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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 Select Counties in GA. This plan received an overall rating of 4.5 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 $36.70. 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 meeting the deductible, you will pay the costs for your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, and you will pay nothing for your Part D covered drugs. If you qualify for the low-income subsidy (LIS), your monthly premium for Part D will be $36.70.
Additional Benefits
The Aetna Medicare Dual Select (HMO D-SNP) plan offers comprehensive coverage with a variety of copays and coinsurance amounts. Inpatient hospital stays have a copay, while outpatient services, including primary care, have copays ranging from $0 to $40. The plan also covers preventive, hearing, vision, and dental services, with various copays and maximum annual benefits. Additional benefits include coverage for ambulance services, emergency services, and home health services with no copay. The plan also provides coverage for home infusion, dialysis, and medical equipment, with some services subject to coinsurance. Other notable benefits include coverage for over-the-counter items, acupuncture, and a meal benefit.
Inpatient Hospital See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers inpatient hospital stays with a copay of $380 for days 1-7, and no copay for days 8-90. Inpatient hospital psychiatric services are covered with a copay of $2036 per admission or stay, but additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $380, and observation services with a $380 copay. Ambulatory Surgical Center (ASC) Services are covered with no copay, while outpatient substance abuse services have a 20% coinsurance for both individual and group sessions. Outpatient blood services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by Aetna Medicare Dual Select (HMO D-SNP), with an $80 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. Ground ambulance services have a $280 copay, while air ambulance services have a 20% coinsurance. Transportation Services to a plan-approved health-related location has no copay, and covers up to 24 one-way trips per year via rideshare, bus/subway, or medical transport. Transportation services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. 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 Physician Services are covered with no copay. Chiropractic Services are covered with a $10 copay for routine care. Occupational Therapy Services are covered with a $25 copay. Physician Specialist Services are covered with a $15 copay. Mental Health Specialty Services, including individual and group sessions, are covered with a $40 copay. Podiatry Services are covered with a $15 copay for Medicare-covered services and routine foot care, and no copay for other services. Other Health Care Professional services are covered with a copay between $0 and $15. Psychiatric Services, including individual and group sessions, are covered with a $40 copay. Physical Therapy and Speech-Language Pathology Services are covered with a $25 copay. Additional Telehealth Benefits are covered with no copay. Opioid Treatment Program Services are covered with a $40 copay.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional preventive services, such as Health Education, Wigs for Hair Loss, and home and bathroom safety devices, are covered. Glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit have no copay. Kidney disease education services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids are covered with no copay. Prescription hearing aids are covered with a maximum benefit of $1,250 per year, while inner ear, outer ear, and over the ear prescription hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay of $0 to $15, and routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum benefit of $290 every year.
Dental Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers Medicare Dental Services with a $15 copay, and other dental services, including 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, with a $0 copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered. The plan has a maximum benefit coverage of $2,000 per year for other dental services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
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.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Dual Select (HMO D-SNP) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetic Devices, and Medical Supplies have a 20% coinsurance. Diabetic Supplies have no coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $95, and lab services with no copay. Diagnostic Radiological Services have a coinsurance of at most 20%, while Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $35 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. 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. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare Dual Select (HMO D-SNP) plan. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Dual Select (HMO D-SNP) plan covers acupuncture with no copay, but is limited to 20 treatments per year. Over-the-counter items have no copay, with a maximum benefit of $75.00 per month, and the plan also covers nicotine replacement therapy and Naloxone. The plan also covers a meal benefit with no copay, and other services including annual wellness exams and screening mammography with no copay. Some other services are not covered.
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