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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 2026, 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 4.5 out of 5 stars in 2026.
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 robust coverage with no copays or coinsurance for essential services like primary care visits, routine annual physicals, and home health care. Members also enjoy no copays or coinsurance for routine dental care up to a $1,500 annual limit, routine hearing exams with hearing aid coverage up to $1,250 per ear, and annual vision exams with a $200 eyewear allowance. These benefits make managing everyday health, vision, and dental needs highly affordable. For specialized care, the plan features a $40 copay for specialist visits and physical therapy with no coinsurance. Inpatient hospital stays require a $325 daily copay for days one through six, while emergency room visits carry a $130 copay that is waived if you are admitted. Additionally, members receive helpful perks like a $90 quarterly over-the-counter reimbursement and a chronic illness meal benefit to support overall wellness.
Inpatient Hospital See details
Aetna Medicare Eagle (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $325 copay per day for days 1 to 6 of acute stays and a $370 copay per day for days 1 to 5 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Eagle (HMO-POS) covers outpatient services with no coinsurance, featuring no copay to a $325 copay for outpatient hospital services and a $325 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions carry a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Eagle (HMO-POS) covers partial hospitalization services with no coinsurance and a copay of either $55.00 or $145.00. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Eagle (HMO-POS) covers ground ambulance services with a $320 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. For transportation benefits, some services are covered, but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Eagle (HMO-POS) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both featuring no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum with no coinsurance, requiring a $130 copay for medical services and a $320 copay for emergency transportation.
Primary Care See details
Aetna Medicare Eagle (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and mental health services require a $40 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance (routine chiropractic is not covered), telehealth services feature a $0 to $50 copay with 20% coinsurance, and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Eagle (HMO-POS), featuring no copay and no coinsurance for annual physicals, health education, and select screenings, while kidney disease education has no copay but requires a 20% coinsurance. Several supplemental benefits, including in-home safety assessments, personal emergency response systems, and nutritional/dietary benefits, are not covered.
Hearing Services See details
Aetna Medicare Eagle (HMO-POS) hearing services are partially covered, offering routine exams, fitting evaluations, and prescription hearing aids with no copay and no coinsurance. While prescription hearing aids are covered up to $1,250 per ear annually, over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Aetna Medicare Eagle (HMO-POS) covers vision services with no copayments, no coinsurance, and no deductibles. This coverage includes one routine eye exam per year, unlimited follow-up diabetic eye exams, and up to a $200 annual maximum benefit for eyewear, including contacts, eyeglasses, lenses, and frames.
Dental Services See details
Aetna Medicare Eagle (HMO-POS) partially covers dental services up to a $1,500 annual maximum, offering covered preventive and comprehensive services with no copay and no coinsurance, while Medicare-covered dental services require a $40 copay and no coinsurance. Implant services, maxillofacial prosthetics, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare Eagle (HMO-POS) covers Home Infusion bundled Services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other Part B drugs feature no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Eagle (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Eagle (HMO-POS) covers medical equipment, including DME, prosthetics, and diabetic supplies, with no copays and required prior authorization. Coinsurance ranges from 0% to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Eagle (HMO-POS) with prior authorization, featuring no copay or coinsurance for lab services and a $0 to $20 copay with no coinsurance for diagnostic tests. Outpatient X-rays require a $10 copay plus coinsurance, diagnostic radiology starts with no copay, and therapeutic radiology requires a minimum 20% coinsurance alongside a copay.
Home Health Services See details
Home health services are covered by Aetna Medicare Eagle (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Eagle (HMO-POS) with no coinsurance, but only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered, with individual copays ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Eagle (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Eagle (HMO-POS) provides partially covered other services with no copay and no coinsurance, which includes a chronic illness meal benefit, additional wellness and cancer screenings, and a $90 quarterly over-the-counter reimbursement. Acupuncture and dual-eligible SNP services are not covered under this benefit.
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