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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 South 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 $2900.00 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 annual drug deductible. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, Tier 1 drugs carry a $2 copay and Tier 2 drugs carry a $12 copay for a one-month supply. For higher-tier medications, the plan transitions from copays to coinsurance. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 30% coinsurance regardless of the pharmacy type. These coinsurance rates apply across preferred and standard pharmacies as well as mail-order options.
Additional Benefits
The Aetna Medicare Select (HMO) plan offers robust core medical coverage with no copay for primary care visits, routine physicals, and home health services. For hospital stays, members pay a $125 daily copay for the first six days of inpatient care and no copay thereafter, while outpatient hospital services range from no copay up to a $125 copay. Emergency room visits carry a $150 copay, which is waived if admitted, while urgent care services require no copay. Specialist visits and Medicare-covered dental exams require a low $20 copay, while routine dental, vision, and hearing services are available with no copay. The plan also includes valuable supplemental allowances, such as up to $1,000 per ear annually for prescription hearing aids, a $100 annual limit for eyewear, and a $30 quarterly over-the-counter reimbursement. Diagnostic lab work and X-rays are also fully covered with no copay, helping to keep your healthcare costs predictable.
Inpatient Hospital See details
Aetna Medicare Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization and a $125 daily copay for days 1 through 6, and no copay for days 7 through 90. This benefit is partially covered because unlimited additional acute care days are included at no copay, whereas additional psychiatric days, non-Medicare-covered stays, and room upgrades are not covered.
Outpatient Services See details
Outpatient Services covered under Aetna Medicare Select (HMO) feature no coinsurance, with ambulatory surgical center services, outpatient substance abuse sessions, and outpatient blood services all requiring no copay. Outpatient hospital services carry a copay of $0 to $125, and observation services require a $125 copay per stay, with prior authorization required for most of these benefits.
Partial Hospitalization See details
Aetna Medicare Select (HMO) covers partial hospitalization services with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Select (HMO), featuring ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and non-emergency transportation services to health-related locations are not covered.
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 services have no copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with a $150 copay for emergency or urgent care, a $250 copay for emergency transportation, and no coinsurance.
Primary Care See details
Primary care benefits under Aetna Medicare Select (HMO) feature no copay and no coinsurance for primary care, occupational therapy, physical and speech therapy, mental health, psychiatric, and opioid treatment services. Specialist visits and podiatry require a $20 copay with no coinsurance, telehealth services have a 20% coinsurance with a $0 to $20 copay, and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Select (HMO) provides preventive services with no copay and no coinsurance for annual physical exams, health education, and fitness benefits, though kidney disease education requires a 20% coinsurance. This benefit is partially covered, as sub-services such as medical nutrition therapy, weight management programs, therapeutic massage, and in-home support services are not covered.
Hearing Services See details
Aetna Medicare Select (HMO) covers annual routine hearing exams and fitting evaluations with no copay, no coinsurance, and no deductible, while Medicare-covered exams require a $20 copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,000 per ear every year, 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) offers partially covered vision services with no copay and no coinsurance, which includes one routine eye exam per year and unlimited diabetic eye exams. Eyewear is also covered with no copay, no coinsurance, and no deductible up to a $100 annual limit for contact lenses and up to two pairs of eyeglasses, but individual eyeglass lenses and eyeglass frames are not covered.
Dental Services See details
Dental services are partially covered by Aetna Medicare Select (HMO), offering Medicare-covered dental services for a $20 copay and no coinsurance, alongside other covered preventive and comprehensive services with no copay, no coinsurance, and a $1,500 annual maximum. Fluoride treatments, other preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered, and some covered services require prior authorization.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Select (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Select (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered under Aetna Medicare Select (HMO), featuring durable medical equipment (DME) and diabetic supplies with no copay and 0% to 20% coinsurance. Prosthetic devices require a 20% coinsurance with no copay, while medical supplies and diabetic therapeutic shoes or inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Select (HMO) with prior authorization and referrals required. Diagnostic procedures have a $0 to $25 copay with no coinsurance, lab services, diagnostic radiological services, and outpatient X-rays have no 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
Aetna Medicare Select (HMO) does not cover Cardiac Rehabilitation Services, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Select (HMO) 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, a prior three-day hospital stay is not needed, and additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Aetna Medicare Select (HMO) covers several additional services with no copay and no coinsurance, including chronic illness meals, wellness screenings, and a $30 quarterly over-the-counter reimbursement. Acupuncture is not covered under this plan.
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