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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 Select Counties in KY. 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 $125.00. 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 $9550.00 (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 $9550.00 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 with predictable cost-sharing, including no copay for primary care physician visits and a low copay of zero to $40 for specialists. For hospital stays, members pay a $380 daily copay for the first seven days of inpatient care, while outpatient hospital services range from no copay up to $380. Emergency care is accessible with a $115 copay, which is waived upon admission, and urgent care visits require a $40 copay. Routine vision, hearing, and preventive dental services are fully covered with no copay or coinsurance, helping you manage your everyday wellness costs. The plan also provides allowances for essential health products, including a $200 annual limit for eyewear and a quarterly $100 allowance for over-the-counter items with no copay. Comprehensive dental care is also available with coinsurance ranging from 20% to 50% up to a $1,000 annual limit.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) covers inpatient acute hospital stays with no coinsurance and a $380 copay for days 1 through 7, followed by no copay for day 8 and beyond. Inpatient psychiatric care is covered with no coinsurance and a $290 copay for days 1 through 7, but upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under Aetna Medicare Eagle Giveback (PPO) feature no coinsurance, with ambulatory surgical center and blood services also offering no copay. Outpatient hospital services have a copay ranging from $0 to $380, observation services carry a $380 copay per stay, and individual or group substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization services with a copay of either $70.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by the Aetna Medicare Eagle Giveback (PPO) plan, as transportation services to plan-approved or any health-related locations are not covered. Ground ambulance services require a $280 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for both.
Emergency Services See details
Aetna Medicare Eagle Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 lifetime limit with no coinsurance and copays ranging from $115 to $280.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) offers primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Physical, occupational, mental health, and podiatry services require a $35 to $40 copay and no coinsurance, though 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 by Aetna Medicare Eagle Giveback (PPO), offering no copay and no coinsurance for annual physical exams, health education, and various screenings, while kidney disease education has no copay but a 20% coinsurance. Several supplemental services are not covered, including personal emergency response systems, weight management programs, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by the Aetna Medicare Eagle Giveback (PPO), offering routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $40 copay and no coinsurance. Prescription hearing aids are also partially covered with no copay or coinsurance up to a $1,000 annual limit per ear, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Eagle Giveback (PPO) covers vision services with no coinsurance, offering routine and diabetic eye exams with no copay and Medicare-covered exams for a $0 to $40 copay. Covered eyewear, including lenses, frames, and contacts, has no copay and is subject to a combined $200 annual maximum, while eye exams have a $50 annual limit.
Dental Services See details
Dental services are partially covered by Aetna Medicare Eagle Giveback (PPO), offering preventive care with no copay and no coinsurance, and comprehensive services with no copay and 20% to 50% coinsurance up to a $1,000 annual limit. Medicare-covered dental services require a $40 copay and no coinsurance, while fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic dental, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle Giveback (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Eagle Giveback (PPO) plan with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Eagle Giveback (PPO) with no copays, and coinsurance ranging from no coinsurance to 20% for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Eagle Giveback (PPO) and require prior authorization. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $75 copay for diagnostic procedures, while radiological services include a $10 copay for X-rays, no copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
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 under the Aetna Medicare Eagle Giveback (PPO) feature no coinsurance, and while some services are covered, specific programs including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require copayments ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers skilled nursing facility (SNF) care with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior hospital stay is not needed, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services with no copay and no coinsurance, including up to $100 every three months for over-the-counter items, annual wellness exams, and additional colorectal screenings (gFOBT and FIT). Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this benefit.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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