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Aetna Medicare Dual Select (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare 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 Dual Select (HMO D-SNP) in 2025, please refer to our full plan details page.
Aetna Medicare Dual Select (HMO D-SNP) is a HMO D-SNP plan offered by CVS Health Corporation available for enrollment in 2025 to people living in AL - Statewide. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare 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 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 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 Dual Select (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $12.00. 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 $590.00 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 $7900.00 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 Dual Select (HMO D-SNP) plan has a $590 deductible for prescription drugs. If you qualify for the low-income subsidy (LIS), the plan's premium may be reduced. During the initial coverage phase, after you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. Once you reach $2000 in out-of-pocket drug costs, you will enter the catastrophic coverage phase where you will pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) plan offers comprehensive coverage with a focus on affordability. The plan includes no copays for primary care visits, routine hearing and vision exams, and many preventive and dental services. You'll also find coverage for hospital stays, outpatient services, and various therapies, with costs varying depending on the service. This plan provides coverage for emergency services, ambulance services, and home health services with no copay. It also includes benefits like hearing aids, eyewear, and dental services with varying levels of coverage and cost sharing. However, some services like cardiac rehabilitation and certain other therapies are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by Aetna Medicare Dual Select (HMO D-SNP), including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $380 copay for days 1-7, and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a $678 copay for days 1-3, and no copay for days 4-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, as well as additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric, are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services with a copay between $0 and $380, and observation services with a $380 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services are covered with a 20% coinsurance for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Dual Select (HMO D-SNP) plan with prior authorization required, and has a copay of $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. Ground ambulance services have a $295 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location are covered with no copay, up to 24 one-way trips per year, and transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $110 copay, Urgently Needed Services have a $25 copay, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation have no copay.
Primary Care See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers primary care physician services with no copay and chiropractic services with a $10 copay. Occupational therapy services, physician specialist services, and physical therapy/speech-language pathology services have a $15 copay. Mental health and psychiatric individual and group sessions have a $40 copay. Additional telehealth benefits have no copay. Podiatry services and other health care professional services have varying copays.
Preventive Services See details
Preventive services include an annual physical exam, additional preventive services, kidney disease education services, and other preventive services. Annual physical exams have no copay. Additional preventive services have a copay, and kidney disease education services have 20% coinsurance. Other preventive services include Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all of which have no copay.
Hearing Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers hearing exams with a $15 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a maximum benefit of $500 per year, and no copay for Prescription Hearing Aids (all types), but Prescription Hearing Aids for inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay between $0 and $15, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, has no copay and a combined maximum plan benefit of $250 every year.
Dental Services See details
Aetna Medicare Dual Select (HMO D-SNP) offers dental services, including Medicare Dental Services with a $15 copay, and other services with a maximum plan benefit coverage of $2200 per year. Oral exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, and Other Preventive Dental Services have no copay. Restorative Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery have no copay. However, Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B insulin drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance and requires authorization, while Diabetic Supplies have no coinsurance. Prosthetics, medical supplies, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, and Lab Services have no copay. Diagnostic Radiological Services have up to 20% coinsurance, while Therapeutic Radiological Services have a $45 copay, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. While the plan covers some cardiac rehabilitation services, it does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan. There is no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan's "Other Services" benefit covers over-the-counter items and meal benefits with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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