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Aetna Medicare Advantra Eagle (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra 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 Advantra Eagle (HMO-POS) in 2025, please refer to our full plan details page.
Aetna Medicare Advantra Eagle (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 4.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Advantra 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 Advantra 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 Advantra 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 $111.00. 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 (HMO-POS).
Additional Benefits
The Aetna Medicare Advantra Eagle (HMO-POS) plan offers comprehensive coverage with a variety of benefits. This plan covers inpatient hospital stays with a copay, and outpatient services with a copay between $0 and $250. Emergency services have a $125 copay, waived if admitted to the hospital within 24 hours. This plan includes primary care with no copay for physician services, and specialist visits at a $10 copay. Preventive services like annual physical exams and routine eye exams are covered with no copay, and dental services are covered up to $2,500 per year. The plan also provides coverage for hearing exams, prescription hearing aids, and vision services, all with varying copays and maximum benefit amounts.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, there is a $495 copay per admission for a Medicare-covered stay and no copay for additional days. For Inpatient Hospital Psychiatric, there is a $176 copay for days 1-9, and no copay for days 10-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute and Additional Days for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services includes coverage for outpatient hospital services with a copay between $0 and $250, observation services with a $250 copay, and ambulatory surgical center services with no copay. Outpatient substance abuse services have a $5 copay for both individual and group sessions, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Advantra Eagle (HMO-POS) plan, with no copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Advantra Eagle (HMO-POS), including ground and air ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance; transportation services to a plan-approved health-related location are covered with no copay, up to 12 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage have a copay of $125, and Worldwide Emergency Transportation has a copay of $250; there is no coinsurance for any of these services. The copay for emergency services is waived if you are admitted to the hospital within 24 hours. Worldwide Emergency Services has a maximum plan benefit coverage of $150,000.
Primary Care See details
Primary Care includes coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $20 copay, Occupational Therapy Services with a $10 copay, Physician Specialist Services with a $10 copay, Mental Health Specialty Services with a $5 copay for individual and group sessions, Podiatry Services with a $10 copay, Other Health Care Professional with a copay between $0 and $10, Psychiatric Services with a $5 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services with a $10 copay, additional telehealth benefits with a 20% coinsurance and a copay between $0 and $50, and Opioid Treatment Program Services with a $5 copay. Routine Chiropractic Care has a $20 copay for up to 12 visits per year.
Preventive Services See details
Preventive services include annual physical exams with no copay, and various other services such as glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit, all with no copay. Kidney disease education services have a 20% coinsurance. Additional preventive services such as Health Education, Nutritional/Dietary Benefit, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, and Remote Access Technologies have a copay, and wigs for hair loss related to chemotherapy have no copay, up to a maximum of $400 per year. 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, 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, or Counseling Services.
Hearing Services See details
Hearing exams are covered, with a $10 copay; routine hearing exams and fitting/evaluation for hearing aids are covered with no copay, up to once per year. Prescription hearing aids are covered, with a maximum benefit of $500 per year, and a $0 copay for all types of prescription hearing aids except inner ear, outer ear, and over the ear, which are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams and eyewear. Eye exams have a copay of $0-$10, while routine eye exams and other eye exam services have no copay. Eyewear, including contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, have no copay, with a combined maximum benefit of $400 every year.
Dental Services See details
The Aetna Medicare Advantra Eagle (HMO-POS) plan covers Medicare Dental Services with a $10 copay, and other dental services like oral exams, dental x-rays, and other diagnostic services with no copay, up to a maximum of $2,500 per year. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Advantra Eagle (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, is covered. Durable Medical Equipment has a coinsurance of 0-20%, while durable medical equipment for use outside the home is not covered. Prosthetic devices have a 20% coinsurance, and medical supplies have a coinsurance of 0-20%. Diabetic supplies have a coinsurance of 0-20%, and diabetic therapeutic shoes/inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, and may require prior authorization. Diagnostic Procedures/Tests have no copay, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $250, and Therapeutic Radiological Services have a coinsurance of at most 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Advantra Eagle (HMO-POS) plan with no copay and no coinsurance, though additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Advantra Eagle (HMO-POS) plan, but the plan does not specify the cost sharing details. However, Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is a $10 copay, and for days 21-100, there is a $214 copay. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
The Aetna Medicare Advantra Eagle (HMO-POS) plan covers over-the-counter items with no copay, up to a maximum of $90 every three months. The plan also covers meal benefits with no copay, and other services like annual wellness exams, screening mammography, gFOBT, and FIT with no copay. Acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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