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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 Virginia service area. 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 $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 $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) offers robust medical coverage with affordable out-of-pocket costs, featuring no copays and no coinsurance for primary care visits, preventive services, and home health care. Specialist visits range from no copay to a $35 copay, while inpatient hospital stays require a daily copay of $334 for the first eight days with no coinsurance. Outpatient hospital services feature a copay ranging from no copay to $334, and emergency room visits carry a $130 copay that is waived if you are admitted. This plan also includes valuable supplemental benefits to support your everyday health, such as routine dental, vision, and hearing exams with no copays. You will benefit from a $1,250 annual prescription hearing aid allowance per ear and a $200 annual eyewear allowance with no copays or coinsurance. Additionally, the plan provides a $60 quarterly over-the-counter reimbursement allowance and covers preventive dental cleanings and x-rays at no cost to you.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) covers inpatient hospital services with no coinsurance, requiring a $334 daily copay for days 1 through 8 of acute stays (with no copay for days 9 and beyond) and a $355 daily copay for days 1 through 4 of psychiatric stays (with no copay for days 5 through 90). Prior authorization is required, and 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 $334 copay for outpatient hospital services and a $334 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization services with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Eagle Giveback (PPO) require prior authorization, offering ground ambulance services for a $275 copay and no coinsurance, and air ambulance services for a 20% coinsurance and no copay. Transportation services are 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 urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, and worldwide emergency transportation has a $275 copay, with no coinsurance up to a maximum plan limit of $250,000.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) covers primary care visits with no copay and no coinsurance, and specialist visits with a $0 to $35 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric services require copays of $30 to $35 with no coinsurance, while telehealth benefits have a $0 to $50 copay and 20% coinsurance. Podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic care are not.
Preventive Services See details
Aetna Medicare Eagle Giveback (PPO) covers preventive services, including annual physicals and screenings, with no copay and no coinsurance. Supplemental benefits are partially covered, offering no copay or coinsurance for memory fitness and health education, while excluding in-home support, nutritional training, and personal emergency response systems. Kidney disease education is covered with no copay and a 20% coinsurance.
Hearing Services See details
Aetna Medicare Eagle Giveback (PPO) provides partially covered hearing services, including Medicare-covered exams for a $35 copay and no coinsurance, plus annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $1,250 maximum per ear annually, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by the Aetna Medicare Eagle Giveback (PPO) with no coinsurance and no deductible, featuring a $0 to $35 copay for eye exams and no copay for one routine exam per year up to a $50 limit. Eyewear, including contacts and eyeglasses, is also covered with no copay and no coinsurance up to a $200 annual maximum.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Eagle Giveback (PPO), offering Medicare-covered care for a $35 copay and no coinsurance, alongside preventive exams, cleanings, and x-rays with no copay and no coinsurance. Comprehensive services like restorative, endodontic, and periodontic care are covered up to a $1,500 annual limit with no copay and 20% to 50% coinsurance, while fluoride, implants, maxillofacial prosthetics, 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, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Eagle Giveback (PPO) 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 0% to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Aetna Medicare Eagle Giveback (PPO) with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and procedures with a $0 to $100 copay, while radiological services carry copays starting at $0 for diagnostic scans, no copay for X-rays (coinsurance applies), and a minimum 20% coinsurance for therapeutic treatments.
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 under the Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance. However, some services are covered in practice while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are 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 a daily copay of $10 for days 1 through 20 and $186 for days 21 through 100. Prior authorization is required, and while a three-day prior hospital stay is not necessary, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance, though acupuncture is not covered. Covered benefits include a $60 quarterly over-the-counter reimbursement allowance, meals for chronic illness, annual wellness exams, and additional colorectal screenings.
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