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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 Southwest 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 $4.80. 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 has an annual prescription drug deductible of $615. Under this plan, there is no copay for Tier 1 preferred generic and Tier 2 generic drugs purchased at standard pharmacies or through standard mail order. This no-copay benefit applies to one-month, two-month, and three-month supplies of these generic medications. For brand-name and specialty prescriptions, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance for all supply durations at standard pharmacies and standard mail order. Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance, with the Tier 5 rate applying to one-month supplies.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive coverage with no copays for primary care, specialist visits, and home health services, though these medical visits generally require a 20% coinsurance. For hospital care, inpatient acute stays require a $2,230 copay per admission with no coinsurance, while outpatient hospital services feature no coinsurance and copays ranging from no copay up to $185. Emergency care is available with a $115 copay that is waived upon admission, alongside up to 48 routine one-way transportation trips with no copays or coinsurance. This plan also provides robust supplemental benefits, including preventive and comprehensive dental care up to a $2,000 annual limit with no copay and no coinsurance. Vision and hearing services feature no copays for routine exams and fitting evaluations, and the plan covers up to $300 annually for eyewear and up to $1,250 per ear yearly for prescription hearing aids with no copays or coinsurance. Additionally, members benefit from durable medical equipment with no copay or coinsurance, as well as a $250 monthly over-the-counter allowance.
Inpatient Hospital See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers inpatient hospital services, requiring prior authorization and offering no coinsurance for all covered stays. Acute care stays incur a $2,230 copay per admission with unlimited additional days, while psychiatric stays require a $2,080 copay per admission; however, 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 hospital and observation services with no coinsurance and copays ranging from no copay up to $185. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse services have no copay but require a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Full Dual Select (HMO D-SNP) with prior authorization, costing either a 20% coinsurance with no copay, or a $110.00 copay with no coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while 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 are covered with 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 lifetime maximum with no copays or coinsurance.
Primary Care See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers primary care, specialist, therapy, and mental health services with no copay and a 20% coinsurance. Chiropractic services are partially covered, offering up to 24 routine visits per year with no copay and 20% coinsurance, but excluding other chiropractic services.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), with most covered services—such as annual physicals and glaucoma screenings—offering no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several supplemental benefits like weight management, therapeutic massage, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring no deductible, a 20% coinsurance and no copay for annual routine exams, and no copay or coinsurance for fitting evaluations. Up to two prescription hearing aids are covered with no copay or coinsurance up to $1,250 per ear yearly, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered under Aetna Medicare Full Dual Select (HMO D-SNP), featuring routine eye exams with a 20% coinsurance and no copay, and other eye exams with no copay or deductible. Covered eyewear, including contact lenses and up to two pairs of eyeglasses, has no copay or coinsurance up to a $300 annual maximum, though individual eyeglass frames and lenses are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), with Medicare-covered dental requiring no copay and a 20% coinsurance. Other covered preventive and comprehensive dental services have no copay and no coinsurance up to a $2,000 yearly maximum, though fluoride treatment, other preventive dental, 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, requiring prior authorization and step therapy. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by the Aetna Medicare Full Dual Select (HMO D-SNP) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copays and no coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic supplies. Diabetic therapeutic shoes and inserts are also covered with no copay but require a 20% coinsurance, and prior authorization is required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with prior authorization and referrals required. Lab services have no copay and no coinsurance, while diagnostic tests range from a $0 to $50 copay with no coinsurance. Outpatient X-rays feature no copay but require coinsurance, and therapeutic radiological services require a minimum 20% coinsurance and a copay.
Home Health Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and a required referral. However, only some services are covered, as standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation 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 and requires prior authorization, offering no copay for days 1 through 20 and a $218 copay for days 21 through 100. A prior three-day inpatient hospital stay is not required, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance for covered benefits, which include a $250 monthly over-the-counter allowance, chronic illness meals, and annual wellness exams. Acupuncture is not covered under this benefit.
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