Aetna Medicare Eagle Plan (PPO)

Medicare Plan Details (2022 Plan)


Monthly Premium

 

by Aetna Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.5
out of 5 stars

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Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$0
$0
$0
$0
$11,300 In and Out-of-network
$5,500 In-network
No
Yes
Yes
Yes

Doctor Services

In-network: $0 copay
Out-of-network: $25 copay per visit
In-network: $30 copay per visit
Out-of-network: $50 copay per visit

Tests, labs, & imaging

In-network: $0-95 copay
Out-of-network: 35% coinsurance
In-network: $0 copay
Out-of-network: 35% coinsurance
In-network: $0-200 copay
Out-of-network: 35% coinsurance
In-network: $0-35 copay
Out-of-network: 35% coinsurance
$90 copay per visit (always covered)
$50 copay per visit (always covered)

Hospital Services

In-network: $225 per day for days 1 through 7
$0 per day for days 8 through 90
Out-of-network: 35% per stay
In-network: $0-195 copay per visit
Out-of-network: 35% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$188 per day for days 21 through 100
Out-of-network: 35% per stay

Preventive services

In-network: $0 copay
Out-of-network: $0 copay

Ambulance

In-network: $270 copay
Out-of-network: $270 copay

Therapy services

In-network: $20 copay
Out-of-network: $50 copay
In-network: $20 copay
Out-of-network: $50 copay

Mental health services

In-network: $30 copay
Out-of-network: $50 copay
In-network: $30 copay
Out-of-network: $50 copay
In-network: $30 copay
Out-of-network: $50 copay
In-network: $30 copay
Out-of-network: $50 copay

Opioid treatment services

Covered

Other services

In-network: 20% coinsurance per item
Out-of-network: 25% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 35% coinsurance per item
In-network: 0-20% coinsurance per item
Out-of-network: 0-20% coinsurance per item

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

In-network: 20% coinsurance
Out-of-network: 35% coinsurance
In-network: 20% coinsurance
Out-of-network: 35% coinsurance

Hearing

In-network: $30 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $0 copay

Preventive Dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Vision

In-network: $0 copay
Out-of-network: $50 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Other benefits

Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4.5
 5
 4
 4
 4
 5

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