Aetna Medicare Advantra Eagle (HMO-POS)

West Virginia Medicare Advantage Plan (2024 Plan)


Monthly Premium
by Aetna Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.0
out of 5 stars

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Plan Name
Aetna Medicare Advantra Eagle (HMO-POS)
Insurance Carrier
Aetna Medicare
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
HMO

Aetna Medicare Advantra Eagle (HMO-POS) is a Medicare Advantage Plan Without Prescription Drugs, which is available in West Virginia and offered by the health insurance company Aetna Medicare. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$6,900
Primary doctor visit
$0 copay
Specialist visit
$35 copay per visit
ER visit
$100 copay per visit (always covered)
Ambulance
$250 copay

Aetna Medicare Advantra Eagle (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,900 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Aetna Medicare Advantra Eagle (HMO-POS) are defined below.

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Aetna Medicare Advantra Eagle (HMO-POS) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Aetna Medicare Advantra Eagle (HMO-POS) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Aetna Medicare Advantra Eagle (HMO-POS) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Aetna Medicare Advantra Eagle (HMO-POS) received an overall government quality rating of 4.0 stars out of 5 stars.

Aetna Medicare Advantra Eagle (HMO-POS) performed worse than West Virginia’s State average overall quality score of 4.1 stars.

This Plan’s 5-star Gov’t Quality Score
West Virginia State Average Score
Overall Government 5 Star Quality Rating
 4.0
 4.1
Summary rating of health plan quality
 4
 4.2
Staying healthy: screenings, tests, & vaccines
 2
 2.9
Managing chronic (long term) conditions
 3
 3.3
Member experience with health plan
 4
 4.3
Member complaints & changes in the health plan's performance
 4
 4.4
Health plan customer service
 4
 4.7

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Aetna Medicare Advantra Eagle (HMO-POS) received 4 stars for its health plan quality score which is worse than the West Virginia State average health plan quality score of 4.2 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$6,900 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: No Data
Specialist visit
In-network: $35 copay per visit
Out-of-network: No Data

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: No Data
Lab services
In-network: $0 copay
Out-of-network: No Data
Diagnostic radiology services (like MRI)
In-network: $0-275 copay
Out-of-network: No Data
Outpatient x-rays
In-network: $15 copay
Out-of-network: No Data
Emergency care
$100 copay per visit (always covered)
Urgent care
$50 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $295 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: Not Applicable
Outpatient hospital coverage
In-network: $0-250 copay per visit
Out-of-network: No Data

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: No Data

Ambulance

Ground ambulance
In-network: $250 copay
Out-of-network: No Data

Therapy services

Occupational therapy visit
In-network: $25 copay
Out-of-network: No Data
Physical therapy & speech & language therapy visit
In-network: $25 copay
Out-of-network: No Data

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $5 copay
Out-of-network: No Data
Outpatient individual therapy with a psychiatrist
In-network: $5 copay
Out-of-network: No Data
Outpatient group therapy visit
In-network: $5 copay
Out-of-network: No Data
Outpatient individual therapy visit
In-network: $5 copay
Out-of-network: No Data

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 0-20% coinsurance per item
Out-of-network: No Data
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: No Data
Diabetes supplies
In-network: 0-20% coinsurance per item
Out-of-network: No Data

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

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: No Data
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: No Data

Hearing

Hearing exam
In-network: $35 copay
Out-of-network: No Data
Fitting/evaluation
In-network: $0 copay
Out-of-network: No Data
Hearing aids - All types
In-network: $0 copay
Out-of-network: No Data

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 50% coinsurance
Fluoride treatment
In-network: $0 copay
Out-of-network: 50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 50% coinsurance

Comprehensive dental

Non-routine services
In-network: $0 copay
Out-of-network: 50% coinsurance
Diagnostic services
In-network: $0 copay
Out-of-network: 50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Extractions
In-network: $0 copay
Out-of-network: 50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: $0 copay
Out-of-network: 50% coinsurance

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: No Data
Contact lenses
In-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: No Data
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: No Data
Upgrades
In-network: $0 copay
Out-of-network: No Data

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