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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 MS. 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 $590.00 deductible for prescription drugs. After meeting your deductible, you'll pay either a copay or coinsurance depending on the drug tier and pharmacy you use. For preferred generic drugs, you will have no copay at preferred and mail-order pharmacies, and a $12.00 copay at standard pharmacies. For other tiers, you will pay coinsurance of 24% or 25%. Once your total drug costs reach $2000.00, you enter the catastrophic coverage phase, where you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare Giveback Choice (PPO) plan offers a range of benefits with varying costs. This plan provides coverage for inpatient hospital stays with copays, outpatient services with copays, and services like ambulance, emergency, and primary care visits, all with associated copays and coinsurance. Preventive services, routine vision exams, eyewear, and many dental services are available with no copay. Additional benefits include hearing exams, prescription hearing aids, and home health services, each with different costs or coverage limits. The plan also covers durable medical equipment, diagnostic services, and skilled nursing facility stays with copays or coinsurance. Some services, such as cardiac rehabilitation, are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits with the Aetna Medicare Giveback Choice (PPO) plan include coverage for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services. For Inpatient Hospital-Acute, you'll pay a $375 copay for days 1-7, and no copay for days 8-90; and for Inpatient Hospital Psychiatric, you'll 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, but 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 not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, and outpatient blood services, are covered. Outpatient hospital services have a copay between $0 and $375, observation services have a copay of $375, and outpatient blood services have no copay. Ambulatory Surgical Center (ASC) Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse 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, while Air Ambulance Services have a 20% coinsurance, and Transportation Services are not covered.
Emergency Services See details
Emergency Services are covered under the Aetna Medicare Giveback Choice (PPO) plan. Emergency services have a $110 copay with no coinsurance, while urgently needed services have a $45 copay with no coinsurance. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered with copays of $110 and $295 respectively, and no coinsurance.
Primary Care See details
The Aetna Medicare Giveback Choice (PPO) plan covers primary care physician services for a $5 copay, chiropractic services for a $15 copay, and occupational therapy with a $25 copay. It also covers physician specialist services with a copay between $5 and $50, mental health services and psychiatric services with a $30 copay for individual and group sessions, and physical therapy and speech-language pathology services for a $25 copay. Additional telehealth benefits are covered with a 20% coinsurance and a copay between $0 and $50. Opioid treatment program services are covered with a $30 copay. Podiatry services are not covered, and routine chiropractic care is not covered.
Preventive Services See details
Preventive Services, including Medicare-covered services, are covered with no copay. Annual physical exams and additional preventive services are covered with no copay. Kidney Disease Education Services are covered with 20% coinsurance.
Hearing Services See details
Hearing Services include hearing exams with a $50 copay, and Routine Hearing Exams and Fitting/Evaluation for Hearing Aid with no copay. Prescription Hearing Aids (all types) are covered with a maximum benefit of $500 per ear, and 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
The Aetna Medicare Giveback Choice (PPO) plan covers vision services, including eye exams with a copay ranging from $0 to $50, and eyewear with no copay, and a combined maximum benefit of $140 per year. The plan offers no copay for routine eye exams, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
The Aetna Medicare Giveback Choice (PPO) plan covers dental services, including oral exams, dental x-rays, other diagnostic services, cleanings, fluoride treatments, other preventive services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery with no copay, but does not cover maxillofacial prosthetics, implant services, or orthodontics. There is a $50 copay for Medicare dental services. There is a $1,000 maximum plan benefit per year for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare Giveback Choice (PPO) plan. 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 under the Aetna Medicare Giveback Choice (PPO) plan. This plan requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 17% coinsurance and requires authorization, but Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 17% coinsurance. Medical Supplies have a 17% coinsurance. Diabetic Supplies have between 0% and 20% coinsurance, while Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
The Aetna Medicare Giveback Choice (PPO) plan covers diagnostic and radiological services, including diagnostic procedures and tests with a copay between $0 and $95, and lab services with no copay. Radiological services are covered with a maximum copay of $300 for diagnostic services, 20% coinsurance for therapeutic services, and a $5 copay for outpatient 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 also does not cover 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. You will have no copay for days 1-20, and a $214 copay per day for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other services covered by the Aetna Medicare Giveback Choice (PPO) plan include a meal benefit, annual wellness exam, screening mammography, and gFOBT/FIT, all with no copay. Acupuncture, over-the-counter items, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and many other services are not covered.
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