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Aetna Medicare Eagle Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Eagle 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 Giveback (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Eagle Giveback (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in North Carolina. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Eagle 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 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 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 $80.00. 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 $7750.00 (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 $7750.00 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 Aetna Medicare Eagle Giveback (PPO).
Additional Benefits
The Aetna Medicare Eagle Giveback (PPO) plan offers comprehensive medical coverage, featuring no copays for primary care visits and copays ranging from no copay to $35 for specialists. Emergency room visits require a $130 copay, while urgent care visits carry a $50 copay, both with no coinsurance. Inpatient hospital stays require daily copays for the first eight days, whereas home health, lab services, and outpatient x-rays are available with no copay and no coinsurance. Beyond standard care, this plan includes valuable dental, vision, and hearing benefits with no deductibles. Routine hearing and vision exams, along with preventive dental care, feature no copay, and the plan provides generous allowances such as $2,000 annually for dental services and $250 for eyewear. Additionally, you will benefit from a $50 quarterly over-the-counter allowance, while medical equipment and dialysis require no copay and up to 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) offers partially covered inpatient hospital services with no coinsurance, requiring a $382 daily copay for days 1-8 of acute stays and a $292 daily copay for days 1-8 of psychiatric stays, followed by no copay for subsequent days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Eagle Giveback (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $382, observation services have a $382 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization services with a copay of $140 or $145 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Aetna Medicare Eagle Giveback (PPO) plan, which covers ambulance services with prior authorization but does not cover transportation services to plan-approved or health-related locations. Ground ambulance services require a $275 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Eagle 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, and urgent care with a $50 copay and no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay and no coinsurance, while worldwide emergency transportation has a $275 copay and no coinsurance, up to a maximum plan benefit of $250,000.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) features primary care doctor visits with no copay and no coinsurance, and specialist visits with a $0 to $35 copay and no coinsurance. Physical, occupational, and speech therapies require a $30 copay and no coinsurance, while chiropractic and podiatry services are not covered. Mental health and psychiatric services have a $40 copay and no coinsurance, whereas telehealth benefits carry a 20% coinsurance and a $0 to $50 copay.
Preventive Services See details
Preventive Services under the Aetna Medicare Eagle Giveback (PPO) are partially covered, offering no copay and no coinsurance for annual physicals, glaucoma screenings, and diabetes training, though kidney disease education requires a 20% coinsurance with no copay. Several supplemental preventive services are not covered, including personal emergency response systems, in-home safety assessments, nutritional/dietary benefits, and weight management programs.
Hearing Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers hearing services with no deductible, offering routine exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $1,250 per ear annually, but OTC hearing aids and inner, outer, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (PPO) covers vision services with no deductibles and no coinsurance, including eye exams with a $0 to $35 copay. Eyewear, including contacts, lenses, and frames, is covered with no copay up to a combined annual maximum of $250.
Dental Services See details
Dental services are partially covered by the Aetna Medicare Eagle Giveback (PPO) with a $2,000 annual maximum benefit for both in-network and out-of-network care. Medicare-covered dental services require a $35 copay and no coinsurance, while other covered preventive and comprehensive dental services have no copay and no coinsurance. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Eagle Giveback (PPO) with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Eagle Giveback (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Eagle Giveback (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with no copayments and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies may be limited to specific manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Eagle Giveback (PPO) with prior authorization required. Lab services, outpatient X-rays, and diagnostic radiological services feature no copay and no coinsurance, diagnostic procedures have a copay ranging from $0 to $200, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, though some services are not covered, including standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for PAD ($25 copay).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a three-day prior inpatient hospital stay is not required, additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services, offering over-the-counter (OTC) items up to $50 every three months, annual wellness exams, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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