A non-government entity
Aetna Medicare Premier Plus 2 (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Premier Plus 2 (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Premier Plus 2 (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Premier Plus 2 (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Southern & Western Colorado. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Premier Plus 2 (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 Aetna Medicare Premier Plus 2 (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 Aetna Medicare Premier Plus 2 (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.
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 $590.00 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 $8950.00 (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 $8950.00 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:
Sign up for Aetna Medicare Premier Plus 2 (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Premier Plus 2 (PPO) plan has an enhanced alternative drug benefit. The plan has a deductible of $590.00. In the initial coverage phase, after the deductible is met, you will pay a copay or coinsurance depending on the drug tier and pharmacy. For example, preferred generic drugs have no copay at preferred pharmacies and preferred mail order, and a $12 copay at standard pharmacies and standard mail order. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The Aetna Medicare Premier Plus 2 (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the service. It also covers primary care, preventive, vision, and dental services, often with no copay, and provides benefits for hearing aids and medical equipment. This plan includes coverage for emergency services, ambulance, and home health services, while also offering additional benefits like OTC items and home infusion services. However, some services like cardiac rehabilitation and additional days in a skilled nursing facility are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered under the Aetna Medicare Premier Plus 2 (PPO) plan. For Inpatient Hospital-Acute, you pay a $295 copay for days 1-5, and no copay for days 6-90; additional days are also covered with no copay. Inpatient Hospital Psychiatric services have a $370 copay for days 1-5, and no copay for days 6-90, but additional days are not covered.
Outpatient Services See details
Outpatient services are covered, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $0 and $350, observation services have a $350 copay, ambulatory surgical center services have no copay, individual and group sessions for outpatient substance abuse have a $40 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Aetna Medicare Premier Plus 2 (PPO) covers partial hospitalization with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Premier Plus 2 (PPO). Ground ambulance services have a $275 copay, while air ambulance services have a 20% coinsurance; transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services have a $125 copay, Urgently Needed Services have a $50 copay, Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $125 copay, and Worldwide Emergency Transportation has a $275 copay.
Primary Care See details
The Aetna Medicare Premier Plus 2 (PPO) plan covers primary care physician services with no copay, chiropractic services with a $20 copay, and occupational therapy with a $40 copay. Physician specialist services have a copay between $0 and $40, while mental health specialty services, psychiatric services, and opioid treatment program services each have a $40 copay for individual and group sessions. Physical therapy and speech-language pathology services have a $20 copay, and additional telehealth benefits have a 20% coinsurance and a copay between $0 and $50.
Preventive Services See details
Preventive services, including annual physical exams, are covered with no copay. Additional preventive services such as Health Education, Nutritional/Dietary Benefits, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, and Remote Access Technologies are covered with a $0 copay, while wigs for hair loss related to chemotherapy are covered with a $0 copay and a maximum plan benefit coverage amount of $400. Kidney disease education services are covered with 20% coinsurance. Other preventive services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit are covered with no copay.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered, but the plan does not cover prescription hearing aids for the inner ear, outer ear, and over the ear. OTC hearing aids are not covered.
Vision Services See details
Vision services, including eye exams and eyewear, are covered under the Aetna Medicare Premier Plus 2 (PPO) plan. There is no copay for eye exams and eyewear. The plan offers a combined maximum of $190 per year for eyewear.
Dental Services See details
Dental Services are covered, with a $1,000 maximum benefit per year for both in-network and out-of-network services. Medicare Dental Services require prior authorization and have a $40 copay. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with a coinsurance between 0% and 20%. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Premier Plus 2 (PPO) plan, with a coinsurance between 20% and 20%. Prior authorization is required for coverage.
Medical Equipment See details
Medical equipment benefits are covered, including durable medical equipment with 0% to 20% coinsurance and no copay, though durable medical equipment for use outside the home is not covered. Prosthetic devices and medical supplies are covered with 20% coinsurance for prosthetic devices, and a 0% to 20% coinsurance for medical supplies. Diabetic equipment is also covered with varying coinsurance and authorization required.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Aetna Medicare Premier Plus 2 (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $150, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Premier Plus 2 (PPO) plan with no copay and no coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Premier Plus 2 (PPO) plan. This includes Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Premier Plus 2 (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Premier Plus 2 (PPO) plan covers Over-the-Counter (OTC) items with no copay, and a maximum benefit coverage amount of $30 every three months. The plan also covers meal benefits and other services, but does not cover acupuncture, Dual Eligible SNPs with Highly Integrated Services, or several other services including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and more.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved