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Allina Health Aetna Medicare Select (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Select (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Allina Health Aetna Medicare Select (PPO) in 2025, please refer to our full plan details page.
Allina Health Aetna Medicare Select (PPO) is a PPO plan offered by Allina Health and Aetna Insurance Holding Company available for enrollment in 2025 to people living in Brown and Nicollet Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Allina Health Aetna Medicare Select (PPO) 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 Allina Health Aetna Medicare Select (PPO).
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 Allina Health Aetna Medicare Select (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $61.00. 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 $250.00 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 combined Maximum Out-Of-Pocket cost of $6200.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $6200.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Allina Health Aetna Medicare Select (PPO) plan has a $250 deductible for prescription drugs. Once you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will pay a $10 copay at a preferred pharmacy, and $12 at a standard pharmacy. For standard generic drugs, you will pay 25% coinsurance, regardless of the pharmacy.
Additional Benefits
The Allina Health Aetna Medicare Select (PPO) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have a $400 copay, while outpatient services and primary care often have lower copays, including no copay for many services. The plan also covers preventive, hearing, vision, and dental services, with varying copays and some annual limits. Additional benefits include coverage for ambulance services, emergency services, home health, and skilled nursing facility stays, with copays and coinsurance applying in some instances. Diagnostic and radiological services, medical equipment, and home infusion services are covered, with copays or coinsurance depending on the service. The plan also offers other services like acupuncture and over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both with a $400 copay per admission or stay, and additional days for Inpatient Hospital-Acute with no copay. The plan does not cover Non-Medicare-covered Stay or Upgrades for Inpatient Hospital-Acute, nor Additional Days or Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services with a copay between $0 and $375, Observation Services with a $375 copay, Ambulatory Surgical Center (ASC) Services with no copay, Outpatient Substance Abuse Services with a $35 copay for both individual and group sessions, and Outpatient Blood Services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Allina Health Aetna Medicare Select (PPO) plan, but requires prior authorization. The copay for this benefit is $100.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Allina Health Aetna Medicare Select (PPO). Ground ambulance services have a $375 copay, while air ambulance services have a 20% coinsurance; however, transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage have a $140 copay, while Worldwide Emergency Transportation has a $375 copay; all have no coinsurance.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $40 copay, Physician Specialist Services with a $35 copay, Mental Health Specialty Services with a $35 copay for individual and group sessions, Podiatry Services with a $35 copay, Other Health Care Professional with a copay that ranges from $0 to $35, Psychiatric Services with a $35 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $40 copay, Additional Telehealth Benefits with a 20% coinsurance and a copay that ranges from $0 to $40, and Opioid Treatment Program Services with a $35 copay. Routine Chiropractic Care and Routine Foot Care are also covered, each with a $20 copay.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams with no copay, and additional preventive services with a copay for certain services. Kidney Disease Education Services are covered with 20% coinsurance, and Other Preventive Services have coverage for various services with no copay.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $35 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered up to $750 per year, per ear, with no copay. OTC hearing aids are not covered.
Vision Services See details
Vision services include coverage for eye exams with a copay of $0-$35, and eyewear with no copay. Routine eye exams are limited to one per year with no copay, and other eye exam services are covered with no copay. Eyewear has a combined maximum benefit of $175 per year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, all with no copay.
Dental Services See details
Dental Services includes coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay; however, the plan does not cover maxillofacial prosthetics, implant services, and orthodontics. Medicare Dental Services have a $35 copay. There is a $1000 annual maximum benefit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Allina Health Aetna Medicare Select (PPO) plan, with a coinsurance of 20%. Prior authorization is required for coverage.
Medical Equipment See details
Medical equipment is covered by Allina Health Aetna Medicare Select (PPO), including Durable Medical Equipment (DME) with a coinsurance between 0% and 20%, and Prosthetic Devices and Medical Supplies with a coinsurance of 20% and 0-20% respectively. Diabetic Equipment is also covered, with coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts and copays for Medicare-covered Diabetes Supplies, and Diabetic Supplies covered with a coinsurance between 0% and 20%.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Allina Health Aetna Medicare Select (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $30, while Lab Services have no copay. Diagnostic Radiological Services have a copay of up to $125, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Allina Health Aetna Medicare Select (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Copays apply, but more information about the copay is available.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, with prior authorization required. For days 1-20, there is a $10 copay, for days 21-40, there is a $214 copay, and for days 41-100, there is no copay. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include acupuncture with a $20 copay, over-the-counter items with no copay, and a meal benefit with no copay. The plan also covers annual wellness exams and screening mammograms with no copay.
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