A non-government entity
Aetna Medicare Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Select (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Select (HMO) is a HMO 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 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Select (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Select (HMO).
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 Select (HMO), 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 $200.00 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 $3900.00 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 Select (HMO)
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 Select (HMO) plan features a $200 annual drug deductible alongside affordable copay structures for generic medications. You will pay no copay for Tier 1 preferred generics and Tier 2 generics when using a preferred pharmacy or preferred mail order service. If you choose a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications, the plan transitions to a coinsurance model across all pharmacy types. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs require a 30% coinsurance. Tier 5 specialty drugs also incur a 30% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers comprehensive medical coverage with no copay for primary care visits and a $20 copay for specialists. Inpatient hospital stays require a $200 daily copay for the first seven days, while outpatient hospital services range from no copay up to $200. Emergency care is available with a $150 copay, which is waived if you are admitted to the hospital, and urgent care visits require a $30 copay. For routine wellness, this plan features no copay for annual physicals, routine eye exams, and routine hearing tests, alongside a $1,000 annual allowance for both dental services and prescription hearing aids. Skilled nursing facility care is covered with no copay for the first 20 days, and members receive a $30 quarterly allowance for over-the-counter items. Home health services are also fully covered with no copay or coinsurance, ensuring affordable access to essential care.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Select (HMO) with no coinsurance, requiring prior authorization and a $200 daily copay for days 1 through 7, with no copay for days 8 through 90. Unlimited additional acute care days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Select (HMO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which also have no copays. Outpatient hospital services require a copay of $0 to $200, observation services carry a $200 copay per stay, and individual or group substance abuse sessions have a $10 copay, with prior authorization required for several of these services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Select (HMO) with copays ranging from $30.00 to $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services are covered by Aetna Medicare Select (HMO) with a $240 copay for ground transport and a 20% coinsurance for air transport, with prior authorization required. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Select (HMO) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum limit with no coinsurance and copays of $150 for emergency or urgent care and $240 for emergency transportation.
Primary Care See details
Aetna Medicare Select (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $20 copay and no coinsurance. Physical, occupational, and speech therapies require a $15 copay and no coinsurance, while telehealth benefits range from a $0 to $30 copay with 20% coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
Aetna Medicare Select (HMO) partially covers preventive services with no copay and no coinsurance for annual physicals and screenings, though kidney disease education requires a 20% coinsurance and no copay. Excluded from coverage are in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Select (HMO), featuring a $20 copay and no coinsurance for Medicare-covered exams, and one routine exam and fitting evaluation per year with no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Select (HMO) offers partially covered vision services with no copay and no coinsurance, which includes one routine eye exam per year and unlimited follow-up diabetic eye exams. Eyewear is also covered with no copay or coinsurance up to a $100 annual maximum for contact lenses and up to two pairs of eyeglasses, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Select (HMO) partially covers dental services, offering Medicare-covered dental for a $20 copay and no coinsurance, and other dental services with no copay or coinsurance up to a $1,000 annual maximum. While many preventive and comprehensive services are included, fluoride treatment, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Select (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy and other Part B drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Select (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Select (HMO), featuring durable medical equipment with no copay and no coinsurance to 20% coinsurance, and medical supplies with no copay and no coinsurance. Prosthetic devices are covered with no copay and 20% coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Select (HMO), requiring prior authorization and referrals. Diagnostic procedures and tests feature no coinsurance and a copay of $0 to $75, while lab services and outpatient X-rays have no copay. Diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Select (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare Select (HMO) with no copay and no coinsurance, requiring a referral; however, some services are covered but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Select (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient 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 standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Select (HMO) partially covers other services with no copay and no coinsurance for covered benefits, which include a chronic illness meal benefit, select wellness exams, and a $30 quarterly over-the-counter item allowance. Acupuncture is not covered under this plan.
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