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Aetna Medicare Full Dual Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Full 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 Full Dual Select (HMO D-SNP) in 2026, please refer to our full plan details page.
Aetna Medicare Full Dual Select (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2026 to people living in South Florida. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Full 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 Full 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 Full 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 Full Dual Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $1.30. 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 $615.00 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 $9250.00 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 Full Dual Select (HMO D-SNP) prescription drug plan features an annual deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, members enjoy no copay for one-, two-, or three-month supplies at standard pharmacies and standard mail order. This coverage provides a cost-effective option for essential daily medications. Higher-tier prescription drugs require coinsurance rather than flat copayments under this plan. Tier 3 (Preferred Brand) drugs have a 22% coinsurance, while Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) medications require a 25% coinsurance. These coinsurance rates apply to standard pharmacy and mail-order fills, with specialty tier coverage limited to one-month supplies.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) plan offers comprehensive medical coverage featuring no copays for primary and specialist care, though a 20% coinsurance applies. Inpatient hospital stays require a copayment of $2,230 for acute care and $2,080 for psychiatric care with no coinsurance, while outpatient services range from no copay up to a $100 copay. Emergency care requires a $115 copay, and skilled nursing facility stays have no copay for the first 20 days. Members also receive robust supplemental coverage, including preventive and comprehensive dental services with no copay or coinsurance up to a $2,000 annual limit. Vision and hearing benefits feature no copays for routine exams with a 20% coinsurance, plus allowances of up to $400 for eyewear and $1,250 per ear for prescription hearing aids. Additionally, there are no copays or coinsurance for home health services, durable medical equipment, and a $290 monthly over-the-counter allowance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no coinsurance, requiring prior authorization and a copayment of $2,230 per stay for acute care and $2,080 per stay for psychiatric care. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers outpatient hospital services with a $0 to $100 copay and no coinsurance, and observation services with a $100 copay per stay and no coinsurance. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse services feature no copay and a 20% coinsurance. Prior authorization is required for most of these covered outpatient services.
Partial Hospitalization See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers partial hospitalization services with prior authorization, featuring cost-sharing of either no copay and 20% coinsurance, or a $110 copay and no coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers ground ambulance services with a $200 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 48 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a 20% coinsurance (up to a $40 maximum per visit) and no copay, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no copays and no coinsurance.
Primary Care See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers primary care, specialist, therapy, mental health, and telehealth services with no copay and a 20% coinsurance. Chiropractic services are partially covered, providing up to 24 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance for covered options like annual physical exams, kidney disease education, and glaucoma screenings. Sub-services that are not covered include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health, nutritional or dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling services.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers hearing services, offering routine hearing exams with a 20% coinsurance and no copay, alongside hearing aid fittings and prescription hearing aids with no copays or coinsurance up to a $1,250 annual limit per ear. However, OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring eye exams with no copay, no deductible, and a 20% coinsurance for routine visits. Eyewear is covered with no copay and no coinsurance up to a $400 annual limit, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), offering up to a $2,000 annual maximum with no copay and no coinsurance for covered preventive and comprehensive care, while Medicare-covered dental services require a 20% coinsurance and no copay. Prior authorization is required for several services, and fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers home infusion bundled services with no copay, although prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Full Dual Select (HMO D-SNP) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and no coinsurance, subject to prior authorization. Diabetic therapeutic shoes and inserts are also covered with no copay but require a 20% coinsurance, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers diagnostic and radiological services, though prior authorization and referrals are required. Under this plan, lab services and diagnostic radiological services have no copays and no coinsurance, diagnostic procedures range from no copay up to a $25 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Full Dual Select (HMO D-SNP) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Aetna Medicare Full Dual Select (HMO D-SNP) are covered with no copay and require a referral, though some services are not covered. Specifically, standard cardiac, intensive cardiac, pulmonary, and SET for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and are subject to a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers other services with no copay and no coinsurance, including a $290 monthly over-the-counter allowance, chronic illness meal benefits, and annual wellness exams. Acupuncture and highly integrated dual-eligible services are not covered under this plan.
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