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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 Northwest 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 prescription drug deductible of $615. Under this plan, there is no copay for Tier 1 preferred generic and Tier 2 generic drugs when filled at standard pharmacies or through standard mail order. This no-copay coverage applies to one-month, two-month, and three-month supplies of these generic medications. For brand-name and specialty drugs, member costs are calculated using coinsurance. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs incur a 25% coinsurance at standard pharmacies and mail order. These coinsurance rates apply to all available supply lengths, though Tier 5 specialty medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive medical coverage featuring no copay for primary care, specialist, and home health services, though a twenty percent coinsurance applies to doctor visits. Inpatient hospital stays require a copay of two thousand two hundred twenty dollars per stay with no coinsurance, while emergency room visits have a one hundred fifteen dollar copay that is waived upon admission. Outpatient hospital services feature no coinsurance and copays ranging from no copay to three hundred dollars. This plan also includes valuable extra benefits with no deductibles, including a one thousand dollar annual limit for dental care and a four hundred dollar yearly allowance for eyewear with no copay or coinsurance. Members also benefit from a two hundred thirty-five dollar monthly over-the-counter item allowance and up to forty-eight one-way transportation trips per year to plan-approved locations with no copay or coinsurance. Additionally, routine preventive services, diagnostic labs, and durable medical equipment are fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers inpatient hospital services with no coinsurance, requiring a $2,220 copay per stay for acute care and a $2,080 copay per stay for psychiatric care. Prior authorization is required for these services, and upgrades or non-Medicare-covered stays 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 no copay to $300, and observation services with a $300 copay per stay and no coinsurance. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse services have no copay and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) subject to prior authorization. Depending on the service, you will owe either 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 ground ambulance services with a $235 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. 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 maximum with no copay and no 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 20% coinsurance. Chiropractic services are partially covered under this plan, offering up to 24 routine visits per year with no copay and 20% coinsurance, while other chiropractic services are not covered.
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 fitness benefits, requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several sub-services, including in-home safety assessments, weight management, and therapeutic massage, are not covered.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers hearing services with no deductibles, offering one annual routine exam with a 20% coinsurance and no copay, alongside one fitting evaluation with no copay or coinsurance. Up to two prescription hearing aids are covered each year with no copay or coinsurance up to a $2,000 maximum per ear, though 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) covers vision services with no deductible, offering routine eye exams with no copay and 20% coinsurance, and other eye exams with no copay or coinsurance. Eyewear is covered with no copay or coinsurance up to a $400 annual maximum, which includes contact lenses and up to three pairs of eyeglasses per year, though separate eyeglass lenses and frames 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, and other covered dental services requiring 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, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under 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
Aetna Medicare Full Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and no coinsurance, though diabetic supplies are limited to specified manufacturers. Diabetic therapeutic shoes and inserts are covered with no copay and a 20% coinsurance, and prior authorization is required for these medical equipment benefits.
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. Members will pay no copay and no coinsurance for lab services and outpatient X-rays, a $0 to $100 copay with no coinsurance for diagnostic tests, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home health services are covered by the Aetna Medicare Full Dual Select (HMO D-SNP) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers Cardiac Rehabilitation Services with no copay and a required referral, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered under this benefit and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and 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, though acupuncture is not covered. Covered benefits include a $235 monthly over-the-counter item allowance, meals for chronic illnesses, annual wellness exams, screening mammographies, and additional colorectal cancer screenings.
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