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Aetna Medicare Dual Select (HMO D-SNP) - H3239-010-000

4 out of 5 stars* for plan year 2025

$0.00

Monthly Premium

Aetna Medicare Dual Select (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.

Plan ID: H3239-010-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$0.00

Monthly Premium

Alabama Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Alabama Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$7,900.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$2,000.00
Primary care doctor visit$0
Specialty doctor visitIn-Network|$0 - $15 based on level of Medicaid eligibility.
Inpatient hospital care$0 - $380 per day, days 1-7; $0 per day, days 8-90 based on level of Medicaid eligibility.
Urgent care
Urgent Care:
Copayment for Urgent Care $0 or $25

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0
Maximum Plan Benefit of $250,000
Emergency room visit$0 - $110 based on level of Medicaid eligibility. If you are admitted to the hospital within 24 hours your cost share may be waived.
Ambulance transportation$0 - $295 based on level of Medicaid eligibility.

Health Care Services and Medical Supplies

Aetna Medicare Dual Select (HMO D-SNP) covers a range of additional benefits. Learn more about Aetna Medicare Dual Select (HMO D-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic servicesIn-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $0 or $10
Copayment for Routine Care $0
  • Maximum 12 Routine Care every year
Diabetes supplies, training, nutrition therapy and monitoringIn-Network|0%
Durable medical equipment (DME)In-Network|$0 - 20% based on level of Medicaid eligibility.
Diagnostic tests, lab and radiology services, and X-raysLab Services: In-Network|$0
Diagnostic Procedures: In-Network|$0 for certain Medicare-covered diagnostic tests and services including Retinal fundus, Spirometry, Peripheral arterial disease (PAD)||$0 for services provided by your primary care physician in their office|$0 - $95 based on level of Medicaid eligibility for services performed by a provider other than your primary care physician
Imaging: Xray: $0|CT Scans: $0 - 20%|Diagnostic Radiology other than CT Scans: $0 - 20% based on level of Medicaid eligibility|Diagnostic Radiology Mammogram: 0%.
Home health care$0
Mental health inpatient care0 or $In-Network:

Psychiatric Hospital Services:
$678 per day for days 1 to 3
$0 per day for days 4 to 90
Prior Authorization Required for Psychiatric Hospital Services
Mental health outpatient careIn-Network|$0 - $40 for Mental Health - Group Sessions|$0 - $40 for Mental Health - Individual Sessions|$0 - $40 for Psychiatric Services - Group Sessions|$0 - $40 for Psychiatric Services - Individual Sessions||based on level of Medicaid eligibility
Outpatient services/surgeryAmbulatory Surgical Center: In-Network|$0 for preventive and diagnostic colonoscopy|$0 - $280 for all other ambulatory surgical center services based on level of Medicaid eligibility
Outpatient substance abuse careIn-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare-covered Individual Sessions 0% or 20%
Coinsurance for Medicare-covered Group Sessions 0% or 20%
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter itemsBy qualifying for enrollment in this plan, members receive coverage for approved over-the-counter (OTC) products under the Extra Supports Wallet on the Extra Benefits Card.
Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $0 or $15
Copayment for Routine Foot Care $0
  • Maximum 12 visits every year
Skilled Nursing Facility (SNF) care$0 - $0 per day, days 1-20; $214 per day, days 21-100 based on level of Medicaid eligibility

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental careIn-Network||Preventive dental services:|$0 for oral exams|$0 for cleanings|$0 for fluoride treatment|$0 for x-rays|$0 for other diagnostic dental services|$0 for other preventive dental services||Comprehensive dental services:|$0 for restorative services|$0 for endodontic services|$0 for periodontic services|$0 for removeable prosthodontics|$0 for fixed prosthodontics|$0 for oral and maxillofacial surgery|$0 for adjunctive services|$2,200 benefit amount (allowance) every year for covered preventive and comprehensive dental services. Frequencies and medical necessity requirements vary by covered dental service.||ADA recognized dental services are covered up to the benefit amount excluding implants and related services, orthodontics, cosmetic services, those considered medical in nature, and administrative charges. See EOC for a full list of exclusions.

Vision Benefits

The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

CoverageDetails
Vision careIn-Network||Eye Exams:|$0 for Diabetic eye exams|$0-$15 based on level of Medicaid eligibility for all other Medicare-covered eye exams|$0 for non-Medicare covered eye exams|(Maximum one non-Medicare covered eye exam every year)||Eyewear:|$0 for Medicare-covered prescription eyewear|$0 for Contacts|$0 for Eyeglasses|$0 for Eyeglass Frames|$0 for Eyeglass Lenses|$0 for Upgrades||$250 benefit amount (allowance) every year for non-Medicare covered prescription eyewear.

Hearing Benefits

The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Hearing careIn-Network||Hearing Exams:|$0-$15 based on level of level of Medicaid eligibility for Medicare-covered hearing exams|$0 for non-Medicare covered hearing exams|(Maximum one non-Medicare covered hearing exam every year)|$0 for fitting/evaluation for hearing aids|(Maximum one hearing aid fitting/evaluation every year)||Hearing Aids:|$0 for hearing aids|$500 benefit amount (allowance) per ear, every year for hearing aids|(Maximum two hearing aids every year)

Preventive Services and Health/Wellness Education Programs

The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Preventive services and health/wellness education programsIn-Network|$0 copay for all preventive services covered under Original Medicare

When reviewing Alabama Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

You may be able to find plans in your part of Alabama that offer similar benefits at similar or lower prices than the plan above. Call 1-877-890-1409 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

Plan Documents

Links to plan documents

Alabama Counties Served

Enrolling in H3239-010-000 Medicare Advantage Plans in Alabama

Medicare beneficiaries from Alabama may have access to Medicare Advantage plans from Aetna and other insurance companies.

Get help comparing your local plan options by calling to speak with a licensed insurance agent who can help you find out if your doctor and prescription drugs are covered by a Medicare Advantage plan in your area.

We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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