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Aetna Medicare Select (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Select (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 Select (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Select (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Clark and Nye Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Select (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 Select (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 Select (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. Additionally, this plan comes with a Part B Premium reduction of $7.00. 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 $2000.00 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-POS) plan has an enhanced alternative drug benefit with a deductible of $590. Once you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. Preferred Generic drugs have no copay when using a preferred pharmacy or mail order, and a $12 copay at a standard pharmacy. For other tiers, you will pay coinsurance. For example, Standard Generic, Preferred Brand, and Non-Preferred drugs have 24% or 25% coinsurance depending on the pharmacy. After your yearly out-of-pocket drug costs reach $2000, you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare Select (HMO-POS) plan offers comprehensive coverage with varying costs. This plan includes no copay for primary care, preventive services, hearing and vision exams, and many dental services. Hospital stays have a copay, and outpatient services have a copay or coinsurance, depending on the service. Additional benefits include coverage for ambulance, emergency, and home health services, with specific copays or coinsurance amounts. This plan also covers prescription hearing aids up to a certain amount and offers an allowance for over-the-counter items. Some services like cardiac rehabilitation, podiatry, and certain hearing and vision services are not covered.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered by the Aetna Medicare Select (HMO-POS) plan. For Inpatient Hospital-Acute, you will pay a $100 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you will pay a $370 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services with a copay between $0 and $100, observation services with a $100 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a $40 copay for individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Select (HMO-POS) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Select (HMO-POS) plan. Ground ambulance services have a $275 copay, 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 Select (HMO-POS) plan. Emergency Services has a $140 copay and no coinsurance, Urgently Needed Services has a $20 copay and no coinsurance, and Worldwide Emergency Services has varying copays depending on the specific service, with no coinsurance.
Primary Care See details
The Aetna Medicare Select (HMO-POS) plan covers primary care services with no copay. Chiropractic services have a $20 copay, while occupational therapy services, physician specialist services, and other healthcare professional services have copays ranging from $0 to $30. Mental health and psychiatric services, including individual and group sessions, have a $20 copay. Physical therapy and speech-language pathology services have no copay, and additional telehealth benefits have a 20% coinsurance and a copay between $0 and $40. Opioid treatment program services have a $20 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, as well as additional preventive services like Health Education, Wigs for Hair Loss Related to Chemotherapy, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit, all with no copay. Kidney Disease Education Services are covered with 20% coinsurance. Other services like In-Home Safety Assessment, Personal Emergency Response System (PERS), and others are not covered.
Hearing Services See details
The Aetna Medicare Select (HMO-POS) plan covers hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, with a plan-specified amount up to $1250 per year, but Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services are covered, including eye exams and eyewear. Eye exams, including routine exams and other services, have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, are covered with no copay, and a combined maximum benefit of $250.00 per year applies.
Dental Services See details
Dental services include a $20 copay for Medicare dental services, while 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 have no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered. This plan has a maximum benefit coverage of $1500 per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay, while the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs is between 0-20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Select (HMO-POS) plan, but prior authorization is required. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Select (HMO-POS) plan, including Durable Medical Equipment (DME) with 0% to 20% coinsurance, Prosthetics/Medical Supplies with coinsurance, and Diabetic Equipment with a copay and coinsurance. Diabetic Supplies have 0% to 20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
The Aetna Medicare Select (HMO-POS) plan covers all diagnostic and radiological services, with prior authorization required. Diagnostic Procedures/Tests have no copay, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $115.00, Therapeutic Radiological Services have a coinsurance of at least 20%, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Select (HMO-POS) plan with no copay and no coinsurance, but 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 Select (HMO-POS) plan. While the plan mentions coverage for Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services, none of these services are actually covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Select (HMO-POS) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $100 per day; additional days beyond Medicare-covered SNF stays and non-Medicare-covered stays are not covered.
Other Services See details
The Aetna Medicare Select (HMO-POS) plan covers Over-the-Counter (OTC) Items with no copay, and a maximum benefit coverage amount of $50.00 every three months; other services like acupuncture, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and more are not covered. Other 1 and Other 2 benefits are covered with no copay.
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