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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 New Jersey Counties: All. 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 $75.00. 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 $13900.00 (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 $13900.00 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 comprehensive coverage with no copay and no coinsurance for primary care physician visits, annual physical exams, and fitness benefits. Specialist visits require no copay to a $35 copay, while outpatient hospital services feature no coinsurance and copays ranging from no copay up to $500. Inpatient hospital stays require a $395 daily copay for days one through six, after which there is no copay. For extra wellness needs, the plan provides preventive and comprehensive dental care with no copay and no coinsurance up to a $1,500 annual maximum, alongside routine vision and hearing exams with no copay. Eyewear is covered with no copay up to a $200 annual limit, and prescription hearing aids are covered with copays up to $1,700. Emergency services are also covered worldwide with a $115 copay, which is waived if you are admitted to the hospital.
Inpatient Hospital See details
Aetna Medicare Eagle Giveback (PPO) partially covers inpatient hospital services with no coinsurance and prior authorization required, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. Acute stays require a $395 daily copay for days 1 to 6 and no copay for day 7 and beyond, while psychiatric stays incur a $407 daily copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Eagle Giveback (PPO) with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay ranging from $0 to $500, observation services have a $395 copay per stay, and outpatient substance abuse sessions carry a $35 copay.
Partial Hospitalization See details
Aetna Medicare Eagle Giveback (PPO) covers partial hospitalization with a copay of either $60.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Eagle Giveback (PPO) covers Medicare-approved ground and air ambulance services with a $300 copay and no coinsurance, subject to prior authorization. Other transportation services to health-related locations are not covered under this plan.
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, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum benefit with no coinsurance and copays ranging from $115 to $300.
Primary Care See details
Aetna Medicare Eagle Giveback (PPO) features primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $35 copay and no coinsurance. Other outpatient services like physical, occupational, psychiatric, and mental health therapies require a $35 copay and no coinsurance, while telehealth has a $0 to $40 copay and 20% coinsurance. Podiatry is not covered, and though some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Eagle Giveback (PPO) offers preventive services with no copay and no coinsurance for annual physical exams, wellness screenings, and fitness benefits, while kidney disease education has a 20% coinsurance and no copay. This partially covered benefit also includes health education and chemotherapy wigs up to $400 annually with no copay or coinsurance, but excludes in-home safety assessments, personal emergency response systems, and weight management programs.
Hearing Services See details
Aetna Medicare Eagle Giveback (PPO) covers hearing services with no deductible, offering Medicare-covered exams for a $35 copay and routine exams or fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays up to $1,700 for up to two devices per year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services covered by the Aetna Medicare Eagle Giveback (PPO) feature no deductibles and no coinsurance, offering routine eye exams and eyewear with no copay. There is a $50 annual maximum benefit for eye exams, which have a copay of $0 to $35, and a $200 annual combined maximum benefit for eyewear.
Dental Services See details
Aetna Medicare Eagle Giveback (PPO) offers partially covered dental services with an annual maximum benefit of $1,500 for both in- and out-of-network care. Medicare-covered dental services require a $35 copay and no coinsurance, while other covered preventive and comprehensive services have no copay and no coinsurance, though maxillofacial prosthetics, implant services, 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 and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and 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. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Eagle Giveback (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay 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 under the Aetna Medicare Eagle Giveback (PPO) with prior authorization required, featuring no coinsurance and no copay for lab services and diagnostic radiology. Diagnostic procedures and tests have a copay ranging from $0 to $35, outpatient X-rays require a $35 copay, and therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
Aetna Medicare Eagle Giveback (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered with no coinsurance under the Aetna Medicare Eagle Giveback (PPO), but in practice, sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and carry copays of $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Eagle Giveback (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Eagle Giveback (PPO) partially covers other services, which includes over-the-counter items up to sixty dollars every three months, chronic illness meal benefits, annual wellness exams, and select colorectal screenings with no copay and no coinsurance. Acupuncture is not covered under this plan.
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