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Aetna Medicare Classic (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Classic (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Classic (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Classic (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Spokane and Stevens Counties. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Aetna Medicare Classic (HMO-POS) 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 Classic (HMO-POS).
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 Classic (HMO-POS), 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 $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 $6750.00 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 Classic (HMO-POS) plan has a $590.00 deductible for prescription drugs. After meeting your deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you'll pay no copay at preferred pharmacies or through mail order, and a $12.00 copay at standard pharmacies. Standard generic, preferred brand, and non-preferred drugs have a 22% or 25% coinsurance. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Classic (HMO-POS) plan offers a range of benefits with varying costs. You can expect a $425 copay for inpatient hospital stays for the first five days, and no copay thereafter. Many outpatient services, including primary care, preventive services, and vision services, are available with no copay. This plan includes coverage for hearing aids up to $1500 per year with no copay, and dental services with a $50 copay for Medicare dental services. Emergency services, like ambulance and emergency room visits, have copays ranging from $45 to $275. Other services, such as home health and over-the-counter items, are covered with no copay, while services such as dialysis and medical equipment have a coinsurance.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $425 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will pay a $425 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $375, and Observation Services have a $425 copay per stay. Individual and Group Sessions for Outpatient Substance Abuse have a copay of $40. Ambulatory Surgical Center Services and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Classic (HMO-POS) plan, and requires prior authorization. The copay for this benefit is $55.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Aetna Medicare Classic (HMO-POS) plan. Ground ambulance services have a copay of $275, while air ambulance services have a 20% coinsurance. 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 under the Aetna Medicare Classic (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage each have a $125 copay, Urgently Needed Services has a $45 copay, and Worldwide Emergency Transportation has a $275 copay; there is no coinsurance for any of these services.
Primary Care See details
The Aetna Medicare Classic (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy services with a $35 copay. Physician specialist services have a copay between $0 and $50, and physical therapy and speech-language pathology services have a $35 copay. Mental health and psychiatric services, and opioid treatment program services have a $40 copay for individual or group sessions. Additional telehealth benefits have a 20% coinsurance and a copay between $0 and $50. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Aetna Medicare Classic (HMO-POS) plan covers preventive services, including annual physical exams with no copay. Additional preventive services are covered, including Health Education, Wigs for Hair Loss Related to Chemotherapy, Additional Sessions of Smoking and Tobacco Cessation Counseling, Remote Access Technologies, and Fitness Benefit, all with no copay. Kidney Disease Education Services are covered with 20% coinsurance. Other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids (all types) are covered with a maximum plan benefit coverage of $1500 per year and no copay. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Aetna Medicare Classic (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, with a combined maximum of $155 per year for eyewear.
Dental Services See details
Dental services include coverage for Medicare dental services with a $50 copay, and other dental services are covered with a maximum plan benefit of $500 per year. 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. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. 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 Classic (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Aetna Medicare Classic (HMO-POS) plan covers medical equipment, including Durable Medical Equipment (DME) with 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. The plan also covers Diabetic Equipment, including Diabetic Supplies with no coinsurance to 20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with no copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with prior authorization required. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $325, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Classic (HMO-POS) 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 specific services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. There is a copay for some services, but the specific amount is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Classic (HMO-POS) plan, with a copay of $10 for days 1-20 and a copay of $214 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 Classic (HMO-POS) plan covers Over-the-Counter (OTC) Items with no copay, and covers a maximum of $30 every three months. This plan does not cover acupuncture, meal benefits, or several other services.
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