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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 West 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 $4.80. 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. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy no copay for one-month, two-month, or three-month supplies filled at standard pharmacies or via standard mail order. Higher-tier prescription costs are based on coinsurance rates for standard pharmacy and standard mail-order services. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) plan offers robust medical coverage with a mix of copays and coinsurance depending on the service. For inpatient hospital stays, members pay a copay of $2,230 per acute care stay or $2,080 per psychiatric stay with no coinsurance, while primary care, specialist, and dialysis services require no copay but carry a 20% coinsurance. Outpatient services feature copays ranging from $0 to $250, and emergency care is available with a $115 copay that is waived upon hospital admission. This plan also includes key supplemental benefits, such as dental and vision care, featuring up to $1,000 for select dental services and a $300 annual eyewear allowance with no copays or coinsurance. Additionally, members benefit from no copays or coinsurance for home health services, durable medical equipment, and up to 48 plan-approved one-way transportation trips per year. Other highlights include a $270 monthly over-the-counter reimbursement and skilled nursing facility stays with no copay for the first 20 days.
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. 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 a $0 to $250 copay and no coinsurance, and observation services with a $250 copay per stay and no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copays or coinsurance, while outpatient substance abuse services have no copay but require 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 service, you will either pay a 20% coinsurance with no copay, or a $110 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), as transportation to any health-related location is not covered. Ground ambulance services require a $275 copay and coinsurance, air ambulance services require a 20% coinsurance and a copay, and plan-approved transportation is covered for up to 48 one-way trips per year with no copay and no coinsurance.
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 up to a $250,000 limit with no copays or coinsurance.
Primary Care See details
Primary care benefits under Aetna Medicare Full Dual Select (HMO D-SNP) are covered with no copay and a 20% coinsurance for primary care, specialist, therapy, and mental health services. Chiropractic services are partially covered, offering no copay and 20% coinsurance for routine care 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), featuring no copay and no coinsurance for annual exams and screenings, while kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring one routine hearing exam per year with a 20% coinsurance and no copay, and one fitting evaluation with no copay. Prescription hearing aids are covered up to $1,000 annually with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no deductibles, featuring routine eye exams with no copay and 20% coinsurance, and diabetic eye exams with no copay and no coinsurance. Eyewear is covered with no copay and no coinsurance up to a $300 annual limit, which includes contact lenses and up to two pairs of eyeglasses, though individual 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), offering Medicare-covered dental with no copay and a 20% coinsurance, and other covered dental services with no copay and no coinsurance up to a $1,000 annual limit. Fluoride treatments, other preventive 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. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy, radiation, and alternative drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
The Aetna Medicare Full Dual Select (HMO D-SNP) plan covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, and diabetic supplies with no copays and no coinsurance. Diabetic therapeutic shoes and inserts are covered with no copay but require a 20% coinsurance, and prior authorization is required for these medical equipment benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers diagnostic and radiological services with no coinsurance for diagnostics and no copay for lab services, outpatient X-rays, and diagnostic radiology. Diagnostic procedures and tests require a copay of up to $45, while therapeutic radiological services carry a minimum 20% coinsurance, with prior authorization and referrals required.
Home Health Services See details
Home Health Services are covered by 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) requires a referral and features no copay for covered cardiac rehabilitation services, though some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered and require a 20% coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not needed, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) offers partial coverage for other services with no copay and no coinsurance, including a $270 monthly over-the-counter item reimbursement, chronic illness meal benefits, wellness exams, and select colorectal screenings. Acupuncture and highly integrated dual-eligible SNP services are not covered under this benefit.
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