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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 Treasure Coast 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic medications, you will pay no copay for one-, two-, or three-month supplies at standard pharmacies and standard mail-order services. Tier 2 generic drugs are available with a standard copay of $10 for a one-month supply, $20 for a two-month supply, and $30 for a three-month supply. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. These coinsurance rates apply to both standard retail pharmacies and standard mail-order options, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, home health services, and routine preventive exams. Outpatient services, diagnostic lab tests, and durable medical equipment also feature no copays, while specialist visits and Medicare-covered dental services require a low copay of up to $15. For emergency care and inpatient hospital stays, members pay predictable copays, such as a $115 emergency room copay and a $195 daily copay for the first six days of a hospital stay. This plan also provides robust supplemental coverage, including no copays for up to $2,000 per ear annually for prescription hearing aids and a $2,000 annual limit for routine dental care. Additionally, members can take advantage of a $400 annual eyewear allowance, up to 48 one-way routine transportation trips, and a $175 monthly reimbursement for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Dual Select (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $195 daily copay for days 1 through 6 and no copay for days 7 through 90. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, though unlimited additional acute care days are covered with no copay.
Outpatient Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which both feature no copays. Outpatient hospital services carry a copay of $0 to $195 (including a $195 copay per stay for observation services), while outpatient substance abuse services require a copay of $15 for individual sessions and $10 for group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by the Aetna Medicare Dual Select (HMO D-SNP) plan with a copay of either $55.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers ambulance services with a $170 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, but trips to any other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $25 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 lifetime maximum with no copay and no coinsurance.
Primary Care See details
Primary care services are covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance for primary care visits, and a $0 to $15 copay with no coinsurance for specialist, therapy, and mental health services. Chiropractic care is partially covered, offering up to 24 routine visits per year with no copay and no coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physicals, exams, and select screenings, though kidney disease education requires a 20% coinsurance and no copay. Uncovered services under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers partially covered hearing services, including Medicare-covered exams for a $15 copay and no coinsurance, as well as annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $2,000 per ear annually with no copay and no coinsurance, though OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription devices are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Dual Select (HMO D-SNP) with no copay, no coinsurance, and no deductible, including a $400 annual maximum allowance for eyewear. While annual routine eye exams, diabetic eye exams, contact lenses, and up to three pairs of eyeglasses (lenses and frames) are covered with no copay, individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers dental services with a $15 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,000 annual limit. This benefit is partially covered, as fluoride treatments, other preventive 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 require prior authorization. Under this benefit, Medicare Part B insulin drugs have a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
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 to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Dual Select (HMO D-SNP), featuring no copays and no coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no coinsurance, while diabetic therapeutic shoes and inserts carry a $10 copay, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services covered by the Aetna Medicare Dual Select (HMO D-SNP) feature no coinsurance for diagnostic services, no copay for lab services, and no copay for outpatient X-rays. Diagnostic procedures and tests have a copay ranging from $0 to $90, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Dual Select (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Dual Select (HMO D-SNP) with no copay and no coinsurance, but a referral is required. While the plan technically covers this benefit, only some services are covered in practice, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation 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, requiring prior authorization but no prior three-day 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 limit are not covered.
Other Services See details
Aetna Medicare Dual Select (HMO D-SNP) provides partial coverage for other services with no copay and no coinsurance, including a $175 monthly over-the-counter item reimbursement, meal benefits for chronic illnesses, and supplemental wellness and cancer screenings. Acupuncture is not covered under this plan.
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