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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 NW FL/Panhandle. 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 $20.30. 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 deductible for prescription drugs. After you meet the deductible, you will pay the costs for your prescriptions. The plan has different tiers for drugs, but the specific costs for each tier are not provided in this summary. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D will be $20.30. Once your total drug costs reach $2000, you will enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with a focus on low-cost care. Many services have no copay, including outpatient services, primary care visits, hearing exams, eye exams, dental services, and home health services. The plan also covers inpatient hospital stays with a copay for the first few days. Additional benefits include coverage for ambulance and transportation services, with varying costs depending on the service. The plan also offers coverage for home infusion services, medical equipment, and diagnostic and radiological services. However, it's important to note that some services, such as cardiac rehabilitation and certain other services, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with a copay of $185 for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered stays and upgrades for both services 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 with no copay.
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 by the Aetna Medicare FL Dual Select (HMO D-SNP) plan, 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 have no copay. Transportation services to any 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, while urgently needed services have no copay; worldwide emergency services have a copay depending on the service.
Primary Care See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers 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. Primary care physician services, chiropractic services, physician specialist services, physical therapy and speech-language pathology services, additional telehealth benefits, individual and group sessions for mental health specialty services, individual and group sessions for psychiatric services, and opioid treatment program services have no copay. Occupational therapy services, podiatry services, and other health care professional services have a $0 copay.
Preventive Services See details
Preventive services include annual physical exams with no copay, and other preventive services with a copay. Additional services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, and counseling services are not covered.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a maximum benefit of $1250.00 per year. Prescription hearing aids for the inner ear, outer ear, and over-the-ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have no copay, and include routine eye exams and other eye exam services. Eyewear includes contact lenses, eyeglasses (lenses and frames), and upgrades, all of which have no copay, but eyeglass lenses and frames are not covered.
Dental Services See details
Dental services, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, and other preventive services, are covered with no copay. Restorative services, including fillings, are covered with no copay. Other services, including maxillofacial prosthetics and implant services, are not covered. There is a $3,000 annual maximum for all dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered, including Durable Medical Equipment (DME), with no copay and no coinsurance, though Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies have a copay and coinsurance for specific services, and Medical Supplies have no coinsurance. Diabetic Equipment is covered, and Diabetic Supplies have no coinsurance, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, lab services, and all radiological services, are covered. Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered with no copay and no coinsurance, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, or Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the copay information is not available. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare FL Dual Select (HMO D-SNP) plan covers acupuncture with no copay, but is limited to 24 treatments per year. Over-the-counter items and meal benefits are covered with no copay. Other services include annual wellness exams, screening mammography, gFOBT, and FIT with no copay. The plan does not cover 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, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, 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.
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