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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 Upstate NY Area: HV, Capital, CNY, Rochester, WNY. 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 $75.00. 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 $13900.00 (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 $13900.00 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:
Sign up for Aetna Medicare Eagle Giveback (PPO)
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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 no copay and no coinsurance for primary care visits, home health services, and most preventive care. Specialist visits require a copay of up to $35, while inpatient hospital stays require daily copays for the first six days before transitioning to no copay. Emergency care is accessible worldwide with a $115 copay, and urgent care visits require a $40 copay, both with no coinsurance. Beneficiaries also receive comprehensive supplemental benefits, including routine vision and hearing exams with no copay, alongside a $250 annual eyewear allowance and up to $2,000 for covered dental services. Diagnostic lab tests, medical equipment, and home infusion services are available with no copay, though some specialized treatments and equipment may require up to a 20% coinsurance. Additionally, the plan provides extra perks like a $60 quarterly over-the-counter allowance and chronic illness meal benefits with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by the Aetna Medicare Eagle Giveback (PPO) with no coinsurance, requiring prior authorization. Acute stays require a $375 daily copay for days 1 to 6 and no copay for additional days, while psychiatric stays require a $346 daily copay for days 1 to 6 and no copay for days 7 to 90. 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, including ambulatory surgical center and blood services which feature no copay. Outpatient hospital services require a copay of $0 to $350, while outpatient substance abuse sessions have a $35 copay and observation services require a $375 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by the Aetna Medicare Eagle Giveback (PPO) with a copay of either $60.00 or $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Eagle Giveback (PPO) covers ground and air ambulance services with a $300 copay and no coinsurance, requiring prior authorization. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are covered with a $115 copay, and worldwide emergency transportation has a $300 copay, all with no coinsurance up to a $250,000 maximum benefit.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) covers primary care physician services with no copay and no coinsurance, and specialist services with a $0 to $35 copay and no coinsurance. Physical, occupational, and mental health therapies have copays ranging from $35 to $40 and no coinsurance, while podiatry is not covered, and for chiropractic care some services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Eagle Giveback (PPO), with most covered benefits—such as annual physical exams, health education, and fitness programs—available with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while specific services like weight management, in-home safety assessments, and nutritional benefits are not covered.
Hearing Services See details
Aetna Medicare Eagle Giveback (PPO) covers Medicare-covered hearing exams for a $35 copay and annual routine exams or fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $1,700 for up to two devices per year, while OTC hearing aids and inner, outer, or 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, offering routine eye exams with no copay and Medicare-covered exams with a $0 to $35 copay. Eyewear is also covered with no copay and no coinsurance up to a combined annual limit of $250 for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by the Aetna Medicare Eagle Giveback (PPO), offering up to a $2,000 annual maximum benefit for both in-network and out-of-network care. Medicare dental services require a $35 copay and no coinsurance, while other covered dental services have no copay and no coinsurance, though implant services, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle Giveback (PPO) covers Home Infusion bundled Services with no copay, although prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Eagle Giveback (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
The Aetna Medicare Eagle Giveback (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay. Prior authorization is required for these benefits, and coinsurance ranges from no coinsurance up to 20% depending on the specific item.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by the Aetna Medicare Eagle Giveback (PPO), featuring no coinsurance for diagnostic services, which include lab tests with no copay and diagnostic procedures ranging from a $0 to $35 copay. Radiological services require prior authorization and include diagnostic radiology starting at no copay, outpatient X-rays with a $35 copay plus coinsurance, and therapeutic radiology with a 20% coinsurance and a copay.
Home Health Services See details
Aetna Medicare Eagle Giveback (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Aetna Medicare Eagle Giveback (PPO) feature no coinsurance, but only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers Skilled Nursing Facility (SNF) services 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, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard 100-day Medicare benefit period are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services, offering chronic illness meal benefits, wellness exams, and a $60 quarterly over-the-counter allowance with no copay and no coinsurance. Acupuncture and dual-eligible SNP services are not covered.
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