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Allina Health Aetna Medicare Grand (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Grand (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Allina Health Aetna Medicare Grand (PPO) in 2026, please refer to our full plan details page.
Allina Health Aetna Medicare Grand (PPO) is a PPO plan offered by Allina Health and Aetna Insurance Holding Company available for enrollment in 2025 to people living in Twin Cities Metro and Select MN Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Allina Health Aetna Medicare Grand (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 Allina Health Aetna Medicare Grand (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 Allina Health Aetna Medicare Grand (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $87.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your 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 $300.00 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 $5700.00 (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 $5700.00 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 Allina Health Aetna Medicare Grand (PPO) plan features a $300 annual prescription drug deductible. For Tier 1 preferred generic drugs, members pay no copay when using preferred pharmacies or preferred mail-order services, while standard pharmacies charge a copay starting at $2. Tier 2 generic drugs have a copay starting at $10 at preferred pharmacies and $12 at standard pharmacies. For higher-tier medications, cost-sharing transitions to coinsurance. Tier 3 preferred brand drugs require a 25% coinsurance, while Tier 4 non-preferred drugs carry a 26% coinsurance. Tier 5 specialty drugs require a 29% coinsurance for a one-month supply across all pharmacy and mail-order options.
Additional Benefits
The Allina Health Aetna Medicare Grand (PPO) plan offers robust healthcare coverage with predictable out-of-pocket costs, including no copay for primary care physician visits, annual physical exams, and home health services. Inpatient hospital stays require a $350 copay per admission, while outpatient services range from no copay for ambulatory surgical centers to a maximum $300 copay for outpatient hospital visits. Additionally, emergency care is covered with a $150 copay, which is waived if you are admitted within 24 hours. This plan also features strong supplemental benefits, including dental coverage up to a $1,750 annual limit with no copay for preventive and comprehensive services. Vision and hearing benefits include routine exams with no copay, a $200 annual eyewear allowance, and up to $1,000 per ear for prescription hearing aids. Members also enjoy added perks like a $50 quarterly allowance for over-the-counter items and acupuncture coverage with a $20 copay.
Inpatient Hospital See details
Allina Health Aetna Medicare Grand (PPO) covers inpatient acute and psychiatric hospital stays with a $350 copay per admission and no coinsurance, subject to prior authorization. The benefit is partially covered because unlimited additional acute days are included with no copay, while upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Allina Health Aetna Medicare Grand (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services, a $30 copay for outpatient substance abuse sessions, and copays ranging from $0 to $300 for outpatient hospital and observation services. Prior authorization is required for most of these services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Allina Health Aetna Medicare Grand (PPO) covers partial hospitalization services with a copay of either $75.00 or $180.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Allina Health Aetna Medicare Grand (PPO) covers ambulance services with a $295 copay for ground ambulance services and a 20% coinsurance for air ambulance services, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Allina Health Aetna Medicare Grand (PPO) covers emergency services with a $150 copay (waived if admitted within 24 hours) and urgent care with a $30 copay, both featuring no coinsurance. Worldwide emergency services are covered up to a $250,000 maximum with no coinsurance, requiring a $150 copay for emergency or urgent care and a $295 copay for emergency transportation.
Primary Care See details
Allina Health Aetna Medicare Grand (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, psychiatric, and therapy services have copays ranging from $0 to $30 and no coinsurance. Chiropractic services are partially covered, offering routine care for a $20 copay and no coinsurance for up to 12 visits yearly, though other chiropractic services are not covered. Additional telehealth benefits are also available with a $0 to $30 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Allina Health Aetna Medicare Grand (PPO), offering no copay and no coinsurance for annual physical exams, health education, and most screenings, though kidney disease education requires a 20% coinsurance and no copay. Several supplemental services are not covered, including in-home safety assessments, personal emergency response systems, weight management programs, and nutritional benefits.
Hearing Services See details
Hearing services are partially covered with no deductible by Allina Health Aetna Medicare Grand (PPO), featuring a $30 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Up to two prescription hearing aids are covered annually with no copay or coinsurance up to $1,000 per ear, but OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services covered by Allina Health Aetna Medicare Grand (PPO) feature no deductibles and no coinsurance. Eye exams have copays ranging from no copay to $30, including one routine exam per year with no copay, while eyewear is covered with no copay up to a $200 annual maximum.
Dental Services See details
Dental services are partially covered under the Allina Health Aetna Medicare Grand (PPO) with an annual maximum benefit of $1,750 for both in- and out-of-network care. Medicare-covered dental services require a $30 copay and no coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance, though maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Allina Health Aetna Medicare Grand (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs require 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Allina Health Aetna Medicare Grand (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Allina Health Aetna Medicare Grand (PPO) covers medical equipment with no copays, though prior authorization is required and coinsurance ranges from no coinsurance to 20%. Prosthetic devices require a 20% coinsurance, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Allina Health Aetna Medicare Grand (PPO), featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $30 copay for diagnostic tests. Radiological services require prior authorization and carry no copay for diagnostic radiology, a $15 copay plus coinsurance for X-rays, and a copay with a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Allina Health Aetna Medicare Grand (PPO) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered with no coinsurance under the Allina Health Aetna Medicare Grand (PPO); however, while some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services (each carrying a $20 copay), as well as pulmonary rehabilitation services (carrying a $15 copay), are not covered.
Skilled Nursing Facility (SNF) See details
Allina Health Aetna Medicare Grand (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. Under this plan, there is no copay for days 1 through 20 and days 38 through 100, a $218 daily copay for days 21 through 37, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services covered by Allina Health Aetna Medicare Grand (PPO) include acupuncture for a $20 copay and no coinsurance, up to a limit of 12 treatments per year. Over-the-counter items up to $50 every three months, chronic illness meals, annual wellness exams, screening mammography, and additional gFOBT and FIT screenings are also covered with no copay and no coinsurance.
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