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Aetna Medicare FL Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare FL 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 FL Select (HMO) in 2025, please refer to our full plan details page.
Aetna Medicare FL 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 out of 5 stars in 2025.
It's important to know that Aetna Medicare FL 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 FL 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 FL 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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2900.00 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 Select (HMO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay either a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have no copay when using a preferred pharmacy or preferred mail-order pharmacy. The plan also has an initial coverage limit of $2,000. Once you reach this amount, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services, and emergency care. You'll find no copays for primary care, preventive services like annual check-ups, and many dental services. The plan also covers hearing and vision services, and provides coverage for home health and skilled nursing facilities.
Inpatient Hospital See details
The Aetna Medicare FL Select (HMO) plan covers inpatient hospital stays, including acute and psychiatric care, with a $165 copay for days 1-6 and no copay for days 7-90. Additional days for inpatient hospital-acute are covered with no copay.
Outpatient Services See details
Outpatient Services with the Aetna Medicare FL Select (HMO) plan include coverage for all outpatient hospital services with a copay between $0 and $150, and observation services with a $165 copay. Ambulatory Surgical Center (ASC) Services have no copay, while outpatient substance abuse services have copays of $15 for individual sessions and $10 for group sessions. Outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare FL Select (HMO), with prior authorization required for all ambulance services. Ground ambulance services have a $170 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location have no copay, with up to 24 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare FL Select (HMO) plan. Emergency Services has a $135 copay with no coinsurance, Urgently Needed Services has a $25 copay with no coinsurance, and Worldwide Emergency Services has a $135 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $170 copay for Worldwide Emergency Transportation, all with no coinsurance.
Primary Care See details
The Aetna Medicare FL Select (HMO) plan covers primary care physician services with no copay, and chiropractic services with a $15 copay. Occupational therapy services have a $15 copay, and physician specialist services have a $15 copay. Mental health specialty services, including individual and group sessions, have copays of $10-$15. Podiatry services and other healthcare professional services have copays of $0-$15. Psychiatric services, including individual and group sessions, have copays of $10-$15. Physical therapy and speech-language pathology services have a $15 copay. Additional telehealth benefits have a 20% coinsurance and a $0-$25 copay. Opioid treatment program services have a $15 copay.
Preventive Services See details
Preventive services are covered, including an annual physical exam with no copay. Other preventive services include Health Education, Wigs for Hair Loss Related to Chemotherapy, Additional Sessions of Smoking and Tobacco Cessation Counseling, and Fitness Benefit, all with no copay. Kidney Disease Education Services are covered with 20% coinsurance. Other services like In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are partially covered, with a maximum benefit of $2500 per year and no copay for all types of prescription hearing aids, except for inner ear, outer ear, and over the ear hearing aids, which are not covered.
Vision Services See details
The Aetna Medicare FL Select (HMO) plan covers vision services, including eye exams with a copay of $0-$15, and eyewear with a $0 copay and a combined maximum of $400 per year for contact lenses and eyeglasses. Eyeglass lenses and frames are not covered.
Dental Services See details
The Aetna Medicare FL Select (HMO) plan covers dental services, including Medicare Dental Services with a $15 copay. Other covered services include oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay. However, fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare FL Select (HMO) plan, but require prior authorization. You will pay a coinsurance of 20% for these services.
Medical Equipment See details
Medical Equipment coverage includes Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, Prosthetics/Medical Supplies with a coinsurance, and Diabetic Equipment with a coinsurance between 0% and 20% for Diabetic Supplies, and a $10 copay for Diabetic Therapeutic Shoes/Inserts. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Aetna Medicare FL Select (HMO) plan. Diagnostic Procedures/Tests have a copay between $0 and $90, Lab Services have no copay, and Outpatient X-Ray Services have no copay. Diagnostic Radiological Services have a copay up to $90, while Therapeutic Radiological Services have a coinsurance of at least 20%.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare FL Select (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services. A doctor's referral is required.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare FL Select (HMO) plan, but require prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Aetna Medicare FL Select (HMO) plan covers over-the-counter items with no copay, and a maximum benefit coverage amount of $165 every three months. Acupuncture, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Other services, including annual wellness exams and screening mammography, and gFOBT and FIT, are covered with no copay.
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