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Allina Health Aetna Medicare Eagle (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Eagle (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 Eagle (PPO) in 2026, please refer to our full plan details page.
Allina Health Aetna Medicare Eagle (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 Eagle (PPO) 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 Allina Health Aetna Medicare Eagle (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 Eagle (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 $125.00. 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 combined Maximum Out-Of-Pocket cost of $7000.00 (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 $7000.00 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
Prescription drugs are not covered by Allina Health Aetna Medicare Eagle (PPO).
Additional Benefits
The Allina Health Aetna Medicare Eagle (PPO) plan offers robust coverage for core medical services with predictable out-of-pocket costs. You will pay no copay and no coinsurance for primary care visits, while specialist visits and urgent care services require a $35 copay. For hospital stays, inpatient care features a $295 daily copay for the first five days and no copay thereafter, while emergency room visits carry a $130 copay with no coinsurance. This plan also includes extensive additional benefits, featuring no copays, no coinsurance, and no deductibles for routine eye exams and eyewear up to a $250 annual allowance. Dental services are covered with no copay or coinsurance up to a $2,100 annual limit, and prescription hearing aids are covered up to $1,000 per ear annually. Additionally, members benefit from no copays on home health services and receive a $90 quarterly reimbursement for over-the-counter items.
Inpatient Hospital See details
Allina Health Aetna Medicare Eagle (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $295 daily copay for days 1 through 5 and no copay for days 6 through 90 per stay. Unlimited additional acute hospital days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Allina Health Aetna Medicare Eagle (PPO) covers outpatient services with no coinsurance, featuring a copay of $0 to $295 for outpatient hospital services and $295 per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
Allina Health Aetna Medicare Eagle (PPO) covers partial hospitalization services with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Allina Health Aetna Medicare Eagle (PPO) covers ambulance services with a $295 copay for ground transport and a 20% coinsurance for air transport, with prior authorization required. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
Allina Health Aetna Medicare Eagle (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $35 copay, both featuring no coinsurance. Worldwide emergency and urgent services are also covered with a $130 copay, and worldwide emergency transportation has a $295 copay, with no coinsurance up to a maximum benefit limit of $250,000.
Primary Care See details
Allina Health Aetna Medicare Eagle (PPO) provides primary care physician visits with no copay and no coinsurance, while specialist, therapy, and podiatry services require a $35 copay and no coinsurance. Chiropractic care is partially covered, offering routine visits for a $15 copay and no coinsurance while excluding other chiropractic services. Mental health services require a $30 copay and no coinsurance, and telehealth benefits are available with a 20% coinsurance and a $0 to $35 copay.
Preventive Services See details
Preventive Services are partially covered by Allina Health Aetna Medicare Eagle (PPO) with no copay and no coinsurance for most services, including annual physical exams and screenings, while kidney disease education requires no copay and a 20% coinsurance. The plan does not cover In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Hearing services are partially covered by Allina Health Aetna Medicare Eagle (PPO), offering Medicare-covered exams for a $35 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $1,000 per ear every year with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Allina Health Aetna Medicare Eagle (PPO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. The plan provides up to a $50 annual maximum for eye exams, including one routine exam yearly, and a $250 combined annual allowance for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by the Allina Health Aetna Medicare Eagle (PPO), featuring a $35 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for other covered services up to a $2,100 annual limit. While most preventive and comprehensive services are covered, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Allina Health Aetna Medicare Eagle (PPO) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy 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 Allina Health Aetna Medicare Eagle (PPO) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Allina Health Aetna Medicare Eagle (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copays. Depending on the specific item, you will pay a coinsurance ranging from no coinsurance up to 20%, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Allina Health Aetna Medicare Eagle (PPO) with no coinsurance and a $0 to $20 copay for diagnostic tests, while lab services feature no copay or coinsurance. Outpatient x-rays require a $15 copay with coinsurance, therapeutic radiology carries a minimum 20% coinsurance, and diagnostic radiological services start with no copay, though prior authorization is required.
Home Health Services See details
Home health services are covered under the Allina Health Aetna Medicare Eagle (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Allina Health Aetna Medicare Eagle (PPO) covers some Cardiac Rehabilitation Services with no coinsurance, but standard cardiac rehab (with a $20 copay), intensive cardiac rehab (with a $20 copay), pulmonary rehab (with a $15 copay), and SET for PAD services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Allina Health Aetna Medicare Eagle (PPO) with no coinsurance, featuring no copay for days 1 to 20 and days 44 to 100, and a $218 daily copay for days 21 to 43. Prior authorization is required, but a prior three-day inpatient hospital stay is not, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Allina Health Aetna Medicare Eagle (PPO) partially covers other services, including acupuncture for a $20 copay and no coinsurance (limited to 12 treatments per year), alongside over-the-counter items, chronic illness meals, and select wellness screenings with no copay and no coinsurance. Over-the-counter items are reimbursed up to $90 every three months, while Dual Eligible SNPs with highly integrated services are not covered.
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