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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 Southwest 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 $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 $590.00 deductible for prescription drugs. After the deductible is met, you will pay costs for your drugs based on the tier and pharmacy you use, until your total drug costs reach $2000.00. This plan's premium may be reduced if you qualify for the low-income subsidy. Once your yearly out-of-pocket drug costs reach $2000.00, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare FL Dual Select (HMO D-SNP) plan offers a wide range of benefits with low out-of-pocket costs. Many services, including outpatient, primary care, preventive, vision, and dental services, have no copay. The plan also covers inpatient hospital stays, ambulance services, and emergency services, with varying copays or coinsurance. Additional benefits include coverage for hearing exams, home infusion, dialysis, medical equipment, and diagnostic services, with some services requiring prior authorization or having coinsurance. The plan also offers coverage for acupuncture, over-the-counter items, and meal benefits, with some limitations. However, it's important to note that certain services like cardiac rehabilitation, and additional hours of care are not covered by the plan.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric, are covered with a $105 copay 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 are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center (ASC) 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 include coverage for ground ambulance services with a $100 copay, and air ambulance services with 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 by 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 Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
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 are covered under the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Primary Care Physician Services, Chiropractic Services, Physician Specialist Services, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits have no copay, while Occupational Therapy Services, Mental Health Specialty Services, Podiatry Services, Other Health Care Professional, Psychiatric Services, and Opioid Treatment Program Services have a $0 copay.
Preventive Services See details
Preventive services include coverage for annual physical exams with no copay, and other preventive services are covered. Additional preventive services such as Health Education, Nutritional/Dietary Benefit, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, and Wigs for Hair Loss Related to Chemotherapy are covered with a $0 copay. Kidney Disease Education Services are covered with 20% coinsurance. Other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids are covered with no copay, but prescription hearing aids, OTC hearing aids, prescription hearing aids - inner ear, prescription hearing aids - outer ear, and prescription hearing aids - over the ear are not covered. The plan covers up to $1500 per year for prescription hearing aids.
Vision Services See details
Vision Services include eye exams and eyewear. Eye exams have no copay, and eyewear has no copay. Contact lenses, eyeglasses (lenses and frames), and upgrades are covered, but eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental Services are covered, including oral exams, dental x-rays, other diagnostic services, cleaning, fluoride treatment, and other preventive services, all with no copay. Restorative services, orthodontics, and other services are also covered with no copay, but some require prior authorization and have visit limits. The plan has a $3,000 maximum for dental services per year, and some services are limited to one visit per year. Maxillofacial prosthetics and implant services are not covered.
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 and Other Medicare Part B Drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan, but require prior authorization. There is a 20% coinsurance for dialysis services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with no copay and no coinsurance, Prosthetics/Medical Supplies with a coinsurance for Medicare-covered prosthetic devices and a copay for Medicare-covered medical supplies, and Diabetic Equipment with coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts and a copay for Medicare-covered Diabetes Supplies. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures, tests, lab services, and outpatient X-ray services, are covered with no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a copay of at most $0.
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.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare FL Dual Select (HMO D-SNP) plan. Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are also not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but the additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered. Prior authorization is required.
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, and other services like annual wellness exams, screening mammography, gFOBT, and FIT are covered with no copay. However, the plan does not cover Dual Eligible SNPs with Highly Integrated Services, and several other services are not covered.
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