A non-government entity
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 Limited counties Missouri and Kansas. This plan received an overall rating of 4 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 $120.00. 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 $5500.00 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:
Sign up for Aetna Medicare Eagle (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
Prescription drugs are not covered by Aetna Medicare Eagle (HMO-POS).
Additional Benefits
The Aetna Medicare Eagle (HMO-POS) plan offers robust everyday coverage, featuring no copay or coinsurance for primary care visits, annual physicals, and routine vision and hearing exams. Members can take advantage of valuable supplemental benefits, including a $225 annual eyewear allowance, up to $1,250 per ear annually for prescription hearing aids, and up to $2,000 in yearly dental coverage with no copay. The plan also covers home health services and over-the-counter items with no copay, helping to keep routine health expenses to a minimum. For specialized and emergency care, the plan provides predictable costs, including a $130 copay for emergency room visits and copays ranging from no copay up to $30 for specialist visits and physical therapy. Outpatient surgery and diagnostic lab tests are covered with no copay, while inpatient hospital stays require a $425 daily copay for the first six days. This balance of low-cost preventive care and clear cost-sharing for major medical services makes managing healthcare expenses straightforward.
Inpatient Hospital See details
Aetna Medicare Eagle (HMO-POS) covers inpatient hospital services with no coinsurance, though non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered. Acute stays require a $425 daily copay for days 1 to 6 followed by no copay for unlimited additional days, while psychiatric stays require a $375 daily copay for days 1 to 6 followed by no copay for days 7 to 90.
Outpatient Services See details
Aetna Medicare Eagle (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services which also feature no copays. Outpatient hospital services require a copay of $0 to $395, observation services have a $425 copay per stay, and outpatient substance abuse sessions cost a $30 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Eagle (HMO-POS) with no coinsurance and a copay of either $55.00 or $145.00. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Eagle (HMO-POS) covers ground ambulance services with a $260 copay and air ambulance services with a 20% coinsurance, with prior authorization required for both. For transportation, some services are covered, but transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Eagle (HMO-POS) covers emergency services with a $130 copay and urgently needed services with a $30 copay, both with no coinsurance and no deductible. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $130 to $260, up to a $250,000 maximum plan benefit.
Primary Care See details
Primary care services under Aetna Medicare Eagle (HMO-POS) feature no copay and no coinsurance for primary care physician visits, while specialist visits, physical therapy, and occupational therapy require a copay of $0 to $30 and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, excluding routine chiropractic care and other chiropractic services. Mental health, psychiatric, and podiatry services have a $30 copay and no coinsurance, while telehealth benefits carry a $0 to $30 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Eagle (HMO-POS) provides partially covered preventive services, featuring no copay and no coinsurance for annual physicals, glaucoma screenings, diabetes training, and select supplemental benefits like health education and memory fitness. Kidney disease education is covered with no copay and a 20% coinsurance, while several services such as weight management, nutritional benefits, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services under the Aetna Medicare Eagle (HMO-POS) plan include Medicare-covered exams for a $30 copay and no coinsurance with no deductible, as well as routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear annually, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Eagle (HMO-POS) covers vision services with no copay and no coinsurance for both eye exams and eyewear, and no deductible is required. Members are covered for one routine eye exam per year and receive a $225 annual maximum allowance toward contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Eagle (HMO-POS) plan, which offers up to $2,000 annually for other dental services with no copay and no coinsurance, while Medicare-covered dental services require a $30 copay and no coinsurance. Most preventive and comprehensive services are covered with no copay and no coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Eagle (HMO-POS) with no copay and no coinsurance, though prior authorization is required. Part B insulin drugs feature a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Eagle (HMO-POS) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Eagle (HMO-POS) with no copay, though coinsurance ranges from no coinsurance to 20% depending on the specific item. Prior authorization is required for durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with a flat 20% coinsurance applying to prosthetic devices and diabetic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Eagle (HMO-POS) with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay of $0 to $30, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
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
Aetna Medicare Eagle (HMO-POS) covers Cardiac Rehabilitation Services with no coinsurance, although some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and carry a $5 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle (HMO-POS) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Aetna Medicare Eagle (HMO-POS) covers acupuncture with a $20 copay and no coinsurance for up to 12 treatments yearly, alongside over-the-counter items with no copay and no coinsurance up to a $45 quarterly limit. Chronic illness meal benefits, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings are also covered with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved