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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 District of Columbia and Maryland. 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 $50.00. 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) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits range from a $0 to $35 copay, while inpatient hospital stays require a $382 daily copay for the first eight days. Emergency care is accessible with a $130 copay, which is waived upon immediate admission, and outpatient services feature copays ranging from no copay up to $382. This plan also includes valuable supplemental benefits, such as no copay for routine hearing exams, annual eye exams, and preventive dental care. Members can take advantage of a $200 annual eyewear allowance, up to $1,250 per ear annually for prescription hearing aids, and a $750 annual limit for comprehensive dental services with 20% to 50% coinsurance. Additionally, the plan provides a $60 quarterly allowance for over-the-counter items alongside a chronic illness meal benefit.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) inpatient hospital care is partially covered with no coinsurance, featuring a daily copay of $382 for days 1 through 8 for acute stays and $292 for days 1 through 8 for psychiatric stays, with no copay for additional covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Aetna Medicare Eagle Giveback (PPO) covers outpatient services with no coinsurance, featuring a $0 to $382 copay for outpatient hospital services and a $382 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay.
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 to receive this covered care.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Eagle Giveback (PPO), offering ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay with no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Primary Care services are covered by the Aetna Medicare Eagle Giveback (PPO) with no copay and no coinsurance for primary care visits, and a $0 to $35 copay with no coinsurance for specialists. Physical, occupational, and speech therapies require a $20 copay with no coinsurance, while mental health and psychiatric sessions have a $40 copay with no coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, but routine and other chiropractic services are not covered, and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by the Aetna Medicare Eagle Giveback (PPO), offering annual physical exams, screenings, and fitness benefits with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, featuring a $35 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear annually, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, featuring a $0 to $35 copay for eye exams and no copay for eyewear. The plan offers up to $50 annually for eye exams and a combined maximum benefit of $200 per year for eyewear, including contacts, lenses, and frames.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Eagle Giveback (PPO), featuring preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental for a $35 copay and no coinsurance. Comprehensive services are covered up to a $750 annual limit with no copay and 20% to 50% coinsurance, though other diagnostic services, fluoride, other preventive services, maxillofacial prosthetics, implants, 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 require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under 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 (DME), prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance 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 Aetna Medicare Eagle Giveback (PPO) with prior authorization required, featuring no coinsurance and no copay for lab services, and copays from no copay to $100 for diagnostic procedures. Radiological services require a minimum 20% coinsurance for therapeutic services, but offer outpatient x-rays with no copay and diagnostic radiological services starting at no copay.
Home Health Services See details
Aetna Medicare Eagle Giveback (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Eagle Giveback (PPO) with no coinsurance. Covered services require a copay, which is $20 for both cardiac and intensive cardiac rehabilitation, $15 for pulmonary rehabilitation, and $25 for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by the Aetna Medicare Eagle Giveback (PPO) with no coinsurance, requiring a daily copay of $10 for days 1 to 20 and $218 for days 21 to 100. Prior authorization is required, though a prior three-day hospital stay is not, and additional days beyond the standard 100-day benefit are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services with no copay and no coinsurance, although acupuncture is not covered. Covered benefits include a chronic illness meal benefit, annual wellness exams, additional cancer screenings, and up to $60 every three months for over-the-counter (OTC) items.
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