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Aetna Medicare Giveback Choice Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Giveback Choice Plus (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 Plus (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Giveback Choice Plus (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in Atlanta Metro. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Giveback Choice Plus (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 Plus (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 Plus (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 Plus (PPO) plan has an enhanced alternative drug benefit. The plan has a $590 deductible. In the initial coverage phase, after the deductible, you'll pay a $0 copay for preferred generic drugs at preferred and mail-order pharmacies, and a $12 copay at standard pharmacies. For other tiers, you will pay coinsurance of 22% or 25% depending on the drug and pharmacy type. After your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Giveback Choice Plus (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services have copays depending on the specific service. Emergency services and primary care visits have copays, and there is also coverage for hearing, vision, and dental services with copays or no copays. Preventive services, like annual physical exams, and many diagnostic and radiological services are covered with no copay. The plan also covers home health services and skilled nursing facility stays, with copays for some services. Prescription hearing aids, eye exams, and eyewear also have no copays.
Inpatient Hospital See details
Inpatient Hospital benefits are covered. For Inpatient Hospital-Acute, you will pay a $380 copay for days 1-7, and no copay for days 8-90. Inpatient Hospital Psychiatric has a $2036 copay.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, with a copay between $0 and $380, and observation services with a $380 copay. Ambulatory surgical center services have no copay, outpatient substance abuse services have a $40 copay for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Giveback Choice Plus (PPO) plan, but requires prior authorization. You will pay a copay of $80 for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Giveback Choice Plus (PPO) plan. Ground Ambulance Services have a $265 copay, while Air Ambulance Services have 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 Plus (PPO) plan. Emergency Services and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, Worldwide Emergency Transportation has a $265 copay, and Urgently Needed Services has a $45 copay, with no coinsurance for any of these services.
Primary Care See details
The Aetna Medicare Giveback Choice Plus (PPO) plan covers primary care physician services with a $5 copay, chiropractic services with a $15 copay, occupational therapy services with a $30 copay, and specialist services with a $5 to $50 copay. Mental health specialty services, including individual and group sessions, have a $40 copay, while other healthcare professionals have a $0 to $50 copay. Psychiatric services, including individual and group sessions, also have a $40 copay. Physical therapy and speech-language pathology services have a $45 copay. Additionally, the plan offers telehealth benefits with a 20% coinsurance and a $0 to $50 copay, and opioid treatment program services with a $40 copay. Podiatry services are not covered.
Preventive Services See details
Preventive services include annual physical exams with no copay, and other preventive services like glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit, all with no copay. Kidney disease education services have a 20% coinsurance. Health education, additional sessions of smoking and tobacco cessation counseling, fitness benefit, and remote access technologies have no copay. Wigs for hair loss related to chemotherapy are covered with no copay, up to a maximum of $400 per year. Other services like in-home safety assessments, personal emergency response systems, and others are not covered.
Hearing Services See details
Hearing services include hearing exams with a $50 copay, routine hearing exams with no copay, fitting/evaluation for hearing aids with no copay, and prescription hearing aids with a $500 maximum benefit per ear and no copay. Prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay between $0 and $50, and routine eye exams, other eye exam services, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades have no copay.
Dental Services See details
Dental Services includes coverage for Medicare Dental Services with a $45 copay. Other services like 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 are covered with no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Giveback Choice Plus (PPO) plan, and require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
The Aetna Medicare Giveback Choice Plus (PPO) plan covers medical equipment including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance. The plan also covers Medical Supplies with 20% coinsurance, Diabetic Supplies with no coinsurance, and Diabetic Therapeutic Shoes/Inserts with a $10 copay. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
The Aetna Medicare Giveback Choice Plus (PPO) plan covers diagnostic and radiological services, with some services requiring prior authorization. Diagnostic Procedures/Tests have a copay between $0 and $100, while Lab Services have no copay. Diagnostic Radiological Services and Therapeutic Radiological Services have a coinsurance of at most 20%, and Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Giveback Choice Plus (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 generally covered by the Aetna Medicare Giveback Choice Plus (PPO) plan. However, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Giveback Choice Plus (PPO) plan, but require prior authorization. You will have no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Giveback Choice Plus (PPO) plan's Other Services benefit does not cover acupuncture, over-the-counter items, meal benefits, 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. Other 1 and Other 2 services are covered with no copay.
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