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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 Northern and Southern MS Counties. 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 $47.30. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $1.00. You must continue to pay paying your reduced 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 $9350.00 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. After the deductible, you will pay the costs for your prescriptions based on the drug tier. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for your Part D covered drugs. This plan's premium may be reduced if you qualify for the low-income subsidy.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. It also covers emergency services, primary care, preventive services, and home health services with no copay, or a low copay. The plan provides additional benefits like hearing, vision, and dental services with copays, as well as medical equipment and transportation services with coinsurance or copays.
Inpatient Hospital See details
Inpatient Hospital benefits for the Aetna Medicare Dual Select (HMO D-SNP) plan include coverage for Inpatient Hospital-Acute, with a $380 copay for days 1-7, and no copay for days 8-90, and Inpatient Hospital Psychiatric, with a $673 copay for days 1-3, and no copay for days 4-90. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services with the Aetna Medicare Dual Select (HMO D-SNP) plan cover outpatient hospital services with a copay of $0-$380, observation services with a $380 copay, and ambulatory surgical center (ASC) services with no copay. Outpatient substance abuse services are covered with 20% coinsurance for both individual and group sessions. Outpatient blood services are also covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Dual Select (HMO D-SNP) plan, with a $80 copay. Prior authorization is required for coverage.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, including ground and air ambulance services, and transportation services to plan-approved health-related locations. Ground ambulance services have a $295 copay, while air ambulance services have a 20% coinsurance. Transportation services to plan-approved health-related locations are covered for 36 one-way trips per year with no copay. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, including 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
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $10 copay for routine care, Occupational Therapy Services with a $15 copay, Physician Specialist Services with a $25 copay, and Mental Health Specialty Services with a $40 copay for individual and group sessions. Additionally, Podiatry Services are covered with a $25 copay for Medicare-covered services and routine foot care, Other Health Care Professional services have varying copays, Psychiatric Services have a $40 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services have a $15 copay, Additional Telehealth Benefits have no copay, and Opioid Treatment Program Services have a $40 copay.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, while additional preventive services like Health Education, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Wigs for Hair Loss Related to Chemotherapy may have a copay. Kidney Disease Education Services have a 20% coinsurance, and other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing exams are covered with a $25 copay, routine hearing exams are covered with no copay, and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are covered, with a maximum plan benefit coverage of $1250 per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a copay between $0 and $25, and eyewear with no copay. Eyewear has a combined maximum benefit of $400 every year.
Dental Services See details
Dental services are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan, with a $25 copay for Medicare dental services. 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 are covered with no copay; however, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under 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 benefits are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetics/Medical Supplies and Diabetic Therapeutic Shoes/Inserts also have a 20% coinsurance; however, Diabetic Supplies have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including diagnostic procedures and tests, have a copay between $0 and $95, while lab services have no copay. Diagnostic radiological services and therapeutic radiological services have a coinsurance of at most 20%, 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, though 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. However, the plan does mention that some cardiac rehabilitation services may have a coinsurance, and some may have a copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan, but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers over-the-counter items with no copay and meal benefits with no copay. Other services such as acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and others are not covered.
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