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Aetna Medicare Connect Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Connect Plus (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 Connect Plus (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Connect Plus (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Maryland Service Area. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Connect Plus (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 Connect Plus (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 Connect Plus (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $67.00. 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 Maximum Out-Of-Pocket cost of $7500.00 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 Connect Plus (HMO-POS) plan has a $250 deductible for prescription drugs. After you meet your deductible, you will pay a copay or coinsurance based on the drug tier and the pharmacy you use. For example, if you use a preferred pharmacy, you'll pay a $10 copay for preferred generic drugs and 25% coinsurance for standard generic drugs. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Medicare Connect Plus (HMO-POS) plan offers a wide range of benefits with varying costs. Inpatient hospital stays have copays ranging from $0 to $332, depending on the service and length of stay, while outpatient services have copays between $0 and $332. Emergency services have a $110 copay, and primary care visits are covered with no copay. This plan provides coverage for preventive services, vision, dental, and hearing services, with copays ranging from $0 to $50. Additional benefits include home health services with no copay, ambulance services with a copay or coinsurance, and coverage for medical equipment and diagnostic services. The plan also includes coverage for over-the-counter items, with a maximum of $45 every three months.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you'll pay a $332 copay for days 1-8, and no copay for days 9-90; for Inpatient Hospital Psychiatric, you'll pay a $254 copay for days 1-8, and no copay for days 9-90. Additional days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the Aetna Medicare Connect Plus (HMO-POS) plan, including outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient Hospital Services have a copay between $0 and $332, Observation Services have a $332 copay, Ambulatory Surgical Center (ASC) Services have no copay, and both Individual and Group Sessions for Outpatient Substance Abuse have a $40 copay. Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Connect Plus (HMO-POS) plan, but requires prior authorization. The copay for this benefit is $80.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Connect Plus (HMO-POS) plan, which includes coverage for both ground and air ambulance services. Ground ambulance services have a $275 copay, while air ambulance services have a 20% coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare Connect Plus (HMO-POS) plan. Emergency Services have a $110 copay, Urgently Needed Services have a $40 copay, and Worldwide Emergency Services have a $110 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $275 copay for Worldwide Emergency Transportation.
Primary Care See details
Primary Care Physician services are covered with no copay, while Chiropractic Services have a $15 copay for routine care. Occupational Therapy Services have a $20 copay, and Physician Specialist Services have a copay between $0 and $50. Mental Health and Psychiatric Services have a $40 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services have a $20 copay, and Other Health Care Professional services have a copay between $0 and $50. Additional Telehealth Benefits have a 20% coinsurance and a copay between $0 and $50. Opioid Treatment Program Services have a $40 copay.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, and additional preventive services, including Health Education, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), and Wigs for Hair Loss Related to Chemotherapy, which may have a copay. Kidney Disease Education Services have a 20% coinsurance. Other preventive services like 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 $50 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are covered, but inner ear, outer ear, and over-the-ear prescription hearing aids are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision Services include eye exams with a copay between $0 and $50, and eyewear with no copay. Routine eye exams are covered once per year with no copay, and other eye exam services are covered with no copay. Eyewear has a combined maximum benefit of $150 per year.
Dental Services See details
Dental services include coverage for Medicare dental services with a $50 copay, 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, all 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 by the Aetna Medicare Connect Plus (HMO-POS) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits are covered by the Aetna Medicare Connect Plus (HMO-POS) plan, including Durable Medical Equipment (DME) with no copay and 0-20% coinsurance, Prosthetics/Medical Supplies with no copay and coinsurance for Medicare-covered services, and Diabetic Equipment, including Diabetic Supplies with 0-20% 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, including Diagnostic Procedures/Tests with a copay between $0 and $100, and Lab Services with no copay. Radiological Services include Diagnostic Radiological Services with a copay up to $300, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Connect Plus (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 covered by the Aetna Medicare Connect Plus (HMO-POS) plan, but the plan does not specify any costs. However, the plan does not cover any specific cardiac rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Aetna Medicare Connect Plus (HMO-POS) plan, requiring prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100.
Other Services See details
The Aetna Medicare Connect Plus (HMO-POS) plan covers over-the-counter items with no copay, up to a maximum of $45 every three months. The plan also covers meal benefits and other services, all with no copay. However, acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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