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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 West 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 features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This cost-saving benefit applies to one-month, two-month, and three-month supplies of these generic drugs. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copays. You will pay a 22% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance, which is limited to a one-month supply at standard pharmacies and standard mail order.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) plan offers robust healthcare coverage, featuring no copay and a 20% coinsurance for primary, specialist, and dialysis services. Inpatient hospital stays require a $2,230 copay per stay for acute care and a $2,080 copay for psychiatric care, while outpatient hospital services range from no copay to a $150 copay. Emergency care is covered with a $115 copay, which is waived upon hospital admission, and urgent care requires a 20% coinsurance. Beyond core medical care, the plan provides excellent supplemental benefits, including home health services and durable medical equipment with no copay and no coinsurance. Members also receive a $1,500 annual dental limit, a $300 annual eyewear allowance, and up to $1,250 per ear for hearing aids with no copays. Furthermore, the plan includes a $270 monthly over-the-counter allowance and up to 48 one-way routine transportation trips per year with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required for these services, while 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 $150 copay and no coinsurance, alongside ambulatory surgical center and blood services with no copays or coinsurance. Outpatient substance abuse services feature no copay with a 20% coinsurance, while observation services require a $150 copay per stay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Full Dual Select (HMO D-SNP) and requires prior authorization. Depending on the service, you will either pay a 20% coinsurance with no copay, or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers ambulance services with a $175 copay for ground transport and 20% coinsurance for air transport, both of which require prior authorization. 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 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 limit 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 benefits are partially covered with no copay and 20% coinsurance for up to 24 routine visits per year, though other chiropractic services are not covered.
Preventive Services See details
Preventive services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance for most services, although kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered, as it excludes in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) offers partially covered hearing services, including annual routine exams with a 20% coinsurance and no copay, and hearing aid fittings with no copay or coinsurance. Prescription hearing aids are covered up to $1,250 per ear every year with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) offers vision benefits with no deductible, featuring routine eye exams with no copay and a 20% coinsurance. Eyewear is partially covered with no copay or coinsurance up to a $300 annual limit, which includes contact lenses and eyeglasses but excludes individual eyeglass lenses and eyeglass frames.
Dental Services See details
Dental services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring a $1,500 annual maximum for other dental services with no copay and no coinsurance, and Medicare-covered dental services with no copay and a 20% coinsurance. While services like cleanings, exams, and restorative care are included, fluoride treatment, other preventive 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, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy, radiation, and miscellaneous drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, 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, and prior authorization is required for these benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers diagnostic and radiological services with no coinsurance for diagnostic services, no copays for lab services, outpatient X-rays, and diagnostic radiological services, and a $0 to $40 copay for diagnostic tests. Therapeutic radiological services require a minimum 20% coinsurance, and prior authorization and referrals are required for these benefits.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers some Cardiac Rehabilitation Services with no copay, but cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services are not covered and require a 20% coinsurance and a referral.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers skilled nursing facility care with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, additional days beyond the 100-day 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, although acupuncture is not covered. Covered benefits include a $270 monthly over-the-counter item reimbursement, a meal benefit for chronic illness, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings.
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