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 West 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 $4200.00 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 a $200 prescription drug deductible. For Tier 1 preferred generics and Tier 2 generic drugs, there is no copay when you use a preferred pharmacy or preferred mail order service. If you choose standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the supply length. For higher-tier medications, Tier 3 preferred brand drugs require a 25% coinsurance regardless of the pharmacy or supply duration. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 30% coinsurance, with specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers robust medical coverage featuring no copays and no coinsurance for primary care doctor visits, preventive care, and annual physical exams. Specialist visits require a low $25 copay, while inpatient hospital stays have a $295 daily copay for the first seven days followed by no copay for days eight through 90. Emergency room visits carry a $150 copay, which is completely waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as routine vision exams and up to $100 annually for eyewear with no copays or coinsurance. Dental and hearing services are covered up to a $1,000 annual limit, featuring no copays for routine care and a $25 copay for Medicare-covered services. Additionally, members benefit from no-cost home health services, chronic illness meals, and a $30 quarterly reimbursement for over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Select (HMO) with no coinsurance and a $295 daily copay for days 1 through 7, followed by no copay for days 8 through 90. This partially covered benefit requires prior authorization and does not cover upgrades, non-Medicare-covered stays, or additional days for psychiatric hospitalizations.
Outpatient Services See details
Aetna Medicare Select (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital and observation services require prior authorization with copays ranging from $0 to $295, while outpatient substance abuse services have copays of $10 to $15.
Partial Hospitalization See details
Aetna Medicare Select (HMO) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the service, you will pay a copay of either $55.00 or $180.00.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Select (HMO) require prior authorization, costing a $275 copay and coinsurance for ground transport, and a 20% coinsurance and copay for air transport, with neither charge waived upon hospital admission. Transportation services are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Select (HMO) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $60 copay with no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays of $150 for emergency or urgent care and $275 for emergency transportation.
Primary Care See details
Aetna Medicare Select (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $25 copay and no coinsurance. Physical, occupational, and speech therapies feature a $5 copay and no coinsurance, mental health services have a $10 to $15 copay and no coinsurance, and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Select (HMO) covers most preventive services and annual physical exams with no copay and no coinsurance. Additional supplemental benefits are partially covered, offering services like health education and memory fitness at no cost while excluding others like weight management, and kidney disease education requires a 20% coinsurance and a referral.
Hearing Services See details
Aetna Medicare Select (HMO) partially covers hearing services, offering Medicare-covered exams for a $25 copay and no coinsurance, as well as annual routine exams and fitting evaluations with no copay or coinsurance. Up to two prescription hearing aids are covered with a $1,000 annual maximum per ear and no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are partially covered by Aetna Medicare Select (HMO) with no deductibles, no copays, and no coinsurance for covered services. This benefit includes one routine eye exam per year and up to $100 annually for contact lenses and eyeglasses (lenses and frames), though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Select (HMO), featuring a $25 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $1,000 annual limit. However, 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 Select (HMO) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Select (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Select (HMO) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, and diabetic shoes, though prior authorization is required. Coinsurance costs range from no coinsurance up to 20% for DME and diabetic supplies, while prosthetic devices require 20% coinsurance and medical supplies have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Select (HMO) with no copay for lab and outpatient X-ray services, and copays ranging from $0 to $45 for diagnostic procedures. Diagnostic services carry no coinsurance, while diagnostic radiological services have a $0 minimum copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under Aetna Medicare Select (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered under the Aetna Medicare Select (HMO) plan with no copay, no coinsurance, and a referral requirement, though only some services are covered in practice as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services 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, a $218 copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under Aetna Medicare Select (HMO) are partially covered, offering no copay and no coinsurance for chronic illness meals, annual wellness exams, screening mammographies, and a $30 quarterly over-the-counter item reimbursement. However, acupuncture is not covered under this benefit.
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