Southwest Florida Aetna Plan Updates for 2026*
Aetna Medicare Explorer Premier H5521-438 PPO
Members on this plan will be automatically crosswalked (enrolled) into the Aetna Medicare Signature H5521-272 PPO plan.
Summary of Benefits link for H5521-272
Some key difference between 438 Explorer plan and new Signature 272 plan in-network benefits:
- Max-out-of-pocket increased from $4700 to $5500
- Inpatient hospitalization increased from $275 to $290/day (days 1-6)
- PCP remains $0, specialist increased from $40 to $75
- Diagnostic tests, labs, and imaging remain $0 at non-hospital facilty
- Dental - $0 copay for preventive services, 20% ‑ 50% coinsurance for comprehensive services up to $2000
- Ambulance decreased from $275 to $200
- $0 for Tier 1 and Tier 2 drugs. $615 deductible for Tiers 3-5.
- No over-the-counter or fitness allowance
- Silver Sneakers membership remains
*NEW* Aetna Medicare Signature H5521-710 PPO
- Max out of pocket - $6750 in-network, $10,100 in and out-of-network combined
- $0 Primary Care, $60 Specialist - in-network
- $0 preventitive dental only
- Silver Sneakers gym membership
Aetna Medicare FL Select H1609-027 HMO
- Max out of pocket - $3300
- $0 Primary Care, $25 Specialist
- No fitness reimbursement
- $2500 dental max benefit using Liberty Dental Network
- $20/quarter over-the-counter allowance
Aetna Medicare FL Dual Select H1609-056 HMO D-SNP
Summary of Benfits link - Coming soon!
- Plan option for those with both Medicare and Medicaid
- $192/month over-the-counter allowance or Extra Support Wallet for those with qualifying chronic condition
- $2500 dental allowance
- Transportation - 48 one-way trips
*Additional Aetna plans are available that are not listed here. Please contact me for more information.
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