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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 New England. 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 $9500.00 (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 $9500.00 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 affordable access to essential medical services, featuring no copay and no coinsurance for primary care visits and most preventive care. Specialist visits require a copay of up to $40 with no coinsurance, while inpatient hospital stays feature a $329 daily copay for the first six days. Emergency care is covered with a $130 copay, and urgent care visits carry a $40 copay, both with no coinsurance. This plan also includes valuable supplemental benefits, such as dental coverage up to a $2,000 annual limit with no copay for most services. Routine hearing and vision exams require no copay, and members receive a $300 annual allowance for corrective eyewear. Additionally, the plan provides a quarterly over-the-counter allowance of up to $90 with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) covers inpatient acute hospital stays with no coinsurance, requiring a $329 daily copay for days 1 through 6 and no copay for days 7 and beyond, though upgrades and non-Medicare-covered stays are excluded. Inpatient psychiatric care is also covered with no coinsurance, featuring a $435 daily copay for days 1 through 5 and no copay for days 6 through 90, but additional psychiatric days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by the Aetna Medicare Eagle Giveback (PPO) with no coinsurance, featuring a $0 to $345 copay for outpatient hospital services and a $329 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse services carry a $40 copay per session with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization services with a copay of either $60.00 or $145.00 and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Aetna Medicare Eagle Giveback (PPO) covers ground ambulance services with a $270 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgent care with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered with no coinsurance up to a $250,000 maximum benefit, requiring a $130 copay for emergency or urgent care and a $270 copay for worldwide emergency transportation.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Covered therapies, psychiatric services, and mental health sessions require a $40 copay and no coinsurance, while telehealth services carry a $0 to $40 copay and 20% coinsurance; podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive Services are covered by the Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance for most care, including annual physicals, though kidney disease education requires a 20% coinsurance. This benefit is partially covered, excluding 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, home/bathroom safety modifications, and counseling.
Hearing Services See details
Hearing Services are partially covered under the Aetna Medicare Eagle Giveback (PPO), featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Up to two prescription hearing aids are covered per year with no coinsurance and a copay of $0 to $1,700, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (PPO) covers vision services with no deductibles and no coinsurance. Eye exams require a copay of $0 to $40 with a $50 annual maximum, while corrective eyewear is available with no copay up to a $300 yearly combined limit.
Dental Services See details
Dental services are covered under the Aetna Medicare Eagle Giveback (PPO) with a $2,000 annual maximum benefit for both in- and out-of-network care. Medicare-covered dental services require a $40 copay and no coinsurance, while other covered services have no copay and no coinsurance, except for maxillofacial prosthetics, implant services, and orthodontics, which are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle Giveback (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Aetna Medicare Eagle 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 Giveback (PPO) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes. Depending on the equipment, coinsurance ranges from no coinsurance up to 20%, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Aetna Medicare Eagle Giveback (PPO) with prior authorization, featuring no copay or coinsurance for lab services and a $0 to $45 copay with no coinsurance for diagnostic tests. Diagnostic radiology requires a copay with no coinsurance, while outpatient X-rays require a $10 copay plus coinsurance, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home health services are covered under 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 are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, but copayments apply to individual services. You will pay a $20 copay for cardiac and intensive cardiac rehabilitation, a $15 copay for pulmonary rehabilitation, and a $25 copay for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a daily copay of $10 for days 1 through 20 and $218 for days 21 through 100. Prior authorization is required, a three-day prior hospital stay is not needed before admission, and additional days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other Services under the Aetna Medicare Eagle Giveback (PPO) are partially covered, as acupuncture is not covered. Covered benefits, including chronic illness meals, wellness exams, select cancer screenings, and up to $90 every three months in reimbursed over-the-counter (OTC) items, feature no copay and no coinsurance.
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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.
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