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Aetna Medicare Giveback Choice (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Giveback Choice (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Giveback Choice (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Giveback Choice (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Central and Northwest AR Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Giveback Choice (PPO) 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 Giveback Choice (PPO).
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 Giveback Choice (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $72.00. 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 combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Giveback Choice (PPO) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you'll pay no copay at preferred pharmacies and mail order, and a $12 copay at standard pharmacies. The plan provides enhanced alternative drug coverage. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Giveback Choice (PPO) plan offers a range of benefits, including coverage for inpatient and outpatient services with varying copays. You'll find no copays for many preventive services, hearing exams, vision services, and dental services, with a $1,000 annual maximum for dental. The plan also covers ambulance services, emergency services, and home health services, with specific copays or coinsurance amounts depending on the service. There's also coverage for a variety of other services, including primary care, diagnostic and radiological services, and home infusion services, with associated copays and coinsurance.
Inpatient Hospital See details
Inpatient Hospital coverage includes acute and psychiatric care. For acute care, you will pay a $380 copay for days 1-7, and no copay for days 8-90; for psychiatric care, you will pay a $407 copay for days 1-5, and no copay for days 6-90. Additional days for inpatient acute care are covered with no copay, while non-Medicare-covered stays and upgrades for inpatient acute, and additional days and non-Medicare-covered stays for inpatient psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay between $0 and $380, and for observation services with a copay of $380. Additionally, Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have a $30 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Giveback Choice (PPO) plan, with a copay of $80.00. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered. Ground Ambulance Services have a $295 copay, while Air Ambulance Services have a 20% coinsurance. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Giveback Choice (PPO) plan. Emergency Services have a $110 copay and no coinsurance, Urgently Needed Services have a $45 copay and no coinsurance, and Worldwide Emergency Services have varying copays depending on the service, with no coinsurance.
Primary Care See details
The Aetna Medicare Giveback Choice (PPO) plan covers primary care physician services with a $5 copay, chiropractic services with a $15 copay, and occupational therapy with a $35 copay. The plan also covers physician specialist services with a $5-$45 copay, and mental health services with a $30 copay for individual and group sessions. Other covered services include Other Health Care Professional services with a $0-$45 copay, psychiatric services with a $30 copay for individual and group sessions, and physical therapy with a $35 copay. Additional Telehealth Benefits are covered with a 20% coinsurance and a $0-$45 copay, and Opioid Treatment Program Services are covered with a $30 copay. Podiatry services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive services are covered under the Aetna Medicare Giveback Choice (PPO) plan. Annual physical exams, Health Education, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Wigs for Hair Loss Related to Chemotherapy, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay. Kidney Disease Education Services have a 20% coinsurance.
Hearing Services See details
Hearing exams are covered with a $45 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay, and prescription hearing aids are covered up to $500 per ear, with no copay for prescription hearing aids (all types).
Vision Services See details
Vision services include eye exams with a copay of $0-$45, and eyewear with no copay and a combined maximum of $210 every year. Routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are covered with no copay.
Dental Services See details
Dental services are covered, with a $45 copay for Medicare dental services and no copay for other services. Other covered dental services include 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, all with no copay. This plan has a $1,000 maximum benefit per year. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Giveback Choice (PPO) plan. The coinsurance is 20%.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), with 20% coinsurance and Prosthetics/Medical Supplies, with 20% coinsurance. Diabetic Equipment is covered, with coinsurance and copay based on the service, and Diabetic Supplies have between 0% and 20% coinsurance.
Diagnostic and Radiological Services See details
The Aetna Medicare Giveback Choice (PPO) plan covers diagnostic and radiological services, including diagnostic procedures and tests with a copay between $0 and $95, and lab services with no copay. Radiological services are also covered, with a copay up to $300 for diagnostic services, 20% coinsurance for therapeutic services, and a $5 copay for outpatient X-ray services.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Giveback Choice (PPO) 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 Giveback Choice (PPO) plan. The plan does not cover Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Giveback Choice (PPO) plan's "Other Services" benefit includes a meal benefit with no copay, while acupuncture, over-the-counter items, Dual Eligible SNPs, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Other services include annual wellness exams, screening mammography, and gFOBT/FIT, with no copay.
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