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Aetna Medicare Eagle Giveback (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Eagle Giveback (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Eagle Giveback (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Eagle Giveback (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in New Jersey Counties: All. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Eagle Giveback (HMO) 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 Giveback (HMO).
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 Giveback (HMO), 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 $50.00. 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 $9250.00 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 Giveback (HMO).
Additional Benefits
The Aetna Medicare Eagle Giveback (HMO) plan offers essential medical coverage featuring no copay and no coinsurance for primary care visits, routine preventive care, and home health services. For inpatient hospital stays, members pay a daily copay for the first six days and no copay for subsequent days. Emergency and urgent care services are also covered with flat copays and no coinsurance. This plan also includes key ancillary benefits, offering routine dental, vision, and hearing services with no copay and no coinsurance. Members receive annual allowances for eyewear and prescription hearing aids, alongside a quarterly allowance for over-the-counter items. Additionally, durable medical equipment and diagnostic tests are covered with no copay and coinsurance ranging from 0% to 20% to keep out-of-pocket costs predictable.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (HMO) covers inpatient acute hospital stays with a $395 daily copay for days 1 through 6, no copay for subsequent days, and no coinsurance. Inpatient psychiatric hospital stays are partially covered with a $346 daily copay for days 1 through 6 and no copay for days 7 through 90, though additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Eagle Giveback (HMO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $350, while observation services cost $395 per stay and outpatient substance abuse sessions have a $35 copay.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (HMO) covers partial hospitalization services with a copay of either $60.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the Aetna Medicare Eagle Giveback (HMO) plan, which covers ground and air ambulance services with a $300 copay and no coinsurance. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services under the Aetna Medicare Eagle Giveback (HMO) are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays of $115 for emergency or urgent care and $300 for emergency transportation.
Primary Care See details
Primary care benefits under the Aetna Medicare Eagle Giveback (HMO) feature no copay and no coinsurance for primary care visits, and a $0 to $35 copay with no coinsurance for specialists. Physical, occupational, and speech therapies require a $25 copay and no coinsurance, while podiatry and chiropractic services are not covered. Telehealth services are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Eagle Giveback (HMO) partially covers preventive services, offering annual physicals, health education, and select screenings with no copay and no coinsurance. Kidney disease education services require a 20% coinsurance with no copay, while several sub-services like nutritional therapy and personal emergency response systems are not covered.
Hearing Services See details
Aetna Medicare Eagle Giveback (HMO) provides partially covered hearing services with no coinsurance, featuring no copay for annual routine exams and fittings, and a $35 copay for Medicare-covered exams. Up to two prescription hearing aids are covered per year with no coinsurance and copays up to $1,700, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (HMO) covers vision services with no deductibles and no coinsurance, offering eye exams with a $0 to $35 copay, which includes one routine exam per year with no copay. Eyewear is also covered with no copay up to a combined maximum benefit of $200 every year for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Eagle Giveback (HMO), offering up to a $1,500 annual maximum with no copay and no coinsurance for preventive and most comprehensive care, though implant services, orthodontics, and maxillofacial prosthetics are not covered. Medicare-covered dental services are available for a $35 copay and no coinsurance, with prior authorization required.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Eagle Giveback (HMO) with no copay, though prior authorization and step therapy are required. Covered Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Eagle Giveback (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Eagle Giveback (HMO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from 0% to 20%. Prior authorization is required for these benefits, and prosthetic devices and diabetic therapeutic shoes or inserts carry a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Eagle Giveback (HMO) with prior authorization required. Diagnostic tests and lab services feature no coinsurance, with copays ranging from $0 to $35, while diagnostic radiological services start at no copay. Outpatient X-rays require a $35 copay plus coinsurance, and therapeutic radiological services have a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Eagle Giveback (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Eagle Giveback (HMO) with no copay and no coinsurance. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (HMO) partially covers other services with no copay and no coinsurance, including wellness exams, chronic illness meals, and a $60 quarterly over-the-counter allowance. Acupuncture is not covered under these additional benefits.
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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.
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