Aetna Medicare Eagle (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

Monthly Premium

Health Portion of Premium

Drug Portion of Premium

Health Plan Deductible

Health Plan Max Out-of-Pocket

$8,000 In and Out-of-network
$5,500 In-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://www.aetnamedicare.com

Plan Link

http://www.aetnamedicare.com

Doctor Services

Primary doctor visit

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

Specialist visit

In-network: $35 copay per visit
Out-of-network: $55 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: $0-75 copay
Out-of-network: 50% coinsurance

Lab services

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

Diagnostic radiology services (like MRI)

In-network: $0-250 copay
Out-of-network: 50% coinsurance

Outpatient x-rays

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

Emergency care

$90 copay per visit (always covered)

Urgent care

$45 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: $290 per day for days 1 through 7
$0 per day for days 8 through 90
Out-of-network: 50% per stay

Outpatient hospital coverage

In-network: $0-350 copay per visit
Out-of-network: 50% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$184 per day for days 21 through 100
Out-of-network: 45% per stay

Preventive services

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

Ambulance

Ground ambulance

In-network: $290 copay
Out-of-network: $290 copay

Therapy services

Occupational therapy visit

In-network: $40 copay
Out-of-network: 50% coinsurance

Physical therapy & speech & language therapy visit

In-network: $40 copay
Out-of-network: 50% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist

In-network: $40 copay
Out-of-network: 50% coinsurance

Outpatient individual therapy with a psychiatrist

In-network: $40 copay
Out-of-network: 50% coinsurance

Outpatient group therapy visit

In-network: $40 copay
Out-of-network: 50% coinsurance

Outpatient individual therapy visit

In-network: $40 copay
Out-of-network: 50% coinsurance

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

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

Prosthetics (like braces, artificial limbs)

In-network: 20% coinsurance per item
Out-of-network: 50% coinsurance per item

Diabetes supplies

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

Chemotherapy drugs

In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Other Part B drugs

In-network: 20% coinsurance
Out-of-network: 50% coinsurance

Hearing

Hearing exam

In-network: $0 copay
Out-of-network: $55 copay

Fitting/evaluation

In-network: $0 copay
Out-of-network: $55 copay

Hearing aids - All types