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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, Central 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 has an annual drug deductible of $615. For prescription drug coverage, members pay no copay for Tier 1 preferred generic and Tier 2 generic drugs filled at standard pharmacies or through standard mail order. This zero-dollar cost-sharing applies to one-month, two-month, and three-month supplies. For higher-tier medications, standard pharmacy and mail order fills require coinsurance instead of a flat copay. Tier 3 preferred brand drugs carry a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require 25% coinsurance. The 25% coinsurance for Tier 5 specialty drugs is applicable to a one-month supply.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive medical coverage with a focus on affordable care, featuring no copay for primary care and specialist visits alongside a 20% coinsurance. Inpatient hospital stays require a $2,230 copay per stay for acute care with no coinsurance, while emergency room visits carry a $115 copay that is waived if you are admitted. Outpatient hospital services and diagnostic services are highly accessible, often requiring no coinsurance and low to no copays. This plan also includes valuable supplemental benefits, such as dental, vision, and hearing services with no copay for routine exams, though some services may require a 20% coinsurance. Members benefit from generous annual allowances, including up to $1,500 per ear for hearing aids, a $400 eyewear limit, and a $1,500 limit for preventive and comprehensive dental care with no copay or coinsurance. Additionally, the plan provides practical everyday support with no copay or coinsurance for up to 48 one-way transportation trips and a $240 monthly over-the-counter allowance.
Inpatient Hospital See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,230 copay per stay for acute care and a $2,080 copay per stay for psychiatric care, both of which require prior authorization. While acute care includes unlimited additional days with no copay, non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers outpatient services with no copay and no coinsurance for ambulatory surgical center and blood services. Outpatient hospital services feature no coinsurance with copays ranging from $0 to $175, while outpatient substance abuse services require no copay and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) and require prior authorization, costing either a 20% coinsurance with no copay or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring a $215 copay and no coinsurance for ground ambulance, and a 20% coinsurance with no copay for air ambulance. Transportation is partially covered, offering up to 48 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, though trips to any health-related location are not covered.
Emergency Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers emergency services 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 with no copay or coinsurance up to a $250,000 maximum benefit.
Primary Care See details
Primary Care services for Aetna Medicare Full Dual Select (HMO D-SNP) are covered with no copay and a 20% coinsurance for most care, including primary care physician and specialist visits. Chiropractic benefits 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
Aetna Medicare Full Dual Select (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, standard screenings, and select supplemental benefits like fitness and health education. However, kidney disease education requires a 20% coinsurance and a referral, and several services such as weight management, alternative therapies, and nutritional benefits are not covered.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers hearing services with no deductible, offering routine exams and fitting evaluations for no copay, though routine exams require a 20% coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a maximum of $1,500 per ear annually, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers routine eye exams with no copay and a 20% coinsurance, and diabetic eye exams with no copay and no coinsurance. Eyewear is covered with no copay and no coinsurance up to a $400 annual limit, though this benefit is partially covered because individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Full Dual Select (HMO D-SNP) plan up to a $1,500 annual maximum, with no copay and no coinsurance for covered preventive and comprehensive services, while Medicare-covered dental has no copay and a 20% coinsurance. Prior authorization is required for many services, and fluoride treatment, 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, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs carry no copay and coinsurance ranging from no coinsurance up to 20%, while Medicare 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. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment benefits are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copays, though prior authorization is required for most items. There is no coinsurance for durable medical equipment, prosthetics, and diabetic supplies, but diabetic therapeutic shoes and inserts 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 prior authorization and referrals required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $75 copay for diagnostic procedures, while radiological services include no copay for outpatient X-rays and a minimum 20% coinsurance for therapeutic radiology.
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 are covered under the Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and require a referral. However, some services are not covered, including standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation services, which all carry a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
The Aetna Medicare Full Dual Select (HMO D-SNP) covers Skilled Nursing Facility (SNF) services 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 three-day prior inpatient hospital stay is not required for admission, additional days beyond the standard 100-day limit are not covered.
Other Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers other services, excluding acupuncture. Covered benefits, such as chronic illness meals, annual wellness exams, and a $240 monthly over-the-counter allowance, are provided with no copay and no coinsurance.
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