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Aetna Medicare Advantra Eagle Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra Eagle Plus (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 Advantra Eagle Plus (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Advantra Eagle Plus (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Advantra Eagle Plus (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 Advantra Eagle Plus (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 Advantra Eagle Plus (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 $115.00. 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:
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Drug Coverage
Prescription drugs are not covered by Aetna Medicare Advantra Eagle Plus (HMO-POS).
Additional Benefits
The Aetna Medicare Advantra Eagle Plus (HMO-POS) plan offers comprehensive coverage with no copay for primary care visits, annual physical exams, and home health services. For specialized care, beneficiaries pay low copays ranging from $5 to $10 for specialist visits, while emergency room visits require a $130 copay. Inpatient acute hospital stays carry a $495 copay per stay, and outpatient hospital services range from no copay to a $250 copay. This plan also features robust ancillary benefits, including dental coverage up to $2,500 annually and vision eyewear coverage up to $400 per year with no copay. Additionally, members receive prescription hearing aid coverage up to $500 per ear annually and a $90 quarterly allowance for over-the-counter items with no copay. Diagnostic lab services, X-rays, and routine hearing exams are also fully covered with no copay.
Inpatient Hospital See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) partially covers inpatient hospital services, as upgrades and non-Medicare-covered stays are excluded. Covered acute stays require a $495 copay per stay and no coinsurance, while psychiatric care requires no coinsurance and a $176 daily copay for days 1 through 9 (no copay for days 10 through 90).
Outpatient Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $250, observation services carry a $250 copay per stay, and outpatient substance abuse sessions require a $5 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Advantra Eagle Plus (HMO-POS) with no coinsurance, although prior authorization is required. Depending on the service, patients will pay either no copay or a $145 copay.
Ambulance and Transportation Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum with no coinsurance, featuring a $130 copay for emergency or urgent care and a $250 copay for transportation.
Primary Care See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist, therapy, and mental health visits with copays ranging from $5 to $10 and no coinsurance. Chiropractic services are partially covered, offering routine care for a $15 copay and no coinsurance for up to 12 visits per year, while other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers preventive services with no copay and no coinsurance for annual physical exams, glaucoma screenings, and diabetes training, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered, offering health education, memory fitness, and chemotherapy wigs up to $400 annually with no copay or coinsurance, while services like in-home safety assessments, weight management, and nutritional benefits are not covered.
Hearing Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) hearing services are partially covered, offering Medicare-covered exams for a $10 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) covers vision services with no deductibles or coinsurance, offering eye exams with copays ranging from no copay to $10. Eyewear, including contacts and eyeglasses, is covered with no copay up to a $400 combined maximum benefit limit per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Advantra Eagle Plus (HMO-POS) up to a $2,500 annual limit, featuring no copay and no coinsurance for most preventive and comprehensive services, while Medicare-covered dental services require a $10 copay and no coinsurance. Implant services, orthodontics, and maxillofacial prosthetics are not covered under this plan.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Advantra Eagle Plus (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other Part B drugs carry a 0% to 20% coinsurance, while Medicare Part B insulin drugs require a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Advantra Eagle Plus (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 Advantra Eagle Plus (HMO-POS) with no copay, though prior authorization is required. Beneficiaries will pay no coinsurance to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies, and a flat 20% coinsurance for prosthetic devices and diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services under Aetna Medicare Advantra Eagle Plus (HMO-POS) are covered with no copay and no coinsurance for lab services, diagnostic procedures, and outpatient X-rays. Diagnostic radiological services also carry no copay, while therapeutic radiological services require a 20% coinsurance, with prior authorization required for these benefits.
Home Health Services See details
Home health services are covered under the Aetna Medicare Advantra Eagle Plus (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered with no copay and no coinsurance under the Aetna Medicare Advantra Eagle Plus (HMO-POS) plan. Although some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are partially covered by Aetna Medicare Advantra Eagle Plus (HMO-POS) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $199 daily copay for days 21 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Advantra Eagle Plus (HMO-POS) partially covers other services with no copay and no coinsurance, including chronic illness meal benefits, annual wellness exams, additional colorectal screenings, and up to $90 every three months in over-the-counter item reimbursements. Acupuncture is not covered under these benefits.
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