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 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 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)
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Drug Coverage
The Aetna Medicare Select (HMO) prescription drug plan features an annual drug deductible of $200. For Tier 1 preferred generic and Tier 2 generic medications, you will enjoy no copay when utilizing a preferred pharmacy or preferred mail order service. Standard pharmacies and standard mail order options require a copay, starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Brand-name and specialty medications on higher tiers are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 25% coinsurance regardless of whether you use preferred or standard pharmacies and mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 30% coinsurance, with specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers affordable coverage for core medical services, featuring no copay and no coinsurance for primary care physician visits, annual physicals, and home health services. Inpatient hospital stays require a $195 daily copay for days one through six and no copay for days seven through 90, while emergency room visits carry a $150 copay with no coinsurance. Outpatient hospital services and specialist visits are also highly accessible, with copays ranging from no copay up to $195. This plan also includes valuable supplemental benefits, such as routine dental care with no copay and no coinsurance up to a $2,500 annual maximum. Routine vision exams and eyewear are covered with no copay or coinsurance up to a $300 annual allowance, and routine hearing services feature no copay up to a $1,250 annual limit per ear. Additionally, members benefit from a $50 quarterly over-the-counter allowance and skilled nursing facility care with no copay for the first 20 days.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Select (HMO) with no coinsurance, requiring a $195 daily copay for days 1 through 6 and no copay for days 7 through 90. While unlimited additional acute hospital days are covered with no copay, hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Select (HMO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $195 copay and observation services with a $195 copay per stay. Ambulatory surgical center and blood services are covered with no copay, no coinsurance, and no deductible, while outpatient substance abuse services require no coinsurance and a $10 to $15 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the Aetna Medicare Select (HMO) plan with a copayment of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Select (HMO) with a $170 copay for ground ambulance and a 20% coinsurance for air ambulance services, both requiring prior authorization. While transportation is technically covered, some services are covered but transportation to plan-approved health-related locations and any other health-related locations is not covered.
Emergency Services See details
Aetna Medicare Select (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $25 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $150 to $170.
Primary Care See details
Aetna Medicare Select (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $15 copay and no coinsurance. Therapy, mental health, podiatry, and opioid treatment services require copays ranging from $10 to $15 with no coinsurance, while telehealth services carry a $0 to $25 copay and 20% coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Select (HMO) provides partially covered preventive services with no copay and no coinsurance for annual physicals, fitness benefits, and health education, though kidney disease education requires a 20% coinsurance and no copay. Multiple supplemental options, such as weight management programs, personal emergency response systems, and medical nutrition therapy, are not covered under this plan.
Hearing Services See details
Hearing services under Aetna Medicare Select (HMO) are partially covered with no deductible, featuring Medicare-covered exams for a $15 copay and no coinsurance, and routine exams, fittings, and prescription hearing aids for no copay and no coinsurance up to a $1,250 annual limit per ear. OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Select (HMO) with no copays, no coinsurance, and no deductibles for covered exams and eyewear, which includes a $300 annual allowance. Covered benefits include one routine eye exam per year and contact lenses, but individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Select (HMO), offering Medicare-covered dental with a $15 copay and no coinsurance, and other covered dental benefits with no copay and no coinsurance up to a $2,500 annual maximum. Sub-services not covered under this plan include fluoride treatments, other preventive dental, maxillofacial prosthetics, implant services, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Select (HMO) with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance of 0% to 20%.
Dialysis Services See details
Aetna Medicare Select (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to access this benefit.
Medical Equipment See details
Aetna Medicare Select (HMO) covers medical equipment with prior authorization required, featuring no copay and no coinsurance to 20% coinsurance for durable medical equipment (DME) and medical supplies. Prosthetic devices require no copay and 20% coinsurance, while diabetic supplies carry no coinsurance to 20% coinsurance, and 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) with prior authorization and referrals required. Diagnostic tests and procedures carry no coinsurance and a $0 to $90 copay, lab services have no copay or coinsurance, and therapeutic radiological services require at least 20% coinsurance plus a copay.
Home Health Services See details
Home health services are covered under Aetna Medicare Select (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Select (HMO) plan, as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Select (HMO) with no coinsurance and do not require a prior three-day hospital stay, though prior authorization is required. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the standard Medicare limit are not covered.
Other Services See details
Aetna Medicare Select (HMO) partially covers Other Services with no copay and no coinsurance, which includes a $50 quarterly over-the-counter allowance, chronic illness meal benefits, annual wellness exams, and additional colorectal screenings. Acupuncture is not covered under this plan benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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