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Aetna Medicare Value Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Value 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 Value Plus (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Value Plus (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Nebraska. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Value 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 Value 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 Value Plus (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $49.00. 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 $3900.00 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 Value Plus (HMO-POS) plan has a $590 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, preferred generic drugs have no copay at preferred pharmacies and $12 at standard pharmacies. For standard generic drugs, you'll pay 24% coinsurance. For preferred and non-preferred brand drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Medicare Value Plus (HMO-POS) plan offers a variety of benefits with varying costs. You'll find no copay for many services, including primary care visits, preventive services such as an annual physical, and home health services. The plan also provides coverage for inpatient hospital stays, outpatient services, and emergency services, with copays ranging from $0 to $400, depending on the specific service. Additional benefits include coverage for hearing and vision services, with no copays for eye exams and routine hearing exams, and a yearly maximum benefit for hearing aids and eyewear. Dental services are covered with no copay for most services, but with a $2,000 annual maximum. The plan also covers ambulance services, diagnostic and radiological services, and skilled nursing facility stays, each with specific copays or coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital benefits for Aetna Medicare Value Plus (HMO-POS) include coverage for Inpatient Hospital-Acute with a $350 copay for days 1-5 and no copay for days 6-90, and also covers Inpatient Hospital Psychiatric with a $370 copay for days 1-5 and no copay for days 6-90, while Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered. Additional Days for Inpatient Hospital-Acute benefits are covered with no copay.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Aetna Medicare Value Plus (HMO-POS) plan. Outpatient Hospital Services have a copay between $0 and $400, Observation Services have a $400 copay, and Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services, including both individual and group sessions, have a $40 copay. Outpatient Blood Services are covered with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Value Plus (HMO-POS) plan, but requires prior authorization. For this benefit, you will have a $55 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Value Plus (HMO-POS) plan. Ground ambulance services have a copay of $335, and air ambulance services have a 20% coinsurance, while transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $140 copay with no coinsurance, Urgently Needed Services have a $50 copay with no coinsurance, and Worldwide Emergency Services have a $140 copay for Worldwide Emergency Coverage and Worldwide Urgent Coverage, and a $335 copay for Worldwide Emergency Transportation; all have no coinsurance.
Primary Care See details
The Aetna Medicare Value Plus (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, occupational therapy with a $25 copay, and specialist services with a $25 copay. Mental health services, psychiatric services, and opioid treatment program services have a $40 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $25 copay. Additional telehealth benefits have a 20% coinsurance and a copay between $0 and $50. Podiatry services are not covered.
Preventive Services See details
Preventive services include an annual physical exam with no copay, and additional services such as Health Education, Nutritional/Dietary Benefit, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, and Wigs for Hair Loss Related to Chemotherapy are covered with no copay. Kidney Disease Education Services are covered with 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, 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 $1250.00 per year, but prescription hearing aids - inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
The Aetna Medicare Value Plus (HMO-POS) plan covers vision services, including eye exams and eyewear. There is no copay for eye exams, routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. Eyewear has a combined maximum plan benefit coverage amount of $300 every year.
Dental Services See details
The Aetna Medicare Value Plus (HMO-POS) plan covers 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 no copay. Other dental services have a $2,000 annual maximum. Orthodontics, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs, are covered by the Aetna Medicare Value Plus (HMO-POS) plan. For Medicare Part B Insulin Drugs, there is a $35 copay; for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, coinsurance may apply.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Value Plus (HMO-POS) plan and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the Aetna Medicare Value Plus (HMO-POS) plan, including Durable Medical Equipment (DME) with a 0-20% coinsurance and Prosthetic Devices with a 20% coinsurance. Diabetic Supplies have a 0-20% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services, including all diagnostic services, diagnostic procedures/tests, and lab services, are covered. Diagnostic procedures/tests have a copay between $0 and $20. Outpatient X-Ray Services have a $10 copay, while Diagnostic Radiological Services have a copay of up to $175. Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Value Plus (HMO-POS) 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 Value Plus (HMO-POS) plan. While the plan mentions copays for services, it also states that Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Value Plus (HMO-POS) plan, with a $0 copay for days 1-20, and a $214 copay 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 Value Plus (HMO-POS) plan's other services include Over-the-Counter (OTC) Items with no copay, a maximum benefit of $30 every three months, and Meal Benefits with no copay. Other services such as acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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