D-SNP) plan are covered with no copay and no coinsurance for most services, including primary care, specialist visits, therapy, and mental health. Chiropractic care is partially covered, offering up to 24 routine visits per year with no copay or coinsurance while excluding other chiropractic services, and telehealth benefits carry a 20% coinsurance with no copay.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. However, additional preventive services are only partially covered, excluding options such as weight management programs, nutritional or dietary benefits, in-home safety assessments, and therapeutic massage.
Hearing Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers hearing exams and fitting evaluations with no copay and no coinsurance, including one routine exam per year. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum per ear annually, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers vision services with no copay, no coinsurance, and no deductible, offering one routine eye exam annually and a $300 yearly allowance for contact lenses or up to two pairs of eyeglasses. This benefit is partially covered, as individual 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 $3,000 annual maximum. While exams, cleanings, and various restorative procedures are covered, fluoride treatment, 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, although prior authorization is required. Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required before you can receive these covered services.
Medical Equipment See details
Aetna Medicare Dual Select (HMO D-SNP) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, 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
Diagnostic and radiological services are covered by Aetna Medicare Dual Select (HMO D-SNP), with prior authorization and referrals required. Diagnostic tests range from a $0 to $25 copay with no coinsurance, lab services and outpatient X-rays have no copay, and therapeutic radiological services require a minimum 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. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers cardiac rehabilitation services with no copay and no coinsurance, though a referral is required. While some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
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 through 20 and a $217 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not necessary, additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Aetna Medicare Dual Select (HMO D-SNP) partially covers other services with no copay and no coinsurance, which includes a $260 monthly over-the-counter reimbursement, chronic illness meals, annual wellness exams, screening mammographies, and extra gFOBT and FIT screenings. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered.
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