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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, Central, West, NW, SW, TC, South FL. 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 $120.00. 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:
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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) offers comprehensive medical coverage with no copay for primary care visits, home health services, and routine preventive care. For more specialized care, members pay a $50 copay for specialist visits, a $130 copay for emergency room visits, and a $425 copay per day for the first few days of inpatient hospital stays, all with no coinsurance. Outpatient hospital services feature a copay ranging from no copay up to $350, while diagnostic lab work and X-rays are available with no copay. This plan also includes valuable dental, vision, and hearing benefits with no deductibles and no coinsurance for most routine services. You will enjoy no copay for routine annual eye exams, a $200 annual allowance for eyewear, and no copay for most preventive dental services up to a $1,000 yearly limit. Additionally, medical equipment and dialysis require coinsurance up to 20% with no copay, and members receive a $30 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $425 copay for days 1 through 7 of acute stays and days 1 through 5 of psychiatric stays, followed by no copay for remaining Medicare-covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Eagle Giveback (PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $425 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse individual and group sessions carry a $30 copay with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the specific service, you will pay a copay of either $55.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Eagle Giveback (PPO) covers ambulance services with prior authorization, requiring a $250 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $130 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, while worldwide emergency transportation has a $250 copay, all featuring no coinsurance up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $50 copay and physical, occupational, and speech therapies cost $40, both with no coinsurance. Mental health, psychiatric, and opioid treatment services carry a $30 copay and no coinsurance, whereas chiropractic and podiatry services are not covered. Telehealth benefits are also available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Eagle Giveback (PPO) covers preventive services like annual physicals, health education, and various screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered, as sub-services such as medical nutrition therapy, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Eagle Giveback (PPO), offering no deductibles and no coinsurance for all covered care. Medicare-covered exams require a $50 copay, while one routine exam and fitting evaluation annually have no copay, and up to two prescription hearing aids per year have a copay of $0 to $1,700. OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription hearing aids, are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (PPO) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Beneficiaries receive one routine eye exam per year up to a $50 annual limit, and a combined $200 annual maximum allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Eagle Giveback (PPO), offering no copay and no coinsurance for most diagnostic, preventive, and comprehensive services up to a $1,000 annual combined in- and out-of-network maximum. Medicare-covered dental services require a $50 copay and no coinsurance, while maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance, subject to prior authorization. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature 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, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Eagle Giveback (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Eagle Giveback (PPO), with prior authorization required for all services. Lab services, outpatient X-rays, and diagnostic radiological services have no copay, diagnostic procedures and tests carry a $0 to $75 copay with no coinsurance, and therapeutic radiological services require a minimum 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the Aetna Medicare Eagle Giveback (PPO) plan, which includes exclusions for intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) offers partial coverage for other services with no copay and no coinsurance, including chronic illness meal benefits, annual wellness exams, screening mammographies, additional colorectal cancer screenings, and a $30 quarterly over-the-counter item allowance. Acupuncture is not covered under this benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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