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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 West 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 medications filled at standard pharmacies or through standard mail order. This ensures affordable access to common maintenance prescriptions. For higher-tier medications, costs are based on coinsurance rather than flat copays. You will pay a 22% coinsurance for Tier 3 preferred brand drugs and a 25% coinsurance for Tier 4 non-preferred drugs and Tier 5 specialty tier medications. These coinsurance rates apply to standard pharmacy and standard mail-order fills.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) offers comprehensive healthcare coverage with minimal out-of-pocket expenses, featuring no copay and no coinsurance for primary care visits, routine physicals, and home health services. Specialist office visits require a $25 copay, while inpatient hospital stays incur a $250 copay for the first six days and no copay for days seven through 90. Emergency care is accessible with a $115 copay that is waived upon admission, and urgent care visits carry a $40 copay. Members also enjoy valuable supplemental benefits, including up to $2,500 annually for dental care and a $300 eyewear allowance with no copays or coinsurance. The plan further supports daily health needs by providing a $170 monthly over-the-counter allowance, up to 48 free one-way transportation trips per year, and up to $1,000 per ear annually for prescription hearing aids. Durable medical equipment and diabetic supplies are also fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $250 copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered with no copay, but 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 and blood services with no copay. Outpatient hospital services require a copay of $0 to $250 (with a $250 copay per stay for observation), while outpatient substance abuse services have a $20 copay for individual sessions and a $15 copay for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Dual Select (HMO D-SNP) with a copay of either $60.00 or $110.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ground ambulance services with a $225 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 48 one-way trips per year to plan-approved locations, though 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 admitted to the hospital within 24 hours, and urgent care with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance, up to a maximum benefit of $250,000.
Primary Care See details
Primary care and specialist services are covered by Aetna Medicare Dual Select (HMO D-SNP), featuring no copay and no coinsurance for primary care visits, and a $25 copay with no coinsurance for specialists. Chiropractic services are partially covered, offering up to 24 routine visits per year with no copay, but other chiropractic services are not covered. Other services like therapy, podiatry, and mental health range from a $0 to $25 copay with no coinsurance, while telehealth carries a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), offering annual physicals, supplemental benefits, and routine screenings with no copay and no coinsurance, except for kidney disease education which has no copay but requires a 20% coinsurance. Covered supplemental benefits include health education, personal emergency response systems, smoking cessation, memory fitness, remote access, chemotherapy wigs, and home safety modifications, while services such as in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Dual Select (HMO D-SNP), featuring a $25 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision Services offered by Aetna Medicare Dual Select (HMO D-SNP) are partially covered with no copay, no coinsurance, and no deductible for covered exams and eyewear. The plan includes one routine eye exam per year and a $300 annual limit for eyewear like contact lenses and eyeglasses, though 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 an annual maximum benefit of $2,500 with no copay and no coinsurance for most preventive and comprehensive services, while Medicare-covered dental services require a $25 copay and no coinsurance. Fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 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 for these services.
Medical Equipment See details
Aetna Medicare Dual Select (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays 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, requiring prior authorization and referrals for all services. Members pay no copay or coinsurance for lab services, a $0 to $60 copay with no coinsurance for diagnostic tests, and a copay plus a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered. A referral is required to access these services.
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 and no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 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) partially covers other services with no copay and no coinsurance for covered benefits. Covered benefits include a chronic illness meal benefit, annual wellness exams, additional cancer screenings, and a $170 monthly over-the-counter reimbursement, while acupuncture is not covered.
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