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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 North FL, 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 $6.90. 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 your deductible, you will pay the costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2000. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs. If you qualify for the low-income subsidy, you will pay $6.90 for your prescriptions.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with no copay, including primary care, preventive services, outpatient services, vision, dental, and home health services. This plan also covers inpatient hospital stays with a copay, along with ambulance, emergency, and dialysis services. Additional benefits include coverage for hearing aids, medical equipment, and various therapies.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by Aetna Medicare FL Dual Select (HMO D-SNP), with a $125 copay for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services, observation services, ASC services, and outpatient blood services have no copay, while outpatient substance abuse services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. There is no copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. 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.
Emergency Services See details
Emergency Services, including Urgently Needed Services and Worldwide Emergency Services, are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Emergency Services have a $140 copay, while Urgently Needed Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
Primary Care benefits include no copay for primary care physician services, chiropractic services, routine chiropractic care, physician specialist services, physical therapy, and speech-language pathology services. Mental health specialty services, podiatry services, other health care professional, psychiatric services, and opioid treatment program services have a $0 minimum and maximum copay. Occupational therapy services have no coinsurance, and additional telehealth benefits are covered with no copay.
Preventive Services See details
Preventive services include no copay for annual physical exams, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. Additional preventive services such as wigs for hair loss related to chemotherapy, nutritional/dietary benefits, additional sessions of smoking and tobacco cessation counseling, fitness benefits, and home and bathroom safety devices and modifications are covered with no copay. Kidney disease education services are covered with 20% coinsurance.
Hearing Services See details
Hearing Services include routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. 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 ear every year, with no copay.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and include routine eye exams and other eye exam services. Eyewear has no copay and includes contact lenses, eyeglasses (lenses and frames), and upgrades; however, eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are covered, with a $3,000 maximum benefit per year. You will have no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatments, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and orthodontics. 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, which have a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan, but require prior authorization. The coinsurance for these services is 20%.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable Medical Equipment has no copay and no coinsurance, and durable medical equipment for use outside the home is not covered. Prosthetic Devices have no copay and no coinsurance. Medical Supplies have no coinsurance, and Diabetic Supplies have no coinsurance. Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures, lab services, and radiological services. Diagnostic Procedures/Tests have no copay, while lab 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. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with a doctor referral, but Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. There is a copay for Cardiac and Pulmonary Rehabilitation Services, but the exact amount is not specified.
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. The plan requires prior authorization, and the cost sharing information is available.
Other Services See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers acupuncture, over-the-counter items, a meal benefit, and other services like annual wellness exams and screening mammography, with no copay for each. The plan covers up to 24 acupuncture treatments per year, and provides up to $250 per month for over-the-counter items. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, and other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and Private Duty Nursing Services.
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