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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 South 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 pay no copay for one-month, two-month, or three-month supplies filled through standard pharmacies or standard mail order. This ensures that essential generic prescriptions remain highly accessible and affordable. Higher-tier medications under this plan are subject to coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance for standard pharmacy and mail order services. These cost-sharing percentages apply to one-month, two-month, and three-month supplies, with the exception of specialty drugs which are limited to a one-month fill.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive medical coverage, featuring no copay and a 20% coinsurance for primary care, specialist visits, and dialysis services. For hospital stays, members pay a $2,230 copay per stay for acute inpatient care and up to a $100 copay for outpatient hospital services, both with no coinsurance. Emergency care is available with a $115 copay, which is waived upon admission, while ground ambulance services require a $275 copay. This plan also provides robust supplemental benefits, including no copay and no coinsurance for home health care, durable medical equipment, and up to 48 one-way transportation trips. Additionally, members receive dental coverage up to a $2,500 annual limit, vision eyewear up to a $400 annual limit, and a $305 monthly over-the-counter allowance with no copays or coinsurance. Routine hearing exams and Medicare-covered dental services are also accessible with no copay and a 20% coinsurance.
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 subject to prior authorization. This benefit is partially covered, as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring no copay and no coinsurance for ambulatory surgical center and outpatient blood services. Outpatient hospital services require no coinsurance with copays ranging from $0 to $100 (including a $100 copay per stay for observation), while outpatient substance abuse services have no copay but carry a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Full Dual Select (HMO D-SNP) with prior authorization required. Depending on the service, you will pay either a 20% coinsurance with no copay, or a $110.00 copay with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Full Dual Select (HMO D-SNP), featuring a $275 copay and no coinsurance for ground ambulance, and a 20% coinsurance with no copay for air ambulance. The plan also includes up to 48 one-way transportation trips per year to plan-approved locations with no copay or coinsurance, 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, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a 20% coinsurance up to $40 and no copay, while worldwide emergency, urgent, and transportation services are covered with no copay or coinsurance up to a $250,000 maximum.
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 benefits are partially covered, 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
Aetna Medicare Full Dual Select (HMO D-SNP) preventive services are partially covered with no copay and no coinsurance for covered benefits like annual physical exams and health education. Sub-services that are not covered under this plan include in-home safety assessments, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional 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) with no deductibles. The plan offers no copay and no coinsurance for fitting evaluations, Medicare-covered exams, and prescription hearing aids up to $1,250 per ear annually, though routine exams require a 20% coinsurance with no copay, and OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) features partially covered vision services, including one routine eye exam per year with no copay and 20% coinsurance, and follow-up diabetic exams with no copay. Eyewear is covered with no copay or coinsurance up to a $400 annual limit for contact lenses and complete eyeglasses (lenses and frames), although individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) partially covers dental services, offering Medicare-covered dental with no copay and 20% coinsurance, and other dental services with no copay and no coinsurance up to a $2,500 annual maximum. While exams, cleanings, and restorative services are covered, fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and other preventive dental services 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 and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy and other Part B drugs require no copay with 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 by Aetna Medicare Full Dual Select (HMO D-SNP) 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 medical equipment with no copay and no coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic supplies. However, a 20% coinsurance applies to diabetic therapeutic shoes and inserts, and prior authorization is required for these covered benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Full Dual Select (HMO D-SNP) plan, with prior authorization and referrals required. Diagnostic procedures and tests have a copay of $0 to $25 with no coinsurance, lab services and outpatient X-rays feature no copay, and 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, though 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. Standard 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, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, though a prior three-day inpatient hospital stay is not necessary, and additional days beyond the standard 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 for eligible benefits, which include a $305 monthly over-the-counter allowance, chronic illness meals, and select wellness exams. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and certain other services are not covered.
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