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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 Treasure Coast 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:
Sign up for Aetna Medicare Full Dual Select (HMO D-SNP)
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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 drugs, members pay no copay for one-month, two-month, or three-month supplies filled at standard pharmacies and through standard mail order. This ensures affordable access to essential generic medications. For higher-tier medications, costs are based on a percentage of the drug cost rather than a flat fee. Tier 3 preferred brand drugs require a 22% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance for standard pharmacy and mail order services. Tier 5 specialty drugs also carry a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Full Dual Select (HMO D-SNP) offers comprehensive medical coverage, featuring no copays for primary care, specialist visits, and home health services, though a 20% coinsurance applies to doctor visits. Inpatient hospital stays require a copay of $2,100 for acute care or $2,080 for psychiatric care, while emergency room visits carry a $115 copay that is waived if you are admitted. Durable medical equipment, prosthetics, and medical supplies are fully covered with no copay or coinsurance. This plan also provides valuable supplemental benefits, including up to 48 one-way transportation trips per year and a $235 monthly allowance for over-the-counter items with no copay or coinsurance. Routine dental services are covered up to a $1,000 annual limit with no copay or coinsurance, while prescription hearing aids and eyewear are partially covered up to $2,000 and $400 annually, respectively. Routine eye and hearing exams are available with no copay and a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Full Dual Select (HMO D-SNP) inpatient hospital services are partially covered, featuring no coinsurance for all stays, a $2,100 copay per admission for acute care, and a $2,080 copay per admission for psychiatric care. Prior authorization is required, and non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers outpatient hospital and observation services with no coinsurance and copays ranging from $0 to $195. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse services feature no copay and 20% coinsurance for individual and group sessions.
Partial Hospitalization See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers partial hospitalization services with prior authorization, costing either a $110 copay with no coinsurance or no copay with a 20% coinsurance.
Ambulance and Transportation Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers ground ambulance services with a $170 copay (no coinsurance) and air ambulance services with a 20% coinsurance (no copay), both requiring prior authorization. Transportation is partially covered, offering up to 48 one-way trips per year to plan-approved locations with no copay or coinsurance, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with a $115 copay (waived if admitted within 24 hours) and no coinsurance, while urgently needed services require 20% coinsurance (maximum $40 per visit) and no copay. Worldwide emergency, urgent, and transportation services are also covered with no copay or coinsurance up to a maximum plan benefit of $250,000.
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, providing up to 24 routine visits per year with no copay and 20% coinsurance, though 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 physical exams, diabetes self-management, and glaucoma screenings. Kidney disease education requires a referral and has no copay but carries a 20% coinsurance, while several supplemental benefits like medical nutrition therapy, weight management programs, and therapeutic massage are not covered.
Hearing Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers hearing services with no deductible, featuring routine hearing exams with a 20% coinsurance and no copay, and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered up to $2,000 annually with no copay or coinsurance, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Full Dual Select (HMO D-SNP) with no deductible, offering routine eye exams with no copay and a 20% coinsurance, and diabetic eye exams with no copay. Eyewear is partially covered with no copay or coinsurance up to a $400 annual limit for contact lenses and complete eyeglasses, though individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Full Dual Select (HMO D-SNP) up to a $1,000 annual maximum, offering no copay and no coinsurance for most diagnostic, preventive, and restorative services, while Medicare-covered dental services require a 20% coinsurance and no copay. Fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are 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
Aetna Medicare Full Dual Select (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic supplies with no copay and no coinsurance, subject to prior authorization. Diabetic therapeutic shoes and inserts are also covered with no copay but require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Full Dual Select (HMO D-SNP) covers diagnostic and radiological services, requiring prior authorization and referrals. Diagnostic services have no coinsurance, offering no copay for lab work and copays up to $90 for procedures. Radiological services feature no copay for outpatient X-rays, no minimum copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered under 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 some cardiac rehabilitation services with no copay and a referral requirement. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD 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 prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the standard 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, including chronic illness meal benefits, select wellness screenings, and a $235 monthly over-the-counter allowance. Acupuncture is not covered under this benefit.
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