Aetna Medicare Enhanced Extra (HMO-POS)

Aetna Medicare Enhanced Extra (HMO-POS) is a HMO-POS plan offered by Aetna Better Health of California Inc. available for the 2026 plan year to people living in Santa Clara County. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Aetna Medicare Enhanced Extra (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 Enhanced Extra (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.

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:

Drug Coverage

The Aetna Medicare Enhanced Extra (HMO-POS) plan features an Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. Beneficiaries who qualify for the low-income subsidy can receive a premium reduction, paying $18.80 instead of the standard $30.80 Part D premium. After meeting the deductible, you will pay copayments or coinsurance for your medications during the initial coverage phase. Under this phase, Tier 1 preferred generic drugs have no copay at preferred pharmacies and preferred mail-order services, or a $12.00 copay at standard pharmacies. Tier 2 standard generic drugs require 24% coinsurance, while Tier 3 preferred brand and Tier 4 non-preferred drugs require 25% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions.

Additional Benefits

The Aetna Medicare Enhanced Extra (HMO-POS) plan offers comprehensive coverage for essential medical services, often with low or no out-of-pocket costs. You will pay no copay and no coinsurance for primary care, specialist, and physical therapy visits, while emergency room visits carry a $150 copay that is waived if you are admitted. Inpatient hospital stays require daily copays for the first seven days with no coinsurance, whereas outpatient diagnostic procedures, lab work, and home health services are available with no copay and no coinsurance. For supplemental care, this plan features no copay and no coinsurance for routine dental cleanings, annual eye exams, and yearly hearing evaluations. Prescription hearing aids are covered up to a $1,250 annual maximum per ear with no copay, and comprehensive dental services require a 20% to 50% coinsurance up to a $500 yearly limit. Durable medical equipment and diabetic supplies are also covered, carrying a 0% to 20% coinsurance with no copay.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.