A non-government entity
Aetna Medicare Eagle Plus Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Eagle Plus Giveback (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Eagle Plus Giveback (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Eagle Plus Giveback (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select LA Parishes. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Eagle Plus Giveback (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 Aetna Medicare Eagle Plus Giveback (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 Eagle Plus Giveback (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 $100.00. 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 $10100.00 (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 $10100.00 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 Eagle Plus Giveback (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
Prescription drugs are not covered by Aetna Medicare Eagle Plus Giveback (PPO).
Additional Benefits
The Aetna Medicare Eagle Plus Giveback (PPO) plan provides robust coverage for essential medical services, featuring no copays or coinsurance for primary care visits and routine preventive care. Specialist visits, urgent care, and emergency services are highly accessible with predictable copays and no coinsurance, while inpatient hospital stays require set daily copayments with no coinsurance. Outpatient procedures, diagnostic labs, and home health services are also covered, typically requiring no copayments or low, fixed copays. This plan also includes strong supplemental benefits, offering routine vision and hearing exams with no copays, alongside annual allowances for eyewear and prescription hearing aids. Preventive dental care features no copay, while comprehensive dental services are covered with a 20% to 50% coinsurance up to a $4,000 annual maximum. Additionally, members benefit from a quarterly over-the-counter item allowance, no-copay skilled nursing facility care for the first 20 days, and home medical equipment with coinsurance up to 20%.
Inpatient Hospital See details
Aetna Medicare Eagle Plus Giveback (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $285 daily copay for days 1 to 8 of acute stays and a $458 daily copay for days 1 to 5 of psychiatric stays. There is no copay for subsequent covered days, but upgrades, psychiatric additional days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by the Aetna Medicare Eagle Plus Giveback (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Medicare-covered outpatient hospital services require a copay of $0 to $285, while outpatient substance abuse sessions have a $30 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered by the Aetna Medicare Eagle Plus Giveback (PPO) with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by the Aetna Medicare Eagle Plus Giveback (PPO) plan, as transportation services to plan-approved or any health-related locations are not covered. Ground ambulance services require a $275 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for both.
Emergency Services See details
Aetna Medicare Eagle Plus Giveback (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care has a $50 copay with no coinsurance, and worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Aetna Medicare Eagle Plus Giveback (PPO) provides primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $35 copay and no coinsurance. Mental health, psychiatric, and physical therapies carry a $30 to $35 copay and no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Podiatry is not covered, and chiropractic care is only partially covered, with routine and other chiropractic services excluded from coverage.
Preventive Services See details
Preventive services are partially covered by the Aetna Medicare Eagle Plus Giveback (PPO), offering most covered care like annual physicals and health screenings with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Several supplemental benefits are not covered under this plan, including in-home safety assessments, personal emergency response systems, weight management programs, and nutritional benefits.
Hearing Services See details
Aetna Medicare Eagle Plus Giveback (PPO) offers partially covered hearing services, featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered with no copay or coinsurance up to a $500 annual limit per ear, though OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Eagle Plus Giveback (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a $0 to $35 copay and routine exams with no copay. Eyewear, including contacts and eyeglasses, is also covered with no copay up to a combined maximum benefit of $300 per year.
Dental Services See details
Aetna Medicare Eagle Plus Giveback (PPO) partially covers dental services, featuring medicare-covered dental for a $35 copay and no coinsurance, and preventive care with no copay and no coinsurance. Comprehensive benefits have no copay and 20% to 50% coinsurance up to a $4,000 annual maximum, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle Plus Giveback (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 chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Eagle Plus Giveback (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Eagle Plus Giveback (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required. These services feature no copays, and coinsurance ranges from no coinsurance up to 20% depending on the item.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Aetna Medicare Eagle Plus Giveback (PPO) with no copay for lab services and outpatient X-rays, and no coinsurance for diagnostic services. Outpatient diagnostic procedures and tests have a copay ranging from $0 to $95, while therapeutic radiological services require a minimum 20% coinsurance, and prior authorization is required.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Eagle Plus Giveback (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Eagle Plus Giveback (PPO) with no copay and no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Plus Giveback (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not required, additional days beyond the standard Medicare limit are not covered.
Other Services See details
Aetna Medicare Eagle Plus Giveback (PPO) partially covers other services with no copay and no coinsurance, offering a chronic illness meal benefit, select wellness screenings, and up to $195 every three months for over-the-counter items. Acupuncture is not covered under this plan.
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