Aetna Medicare Dual Select Choice (PPO D-SNP)

Aetna Inc.
Aetna Medicare Dual Select Choice (PPO D-SNP) H1608-077 Plan Details
4 out of 5 stars

Aetna Medicare Dual Select Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H1608-077

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Aetna Medicare Dual Select Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H1608-077

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Aetna Inc.
Aetna Medicare Dual Select Choice (PPO D-SNP) H1608-077 Plan Details
4 out of 5 stars

Aetna Medicare Dual Select Choice (PPO D-SNP) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H1608-077

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $9350
Out-of-Network: N/A
Initial Coverage Limit $2000
Catastrophic Coverage Limit $2,000
Primary Care Doctor Visit
$0 in-network|$0 - $0 based on level of Medicaid eligibility out-of-network
Specialty Doctor Visit
In-Network|$0 - $25 based on level of Medicaid eligibility.||Out-of-Network|$0 - $25 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 in-network.|$0 - $380 per day, days 1-7; $0 per day, days 8-90 based on level of Medicaid eligibility out-of-network
Urgent Care
Copayment for Urgent Care $0 or $15

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 - $280 based on level of Medicaid eligibility in-network.|$0 - $280 based on level of Medicaid eligibility out-of-network

Health Care Services and Medical Supplies

Aetna Medicare Dual Select Choice (PPO D-SNP) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network:
Copayment for Medicare-covered Chiropractic Services $0 or $15
Copayment for Routine Care $0
  • Maximum 12 Routine Care every year
Out-of-Network:

Medicare Covered Chiropractic Services:
Copayment for Medicare Covered Chiropractic Services $0 or $15
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network|0%||Out-of-Network|0% for OneTouch/LifeScan diabetic supplies|$0 - 20% based on level of Medicaid eligibility for other covered diabetic supplies
Durable Medical Eqipment (DME)
In-Network|$0 - 20% based on level of Medicaid eligibility.||Out-of-Network|$0 - 20% based on level of Medicaid eligibility
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Lab Services: In-Network|$0||Out-of-Network|$0 - 40% based on level of Medicaid eligibility
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||Out-of-Network|$0 - 20% based on level of Medicaid eligibility
Imaging: Xray: $0 in-network|$0 - 40% based on level of Medicaid eligibility out-of-network|CT Scans: $0 - 20% in-network|Diagnostic Radiology other than CT Scans: $0 - 20% in-network|based on level of Medicaid eligibility|Diagnostic Radiology Mammogram: 0% in-network|$0 - 20% based on level of Medicaid eligibility out-of-network
Home Health Care
$0 in-network||$0 - $0 based on level of Medicaid eligibility out-of-network
Mental Health Inpatient Care
0 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
Prior authorization required
Out-of-Network:

Psychiatric Hospital Services:
Coinsurance for Psychiatric Hospital per Stay 0% or 40%
Mental Health Outpatient Care
In-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||Out-of-Network|$0 - 40% for Mental Health Services- Group Sessions based on level of Medicaid eligibility|$0 - 40% for Mental Health Services - Individual Sessions based on level of Medicaid eligibility|$0 - 40% for Psychiatric Services:
Group Sessions based on level of Medicaid eligibility|$0 - 40% for Psychiatric Services:
Individual Sessions based on level of Medicaid eligibility
Outpatient Services / Surgery
Ambulatory 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||Out-of-Network|$0 - 20% based on level of Medicaid eligibility
Outpatient Substance Abuse Care
In-Network:
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
Prior authorization required
Out-of-Network:

Medicare Covered Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 0% or 40%
Coinsurance for Medicare Covered Group Sessions 0% or 40%
Over-the-counter (OTC) Items
By 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 Services
In-Network:
Copayment for Medicare-Covered Podiatry Services $0 or $25
Copayment for Routine Foot Care $0
  • Maximum 6 visits every year
Out-of-Network:

Medicare Covered Podiatry Services:
Copayment for Medicare Covered Podiatry Services $0 or $25

Non-Medicare Covered Podiatry Services:
Copayment for Non-Medicare Covered Podiatry Services $0
Skilled Nursing Facility Care
$0 - $0 per day, days 1-20
$214 per day, days 21-100 based on level of Medicaid eligibility in-network|$0 - $0 per day, days 1-20
$214 per day, days 21-100 based on level of Medicaid eligibility out-of-network

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
In-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||Out-of-Network||Preventive dental services:|20% for oral exams|20% for cleanings|20% for fluoride treatments|20% for x-rays|20% for other diagnostic dental services|20% for other preventive dental services||Comprehensive dental services:|20% for restorative services|20% for endodontic services|20% for periodontic services|20% for removeable prosthodontics|20% for fixed prosthodontics|20% for oral and maxillofacial surgery|20% for adjunctive services||$2,000 benefit amount (allowance) every year in and out-of-network for covered preventive and comprehensive dental services.||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 from in-network providers.

Coverage Cost
Vision Benefits
In-Network||Eye Exams:|$0 for Diabetic eye exams|$0-$25 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 in or out-of-network)||Eyewear:|$0 for Medicare-covered prescription eyewear|$0 for Contacts|$0 for Eyeglasses|$0 for Eyeglass Frames|$0 for Eyeglass Lenses|$0 for Upgrades||Out-of-Network||Eye Exams:|$0-$25 based on level of Medicaid eligibility for Medicare-covered eye exams|0% for non-Medicare covered eye exams|(Maximum one non-Medicare covered eye exam every year in or out-of-network)||Eyewear:|0%-40% based on level of Medicaid eligibility for Medicare-covered prescription eyewear|$0 for Contacts|$0 for Eyeglass Frames|$0 for Eyeglass Lenses|$0 for Eyeglass Lenses and Frames|$0 for Upgrades||$300 benefit amount (allowance) every year for non-Medicare covered prescription eyewear.

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network||Hearing Exams:|$0-$25 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 in or out-of-network)|$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)||Out-of-Network:||Hearing Exams:|$0-$25 based on 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 in or out-of-network||Hearing Aids: You must purchase hearing aids through NationsHearing

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In-Network|$0 copay for all preventive services covered under Original Medicare||Out-of-Network|$0 based on level of Medicaid eligibility for all preventive services covered under Original Medicare