A non-government entity
Aetna Medicare Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Select (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Select (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Central FL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Select (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Select (HMO).
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 Select (HMO), 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 $200.00 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 $4150.00 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 Select (HMO) plan features an annual drug deductible of $200. For Tier 1 preferred generics and Tier 2 generics, you pay no copay when using a preferred retail pharmacy or preferred mail-order service. If you choose standard pharmacies or standard mail-order options, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2. For higher-tier medications, cost-sharing transitions from copays to coinsurance. Tier 3 preferred brand drugs require a 25% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 30% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers robust coverage with no copay for primary care physician visits, home health services, and routine preventive care. Specialist visits require a low $10 copay, while inpatient hospital stays have a $225 daily copay for the first six days and no copay thereafter. Emergency room visits carry a $150 copay, which is waived if you are admitted, and outpatient services feature a copay ranging from no copay up to $200. This plan also includes valuable supplemental benefits, such as dental and hearing coverage which both provide up to a $1,000 annual limit with no copay for routine services. Vision care is covered with no copay or deductible, including an annual routine exam and up to $100 yearly for eyewear. Additionally, members benefit from no copays on standard medical equipment and receive a thirty dollar over-the-counter allowance every three months.
Inpatient Hospital See details
Aetna Medicare Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $225 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute hospital days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Select (HMO) covers outpatient services with no coinsurance, featuring a $0 to $200 copay for outpatient hospital services and a $225 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $5 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Select (HMO) covers partial hospitalization with a copay of either $10.00 or $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Select (HMO) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Select (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care is covered with a $55 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $150 to $275 up to a $250,000 maximum limit.
Primary Care See details
Aetna Medicare Select (HMO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $10 copay and no coinsurance. Physical, occupational, speech, and mental health therapies have a $5 copay and no coinsurance, though chiropractic services are not covered.
Preventive Services See details
Preventive Services under Aetna Medicare Select (HMO) are partially covered, with annual physicals, health education, and fitness benefits costing no copay and no coinsurance. Kidney disease education requires a referral and has no copay with a 20% coinsurance, while several supplemental services like medical nutrition therapy, personal emergency response systems, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Select (HMO), offering Medicare-covered exams for a $10 copay and no coinsurance, and annual routine exams and fitting evaluations for no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 per ear yearly with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Select (HMO) covers vision services with no copay, no coinsurance, and no deductible, including one annual routine eye exam and follow-up diabetic eye exams. Eyewear is partially covered with no copay or coinsurance up to a $100 annual limit, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Select (HMO) covers dental services up to a $1,000 annual maximum, offering Medicare-covered dental for a $10 copay and no coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance. This benefit is partially covered, as fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Select (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Select (HMO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Select (HMO) covers medical equipment with no copays for durable medical equipment, medical supplies, and diabetic shoes, though coinsurance ranges from no coinsurance up to 20% depending on the item. Prior authorization is required for these services, and prosthetic devices require a 20% coinsurance while diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services under Aetna Medicare Select (HMO) are covered with prior authorization and referral requirements. Lab services and outpatient X-rays feature no copay, diagnostic tests range from a $0 to $50 copay with no coinsurance, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Select (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Select (HMO) covers cardiac rehabilitation services with no copayment and no coinsurance, though a referral is required. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Select (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days beyond the standard Medicare limit.
Other Services See details
Aetna Medicare Select (HMO) other services are partially covered, offering no copay and no coinsurance for covered benefits like over-the-counter items up to $30 every three months, meals for chronic illness, annual wellness exams, screening mammographies, and additional gFOBT and FIT tests. Acupuncture is not covered under this plan.
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