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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 South 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 $50.00. 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 $9200.00 (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 $9200.00 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) provides robust medical coverage with predictable costs, featuring no copay for primary care visits and copays of $0 to $35 for specialist consultations. Inpatient hospital stays require a $388 copay for days 1 through 7 of acute care, while emergency room visits carry a $115 copay that is waived if you are admitted within 24 hours. Most outpatient services, home health care, and diagnostic lab tests are highly affordable and require no copay or coinsurance. This plan also includes valuable supplemental benefits, featuring no copay for routine dental, vision, and hearing exams. Members benefit from a $2,000 annual dental limit, a $1,250 annual prescription hearing aid allowance per ear, and up to $250 yearly for eyewear with no copays. Additionally, you will pay no copay or coinsurance for annual wellness exams, a $50 quarterly over-the-counter reimbursement, and the first 20 days of skilled nursing facility stays.
Inpatient Hospital See details
Inpatient Hospital services under the Aetna Medicare Eagle Giveback (PPO) are partially covered with no coinsurance, requiring a $388 copay for days 1-7 of acute stays and a $260 copay for days 1-8 of psychiatric stays, with no copay for subsequent days. Additional acute care days are unlimited with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance across all services, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $388, observation services have a $388 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 $105.00 or $110.00 and no coinsurance. Prior authorization is required for this covered benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under the Aetna Medicare Eagle Giveback (PPO) include ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $115 to $275.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $35 copay and no coinsurance. Therapy services require a $30 copay with no coinsurance, while mental health and psychiatric services have a $40 copay and no coinsurance. Some chiropractic services are covered but routine and other chiropractic care are not, and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by the Aetna Medicare Eagle Giveback (PPO), offering no copay and no coinsurance for annual physicals, health education, and screenings, while kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered under this benefit include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, and home and bathroom safety modifications.
Hearing Services See details
Aetna Medicare Eagle Giveback (PPO) provides 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 fittings. Prescription hearing aids are covered up to $1,250 per ear annually with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (PPO) covers vision services with no deductible and no coinsurance, featuring no copay for routine eye exams and up to a $35 copay for Medicare-covered exams. Eyewear, including contact lenses, eyeglasses, frames, and upgrades, is also covered with no copay up to a combined maximum of $250 per year.
Dental Services See details
Dental services are covered by Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance for most preventive and comprehensive services up to a $2,000 annual limit, while Medicare-covered dental has a $35 copay and no coinsurance. This benefit is partially covered, as maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle Giveback (PPO) covers home infusion bundled services with no copay, subject to prior authorization. Under this plan, Medicare Part B insulin carries a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
The Aetna Medicare Eagle Giveback (PPO) covers Dialysis Services with no copay and a 20% coinsurance, though 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 equipment, with no copays for all covered items. Depending on the service, you will pay between no coinsurance and 20% coinsurance, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Eagle Giveback (PPO), featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $200 copay for diagnostic tests. Radiological services require prior authorization and include a $0 minimum copay for diagnostic radiology, a minimum 20% coinsurance for therapeutic radiology, and no copay for outpatient X-rays which are subject to coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Aetna Medicare Eagle Giveback (PPO) plan feature no coinsurance, but the benefit is not covered in practice as cardiac, intensive cardiac, pulmonary, and SET for PAD services are all not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services with no copay and no coinsurance, including annual wellness exams, screening mammographies, additional gFOBT and FIT, and a $50 quarterly over-the-counter item reimbursement. Acupuncture and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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