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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 New Orleans and Baton Rouge Parishes. 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 $77.00. 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 the deductible is met, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For drugs in the preferred generic tier, you will pay no copay at preferred pharmacies and preferred mail order, and a $12 copay at standard pharmacies and standard mail order. For other tiers, you will pay coinsurance of 24% or 25%, depending on the drug. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your prescriptions.
Additional Benefits
The Aetna Medicare Giveback Choice (PPO) plan offers comprehensive coverage, including inpatient and outpatient hospital services, with varying copays depending on the specific service. The plan also covers primary care, specialist visits, mental health services, and physical therapy with copays. Additionally, the plan includes coverage for preventive services, hearing and vision services, dental services, and home health services. This plan provides additional benefits such as ambulance services, emergency services, and medical equipment, with costs varying based on the service. Other notable benefits include no copay for many preventive services, prescription hearing aids, and eyewear. However, it's important to note that some services like cardiac rehabilitation, certain dental procedures, and some transportation services are not covered.
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 copay of $345 for days 1-7 and no copay for days 8-90. For Inpatient Hospital Psychiatric, you will pay a copay of $407 for days 1-5 and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Aetna Medicare Giveback Choice (PPO) plan, with copays ranging from $0 to $345 depending on the service. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse each have a copay of $30.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Giveback Choice (PPO) plan, with a $80 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Giveback Choice (PPO) plan. Ground ambulance services have a $295 copay, and air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Aetna Medicare Giveback Choice (PPO) plan. Emergency Services have a $110 copay with no coinsurance, Urgently Needed Services have a $45 copay with no coinsurance, and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation all have copays of $110, $110, and $295, respectively, with no coinsurance.
Primary Care See details
The Aetna Medicare Giveback Choice (PPO) plan covers primary care physician services with a $5 copay, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, and specialist services with a $5 - $50 copay. Mental health and psychiatric services, including individual and group sessions, have a $30 copay. Physical therapy and speech-language pathology services have a $25 copay, and additional telehealth benefits have a 20% coinsurance and a $0 - $50 copay. Opioid treatment program services have a $30 copay. Podiatry services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive Services includes coverage for Medicare-covered zero dollar preventive services, annual physical exams with no copay, and additional preventive services. Kidney Disease Education Services are covered with a 20% coinsurance, and other preventive services are covered with no copay for glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit.
Hearing Services See details
Hearing Services includes routine hearing exams with a $50 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, while OTC hearing aids, and inner, outer, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
The Aetna Medicare Giveback Choice (PPO) plan covers vision services, including eye exams with a copay between $0 and $50, and eyewear with no copay. Eyewear has a combined maximum benefit of $120 every year for both in-network and out-of-network services.
Dental Services See details
Dental services are covered, with a $50 copay for Medicare dental services, and a $1,000 annual maximum for other dental services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventative dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. However, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with prior authorization required. Medicare Part B Insulin Drugs have 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 by the Aetna Medicare Giveback Choice (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Giveback Choice (PPO), including Durable Medical Equipment (DME) with 20% coinsurance and Prosthetics/Medical Supplies with 20% coinsurance. Diabetic Equipment is also covered, with coinsurance and copay information available in the plan details.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Aetna Medicare Giveback Choice (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $300, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $5 copay.
Home Health Services See details
Home Health Services are covered under 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 any of the sub-services, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and 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. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services include meal benefits with no copay, and other services such as annual wellness exams and screening mammography, and gFOBT and FIT, also with no copay. Acupuncture, over-the-counter items, Dual Eligible SNPs, 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.
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