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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 West 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 $12.30. 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 $590.00 deductible for prescription drugs. After the deductible is met, you will pay the costs for drugs in each tier until your total drug costs reach $2000.00. If you qualify for the low-income subsidy, your monthly premium for Part D is $12.30. Once your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for your Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers comprehensive coverage with a focus on low out-of-pocket costs. Many services, including primary care visits, outpatient services, preventive services, and home health services, have no copay. The plan also includes coverage for dental, vision, and hearing services, with no copays for many of these services, and a maximum annual benefit for prescription hearing aids and dental services. The plan provides coverage for inpatient hospital stays with a copay, and ambulance services with a copay or coinsurance. Emergency services have a copay, while other services like dialysis, home infusion, and certain medical equipment, have coinsurance or copays. This plan also offers additional benefits such as over-the-counter items and a meal benefit.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you will pay a $95 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you will also pay a $95 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay 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. Outpatient hospital services, observation services, ambulatory surgical center services, and outpatient blood services have no copay, and outpatient substance abuse services have no copay for individual and group sessions.
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, with prior authorization required for all ambulance services. Ground ambulance services have a $100 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location are covered with no copay. Transportation services to any other health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Emergency Services have a $140 copay, and 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, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, Physical Therapy, and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services. Routine Chiropractic Care is covered with no copay, up to 24 visits per year.
Preventive Services See details
Preventive services include coverage for Medicare-covered services with no copay, an annual physical exam with no copay, and additional services like health education, nutritional/dietary benefits, smoking cessation counseling, fitness benefits, remote access technologies, home and bathroom safety devices, wigs for hair loss, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. 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 benefit of $1250 per year. OTC hearing aids are not covered.
Vision Services See details
Vision Services are covered, including eye exams and eyewear. Eye exams and eyewear have no copay. Contact lenses and eyeglasses (lenses and frames) are covered. Eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are covered, including oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, and other preventive dental services with no copay. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), oral and maxillofacial surgery, and orthodontics are also covered with no copay. Maxillofacial prosthetics and implant services are not covered. There is a maximum plan benefit of $3,000 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, Medicare Part B Chemotherapy/Radiation Drugs with 0-20% coinsurance, and Other Medicare Part B Drugs with 0-20% coinsurance. 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. The coinsurance for Dialysis 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, while durable medical equipment for use outside the home is not covered. Prosthetic devices have no copay and no coinsurance, while medical supplies have no coinsurance. Diabetic supplies have no coinsurance, and diabetic therapeutic shoes/inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with no copay, lab services with no copay, diagnostic radiological services with a maximum copay of $0, therapeutic radiological services with a maximum copay of $0, and outpatient X-ray services with no copay. Prior authorization and a doctor referral are required.
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, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
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, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered SNF and non-Medicare-covered stays are not covered. Prior authorization is required, and the copay information is available in the plan details.
Other Services See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers acupuncture with no copay up to 24 treatments per year, Over-the-Counter (OTC) items with no copay up to $225 per month, and a meal benefit with no copay. The plan also covers annual wellness exams, screening mammograms, and gFOBT/FIT tests with no copay. Other services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and others are not covered.
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