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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 Charlotte, Collier, Lee. 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, you will pay no copay for Tier 1 preferred generic and Tier 2 generic prescription drugs 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 medications. For higher-tier medications, standard pharmacy and standard mail order options transition to coinsurance. Tier 3 preferred brand drugs carry a 22% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance for all supply durations. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive coverage for core medical needs, featuring a $1,900 copay per stay with no coinsurance for inpatient hospital services and no copay with a 20% coinsurance for primary and specialist care. Emergency services require a $115 copay which is waived if you are admitted, while outpatient hospital visits feature no coinsurance and copays ranging from no copay up to $185. Essential home health services, diagnostic lab tests, and durable medical equipment are also covered with no copay and no coinsurance. For supplemental care, the plan provides dental benefits up to a $1,000 annual limit and eyewear up to a $400 annual limit with no copay and no coinsurance. Routine hearing exams and dialysis services are covered with no copay and a 20% coinsurance, while up to 48 one-way transportation trips per year to plan-approved locations are available with no copay and no coinsurance. Members also benefit from a $235 monthly over-the-counter allowance and chronic illness meals with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers inpatient acute and psychiatric hospital stays with a $1,900 copay per stay and no coinsurance, subject to prior authorization. This benefit is partially covered because 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 no coinsurance and copays ranging from $0 to $185, while ambulatory surgical center and blood services feature no copay and no coinsurance. Outpatient substance abuse services are covered with no copay and a 20% 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 specific service, your costs will be either no copay with a 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 services requiring a $205 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Transportation services are partially covered with no copay and no coinsurance for up to 48 one-way trips per year to plan-approved locations, 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, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and a 20% coinsurance up to $40, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no copay 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. Routine chiropractic and podiatry care are also covered for up to 24 visits per year, though other non-routine chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers preventive services, with most covered benefits like annual physicals and health education requiring no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Non-covered services include in-home safety assessments, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, and counseling.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers routine hearing exams with no deductible, no copay, and a 20% coinsurance, alongside fitting evaluations and prescription hearing aids with no copay or coinsurance. This benefit is partially covered as OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services under the Aetna Medicare Full Dual Select (HMO D-SNP) are partially covered, offering routine eye exams with no copay and 20% coinsurance, and diabetic eye exams with no copay. Covered eyewear has no copay and no coinsurance up to a $400 annual limit for contact lenses and up to three pairs of eyeglasses, 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 Medicare-covered dental services with no copay and 20% coinsurance, alongside other dental services up to a $1,000 annual limit with no copay and no coinsurance. 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 and no coinsurance, though prior authorization is required. Within this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B 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 to receive 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
Diagnostic and radiological services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no coinsurance for diagnostic services, as well as no copay for lab, outpatient X-ray, and diagnostic radiological services. Diagnostic procedures and tests have a copay ranging from $0 to $100, while therapeutic radiological services require a minimum 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 are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and a required referral, though only some services are covered in practice. Standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered under the $0 copay benefit and instead require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) 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, a prior three-day hospital stay is not required, and additional days beyond the 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, and include a $235 monthly over-the-counter allowance, chronic illness meal benefits, and select wellness exams. However, acupuncture and highly integrated dual-eligible services are not covered under this benefit.
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