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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 2025, 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 4.5 out of 5 stars in 2025.
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
The Aetna Medicare Eagle (HMO-POS) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, while outpatient services have copays ranging from $0 to $325. Emergency services have copays, and ambulance services have a copay or coinsurance. Primary care and preventive services have no copays, while specialist visits have a $40 copay. Vision and hearing services, including exams and eyewear, have no copays. Dental services have no copay for many services, with a $1,500 annual maximum. The plan covers home health services with no copay, and offers over-the-counter items and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a copay of $325 for days 1-6, and no copay for days 7-90, with no coinsurance. For Inpatient Hospital Psychiatric, you will pay a copay of $370 for days 1-5, and no copay for days 6-90, with no coinsurance. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, are covered by the Aetna Medicare Eagle (HMO-POS) plan, with copays ranging from $0 to $325. Observation services have a $325 copay, while Ambulatory Surgical Center (ASC) Services have no copay. Outpatient Substance Abuse Services have a $40 copay for both individual and group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Eagle (HMO-POS) plan with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Eagle (HMO-POS) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $320 copay, and air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Services, Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are covered by the Aetna Medicare Eagle (HMO-POS) plan. Emergency Services and Worldwide Emergency Coverage have a $125 copay, Urgently Needed Services has a $50 copay, and Worldwide Emergency Transportation has a $320 copay; all have no coinsurance.
Primary Care See details
The Aetna Medicare Eagle (HMO-POS) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $40 copay, and physician specialist services with a $40 copay. Mental health and psychiatric services, physical therapy, and speech-language pathology services have a $40 copay, and additional telehealth benefits have a 20% coinsurance with a copay between $0 and $50. Opioid treatment program services have a $40 copay, and podiatry services are not covered.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, while services such as In-Home Safety Assessment, Personal Emergency Response System, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, In-Home Support Services, and Support for Caregivers of Enrollees are not covered. Kidney Disease Education Services have a 20% coinsurance, and services such as Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit have no copay.
Hearing Services See details
Hearing services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Hearing exams and routine hearing exams have no copay, and fitting/evaluation for hearing aids has no copay; prescription hearing aids have a maximum plan benefit of $1,250 per year and no copay for two visits.
Vision Services See details
The Aetna Medicare Eagle (HMO-POS) plan covers vision services, including eye exams and eyewear. Eye exams and eyewear have no copay, and routine eye exams are covered once per year. Eyewear has a combined maximum benefit of $200 per year.
Dental Services See details
The Aetna Medicare Eagle (HMO-POS) plan offers dental services, with a $1,500 annual maximum. Medicare Dental Services have a $40 copay, while oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery have no copay. Maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Aetna Medicare Eagle (HMO-POS) plan. The plan has a $35 copay for Medicare Part B Insulin Drugs, and the coinsurance for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs ranges from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Eagle (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the Aetna Medicare Eagle (HMO-POS) plan, with Durable Medical Equipment (DME) subject to a 0-20% coinsurance and Diabetic Supplies subject to a 0-20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance.
Diagnostic and Radiological Services See details
The Aetna Medicare Eagle (HMO-POS) plan covers diagnostic and radiological services. Diagnostic Procedures/Tests have a copay between $0 and $20, while Lab Services have no copay. Diagnostic Radiological Services have a copay of at most $150, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $10 copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Eagle (HMO-POS) plan with no copay and no coinsurance. 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 Eagle (HMO-POS) plan. The plan does not cover any services in this category.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare Eagle (HMO-POS) 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
The Aetna Medicare Eagle (HMO-POS) plan covers Over-the-Counter (OTC) items with no copay, and a maximum benefit coverage amount of $90 every three months. The plan also covers meal benefits with no copay. Other services, including acupuncture, are not covered.
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