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Aetna Medicare Eagle (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Eagle (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Eagle (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Eagle (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Nebraska. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Eagle (HMO-POS) 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 (HMO-POS).
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 (HMO-POS), 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 $90.00. 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 Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 (HMO-POS).
Additional Benefits
Aetna Medicare Eagle (HMO-POS) offers robust medical coverage with no copay for primary care physician visits, routine preventive services, and annual vision or hearing exams. Specialist visits require a $40 copay, while inpatient hospital stays feature no coinsurance and a $325 daily copay for the first six days of care. Supplemental benefits include dental coverage with no copay up to a $1,500 annual limit, plus a $200 annual allowance for eyewear and a $1,250 annual limit per ear for prescription hearing aids. Members also receive up to $90 every three months for over-the-counter items and enjoy no copays for home health care services.
Inpatient Hospital See details
Aetna Medicare Eagle (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1-6 of acute care and a $370 daily copay for days 1-5 of psychiatric care, with no copay for subsequent days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Eagle (HMO-POS) with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $325 for outpatient hospital services, $325 per stay for observation services, and $40 per session for outpatient substance abuse services, with prior authorization required for most care.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Eagle (HMO-POS) with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Eagle (HMO-POS) covers ambulance services with prior authorization, requiring a $320 copay for ground transport and a 20% coinsurance for air transport, with no other copays or coinsurance. Transportation services are not covered in practice, as trips to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Eagle (HMO-POS) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered with a $130 copay, and worldwide emergency transportation carries a $320 copay, up to a $250,000 maximum benefit with no coinsurance.
Primary Care See details
Aetna Medicare Eagle (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits, physical and occupational therapy, and mental health services require a $40 copay and no coinsurance. Podiatry and chiropractic services are not covered, but telehealth benefits are available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Eagle (HMO-POS) plan, with most covered services—such as annual physicals, glaucoma screenings, and diabetes self-management—carrying no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Covered supplemental benefits like fitness and remote access technologies have no copay and no coinsurance, but wigs for hair loss are subject to a $400 annual limit. Sub-services that are not covered include in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home/bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Eagle (HMO-POS) covers hearing exams and fitting evaluations annually with no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 maximum per ear yearly, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Aetna Medicare Eagle (HMO-POS) covers vision services with no copay, no coinsurance, and no deductible, including one routine eye exam per year and follow-up diabetic eye exams. Eyewear, including contact lenses, eyeglasses, and upgrades, is also covered with no copay or coinsurance up to a $200 combined maximum limit per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Eagle (HMO-POS), featuring no copay and no coinsurance for most preventive and comprehensive care up to a $1,500 annual maximum. Medicare-covered dental services require a $40 copay and no coinsurance, but maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Eagle (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy and other Part B drugs are covered with a 0% to 20% coinsurance, while Medicare Part B insulin drugs have a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Eagle (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Eagle (HMO-POS) with no copay, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies require between no coinsurance and 20% coinsurance, while prosthetic devices and diabetic therapeutic shoes or inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under Aetna Medicare Eagle (HMO-POS) with prior authorization, featuring no coinsurance and a $0 to $20 copay for diagnostic tests, and no copay or coinsurance for lab services. Outpatient X-rays require a $10 copay and coinsurance, diagnostic radiology has no copay, and therapeutic radiology requires a copay alongside a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Eagle (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Eagle (HMO-POS) with no copay and no coinsurance. Although some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy for peripheral artery disease are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Eagle (HMO-POS) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not necessary for admission, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Eagle (HMO-POS), featuring no copay and no coinsurance for wellness exams, screening mammographies, additional gFOBT and FIT, chronic illness meal benefits, and up to $90 every three months in over-the-counter item reimbursements. Acupuncture is not covered under this plan.
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