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Aetna Medicare Eagle (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Eagle (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 Eagle (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Eagle (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Iowa. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Eagle (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Eagle (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 Eagle (HMO-POS), 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 $90.00. 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.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6750.00 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
Prescription drugs are not covered by Aetna Medicare Eagle (HMO-POS).
Additional Benefits
The Aetna Medicare Eagle (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, while outpatient services have copays ranging from $0 to $325. Primary care, preventive services, hearing exams, eye exams, and many dental services are covered with no copay. Emergency services, ambulance, and some other services like home infusion and dialysis have copays or coinsurance. The plan also covers a range of additional services such as hearing aids, vision and dental, and offers a quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services, including acute and psychiatric care, are covered under the Aetna Medicare Eagle (HMO-POS) plan. For Inpatient Hospital-Acute, you'll pay a $325 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you'll pay a $370 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered, with copays ranging from $0 to $325 for outpatient hospital services and a $325 copay for observation services. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services are covered with no copay, while Individual and Group Sessions for Outpatient Substance Abuse have a $40 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Eagle (HMO-POS) plan, requiring prior authorization, with a copay of $55.00.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Eagle (HMO-POS) plan. Ground ambulance services have a $320 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, including Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services have a $50 copay, and Worldwide Emergency Transportation has a $320 copay; all have no coinsurance.
Primary Care See details
The Aetna Medicare Eagle (HMO-POS) plan covers primary care physician services with no copay. Chiropractic services have a $15 copay, while occupational therapy services have a $40 copay and no coinsurance. Physician specialist services have a $40 copay, and physical therapy and speech-language pathology services have a $40 copay with no coinsurance. Mental health and psychiatric services have a $40 copay for both individual and group sessions. Additional telehealth benefits have a 20% coinsurance and a copay between $0 and $50. Opioid treatment program services have a $40 copay. Podiatry services are not covered.
Preventive Services See details
The Aetna Medicare Eagle (HMO-POS) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, including Health Education, Nutritional/Dietary Benefit, 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 are also covered with no copay. Kidney Disease Education Services are covered with 20% coinsurance. In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, Counseling Services, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees are not covered.
Hearing Services See details
Hearing Services are covered, including hearing exams with no copay. Routine Hearing Exams and Fitting/Evaluation for Hearing Aids are also covered with no copay. Prescription Hearing Aids (all types) are covered up to a maximum of $1250 per year, but Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, and Prescription Hearing Aids - Over the Ear are not covered. OTC Hearing Aids are not covered.
Vision Services See details
The Aetna Medicare Eagle (HMO-POS) plan covers vision services including eye exams and eyewear with no copay. Routine eye exams are limited to one per year, and eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
Dental Services include coverage for Medicare Dental Services with a $40 copay, 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. This plan also offers a maximum benefit of $1500 per year for other dental services, while Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Aetna Medicare Eagle (HMO-POS) plan, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Eagle (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a coinsurance of 0% to 20%, Prosthetics/Medical Supplies with a coinsurance for covered items, and Diabetic Equipment with varying coinsurance based on the specific supply. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay between $0 and $20, Lab Services with no copay, Diagnostic Radiological Services with a copay up to $150, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with a $10 copay. Prior authorization is required for all diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Eagle (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 covered, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for some services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare Eagle (HMO-POS) plan, but require 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
Under the "Other Services" benefit, Aetna Medicare Eagle (HMO-POS) covers Over-the-Counter (OTC) items with no copay, and a maximum benefit of $90 every three months. The plan does not cover acupuncture, 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, 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.
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