A non-government entity
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 West 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 an enhanced alternative drug benefit. There is no deductible for prescription drugs. During the initial coverage phase, you will pay either a copay or coinsurance for your prescriptions. For preferred generic drugs, you will have no copay at preferred and mail order pharmacies, and a $12 copay at standard pharmacies. For standard generic drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000, you enter the next coverage phase.
Additional Benefits
The Aetna Medicare FL Select (HMO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, and outpatient services have copays depending on the service. Emergency services and primary care visits typically have low copays. This plan provides coverage for preventive services with no copay, as well as coverage for hearing, vision, and dental services with copays. Additional benefits include coverage for ambulance and transportation services, home health services with no copay, and coverage for durable medical equipment and home infusion services.
Inpatient Hospital See details
Inpatient Hospital benefits for Aetna Medicare FL Select (HMO) include a $150 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Inpatient Hospital Psychiatric benefits include a $150 copay for days 1-5 and no copay for days 6-90, but Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services, including outpatient hospital services and observation services, are covered by Aetna Medicare FL Select (HMO). Outpatient hospital services have a copay between $0 and $125, observation services have a $150 copay, and ambulatory surgical center services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare FL Select (HMO) plan, with a $25 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare FL Select (HMO), including both ground and air ambulance services. Ground ambulance services have a $225 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location are covered with no copay, for up to 24 one-way trips per year, but transportation to any other health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Aetna Medicare FL Select (HMO). Emergency Services and Worldwide Emergency Coverage have a $140 copay, Worldwide Emergency Transportation has a $225 copay, and Urgently Needed Services has a $20 copay. All services have no coinsurance.
Primary Care See details
The Aetna Medicare FL Select (HMO) plan covers primary care physician services with no copay, chiropractic services with a $5 copay, and physician specialist services with a $10 copay. Additional benefits include mental health specialty services, podiatry services, and telehealth services, all with varying copays and coinsurance.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and other services like health education, additional smoking cessation counseling, and fitness benefits. Kidney disease education services have a 20% coinsurance, while other preventive services include no copay for glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. Some services like in-home safety assessments, personal emergency response systems, and others are not covered.
Hearing Services See details
Hearing exams are covered for a $10 copay, with routine hearing exams and fitting/evaluation for hearing aids covered with no copay. Prescription hearing aids are covered, with a maximum plan benefit of $1,000 per year, but 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 coverage for eye exams with a copay of $0-$10, routine eye exams with no copay, and other eye exam services with no copay. Eyewear benefits include contact lenses, eyeglasses (lenses and frames), and upgrades with no copay, and a combined maximum of $300 per year, but eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services include a $10 copay for Medicare dental services, and no copay for 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, but fluoride treatment, maxillofacial prosthetics, implants, and orthodontics are not covered. The plan has a maximum benefit of $3,000 per year for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay. 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. You will pay 20% coinsurance for these services, and prior authorization is required.
Medical Equipment See details
The Aetna Medicare FL Select (HMO) plan covers Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetic Devices and Medical Supplies with no copay and no coinsurance for Medical Supplies. Diabetic Equipment is covered, but the plan has coinsurance and copay for some services and requires prior authorization.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $45, and lab services with no copay. Radiological Services are also covered, with a copay up to $50 for diagnostic services, no copay for outpatient X-rays, and 20% coinsurance for therapeutic services.
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 not covered under the Aetna Medicare FL Select (HMO) plan. A doctor referral is required for these services, but the plan does not cover the services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare FL Select (HMO) plan, with prior authorization required. There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered and non-Medicare-covered stays are not covered.
Other Services See details
The Aetna Medicare FL Select (HMO) plan covers Over-the-Counter (OTC) Items with no copay, up to a maximum of $75 every three months, as well as a meal benefit with no copay. Acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and many other services are not covered.
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