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Aetna Medicare Giveback Choice (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Giveback Choice (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Giveback Choice (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Giveback Choice (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in AL. This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Aetna Medicare Giveback Choice (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Giveback Choice (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 Giveback Choice (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 $74.00. 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.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $14000.00 (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 $14000.00 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
The Aetna Medicare Giveback Choice (PPO) plan has a $590 deductible for prescription drugs. After you meet your deductible, you will pay a copay or coinsurance depending on the drug tier and pharmacy you use. For example, you will pay no copay for preferred generic drugs at preferred pharmacies or preferred mail order pharmacies. You will pay 24% coinsurance for standard generic drugs, and 25% coinsurance for preferred brand and non-preferred drugs.
Additional Benefits
The Aetna Medicare Giveback Choice (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays. The plan also covers a wide array of services such as primary care, preventive, hearing, vision, and dental services, often with no copay. Other services like ambulance, emergency, and home health services are covered, with some services having copays or coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $362 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you will pay a $407 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered. Additional days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered by the Aetna Medicare Giveback Choice (PPO) plan. Outpatient hospital services have a copay between $0 and $362, observation services have a $362 copay, and individual and group outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Giveback Choice (PPO) plan, but requires prior authorization. You will have an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Giveback Choice (PPO) plan, but Transportation Services to any health-related location are not covered. Medicare-covered ground ambulance services have a $295 copay, and air ambulance services have a 20% coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Giveback Choice (PPO) plan. Emergency Services and Worldwide Emergency Coverage have a $110 copay, Worldwide Emergency Transportation has a $295 copay, and Urgently Needed Services have a $45 copay; all of these services have no coinsurance.
Primary Care See details
Primary Care Physician Services have a $5 copay, Chiropractic Services have a $15 copay, and Occupational Therapy Services have a $25 copay. Physician Specialist Services have a copay between $5 and $50. Individual and Group Sessions for Mental Health and Psychiatric Specialty Services and Opioid Treatment Program Services have a $30 copay. Physical Therapy and Speech-Language Pathology Services have a $25 copay. Additional Telehealth Benefits have a coinsurance of 20% and a copay between $0 and $50. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered zero dollar services and an annual physical exam with no copay. Additional preventive services, like Health Education, Glaucoma Screening, and Diabetes Self-Management Training, are covered with no copay. Kidney Disease Education Services have a 20% coinsurance. Other services, such as In-Home Safety Assessment, are not covered.
Hearing Services See details
Hearing services include hearing exams with a $50 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $500 per ear per year, with no copay for Prescription Hearing Aids (all types), but Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include coverage for eye exams with a copay between $0 and $50, and eyewear with no copay. Routine eye exams are covered with no copay for 1 visit per year, and other eye exam services are covered with no copay. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades, each with no copay, and a combined maximum of $115 per year.
Dental Services See details
The Aetna Medicare Giveback Choice (PPO) plan covers a range of dental services, including oral exams, dental x-rays, and other diagnostic services with no copay, and a yearly maximum of $1,150 for both in-network and out-of-network services. Other services like fluoride treatments, prophylaxis, and other preventive dental services are also covered with no copay, and there are no copays for restorative services, adjunctive general services, endodontics, periodontics, prosthodontics, fixed, and oral and maxillofacial surgery. Maxillofacial Prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare Giveback Choice (PPO) plan. Insulin has a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Giveback Choice (PPO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetic Devices with 20% coinsurance. Diabetic Supplies have no coinsurance, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures/tests with a copay between $0 and $95, and lab services with no copay. Radiological Services are also covered, with a copay for Medicare-covered diagnostic and therapeutic radiological services, and a coinsurance for Medicare-covered X-ray services.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Giveback Choice (PPO) plan with no copay and no coinsurance; however, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Giveback Choice (PPO) plan. The plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Giveback Choice (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include a meal benefit with no copay, while acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Additionally, Other 1 covers annual wellness exams and screening mammography with no copay, and Other 2 covers gFOBT and FIT with no copay.
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