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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 North 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 $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 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) plan features an annual drug deductible of $615. Under this plan, members benefit from no copay on Tier 1 preferred generic and Tier 2 generic drugs when using standard pharmacies or standard mail order. This ensures that essential, everyday prescription medications remain highly accessible and cost-effective. For brand-name and specialty prescriptions, cost-sharing is based on coinsurance. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance for standard pharmacy and mail-order fills. These clear coinsurance rates help you accurately estimate your out-of-pocket costs for specialized treatments.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) plan offers robust medical coverage, featuring a $2,050 copay per stay with no coinsurance for inpatient hospital care. Primary care, specialist visits, and dialysis services generally require no copay but are subject to a 20% coinsurance. Emergency services are covered with a $115 copay that is waived if you are admitted, while urgently needed care requires a 20% coinsurance and no copay. In addition to core medical care, this plan provides generous supplemental benefits, including routine dental and vision services with no copay, alongside annual allowances of up to $1,000 for dental and $400 for eyewear. Members also benefit from up to 48 one-way transportation trips per year and up to $2,000 per ear annually for prescription hearing aids with no copay or coinsurance. Finally, a monthly allowance of up to $245 is provided for over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care under Aetna Medicare Full Dual Select (HMO D-SNP) is partially covered, featuring a $2,050 copayment per stay and no coinsurance for Medicare-covered acute and psychiatric admissions. Prior authorization is required, and while unlimited additional days are covered for acute stays, upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers outpatient services with copays ranging from $0 to $150 and no coinsurance for outpatient hospital and observation stays. Ambulatory surgical center and outpatient blood services are covered with no copays and no coinsurance, while outpatient substance abuse services have no copay but require a 20% coinsurance for individual and group sessions.
Partial Hospitalization See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers partial hospitalization services, which require prior authorization. Depending on the specific service, you will pay either no copay with 20% coinsurance, or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Aetna Medicare Full Dual Select (HMO D-SNP), with ground ambulance requiring a $250 copay (no coinsurance) and air ambulance requiring a 20% coinsurance (no copay). Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a 20% coinsurance (up to $40 per visit) and no copay, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no copay and no coinsurance.
Primary Care See details
Primary care benefits under the Aetna Medicare Full Dual Select (HMO D-SNP) are partially covered, generally requiring no copay and a 20% coinsurance for PCP visits, specialist services, therapies, and mental health care. Routine chiropractic and podiatry services are covered for up to 24 visits per year, though other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring no copay and no coinsurance for annual physicals, health education, and select screenings, though kidney disease education requires a 20% coinsurance and a referral. Several supplemental services are not covered under this plan, including medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, and in-home support services.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers hearing services, including one routine hearing exam per year with a 20% coinsurance and no copay, and one fitting evaluation with no copay or coinsurance. Up to $2,000 per ear is covered annually for up to two prescription hearing aids with no copay or coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no deductibles, offering routine eye exams with no copay and a 20% coinsurance, and follow-up diabetic eye exams with no copay. Eyewear is partially covered with no copay and no coinsurance up to a $400 annual limit, which includes contact lenses and up to three pairs of eyeglasses (lenses and frames) per year, though individual eyeglass lenses and individual eyeglass frames are not covered.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring Medicare-covered dental with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $1,000 annual limit. Fluoride treatments, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs have a 0% to 20% coinsurance and no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic supplies with no copay and no coinsurance. Diabetic therapeutic shoes and inserts are also covered with no copay but require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no coinsurance for diagnostic services and a copay of $0 to $75 for diagnostic procedures and tests. There is no copay for lab services, outpatient X-rays, and diagnostic radiological services, while 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Aetna Medicare Full Dual Select (HMO D-SNP) require a referral and have no copay, although some services are not covered. Specifically, standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require 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 and allowing admission without a prior three-day hospital stay. Beneficiaries pay no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the Medicare-covered 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 chronic illness meal benefit, annual wellness exams, screening mammography, additional colorectal screenings, and up to $245 monthly for over-the-counter items. Acupuncture is not covered under this plan.
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