2027 Medicare Advantage plan

Aetna Medicare Advantra Eagle Plus (HMO-POS): 2027 benefits and costs

Aetna Medicare HMO-POS

CMS plan ID: H3959-041-0 · Plan year: 2027

Aetna Medicare Advantra Eagle Plus (HMO-POS) is a 2027 Medicare Advantage plan offered by Aetna Medicare. It is listed in Pennsylvania.

2027 plan costs at a glance

Monthly plan premium$0.00

In-network medical out-of-pocket maximum$5,500.00

Organization: Aetna Medicare
Plan organization: AETNA HEALTH INC. (PA)
Parent company: CVS Health Corporation
Plan type: HMO-POS
Part C premium: $0.00
Prescription drug coverage: No
2027 CMS Star Rating

Standard monthly Medicare Part B premium: $209.50 (estimated)
Monthly Part B premium after plan reduction: $74.50 (estimated)$209.50 standard premium less $135.00 plan reduction.

You must continue to pay your Medicare Part B premium.

In-network medical deductible: None
Combined in/out-of-network medical deductible: None
Out-of-network medical deductible: None
In-network medical maximum: $5,500.00
Applies to certain in-network supplemental services.
Combined in/out-of-network medical maximum: Not applicable
Out-of-network medical maximum: Not applicable

Part B premium reduction: $135.00

2027 benefit summary

Doctor visits and medical care

Common medical services and member costs
Service	In-network	What to know
Primary care doctor	$0.00 copay Service-specific deductible No
Specialist visit	$10.00 copay Service-specific deductible No	Approval required No Referral required No
Telehealth	$0.00 to $50.00 copay; 20% coinsurance Service-specific deductible No	Approval required Yes Referral required No
Emergency care	$130.00 copay
Urgent care	$50.00 copay
Home health	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Dialysis	20% coinsurance Service-specific deductible No	Approval required Yes Referral required No
Part B chemotherapy and radiation drugs	0% to 20% coinsurance Deductible applies No	Approval required Yes
Other Part B drugs	0% to 20% coinsurance Deductible applies No	Approval required Yes
Kidney disease education services	20% coinsurance Service-specific deductible No	Approval required No Referral required No
Medicare-covered chiropractic	$15.00 copay Service-specific deductible No	Approval required No Referral required No
Medicare-covered foot care	$10.00 copay Service-specific deductible No	Approval required No Referral required No
Other health professionals	$0.00 to $10.00 copay Service-specific deductible No	Approval required No Referral required No

Hospital, outpatient surgery and observation care

Inpatient stays and skilled nursing care

In-network stays. Charges can depend on the number of days and the benefit period.
Care	Your share of the cost	What to know
Inpatient hospital stay	$495.00 copay per stay	Approval required Yes Referral required No Benefit period Per Admission or Per Stay
Inpatient mental health care	$0.00 copay per stay Days 1–9: $176.00 copay per day Days 10–90: $0.00 copay per day	Approval required Yes Referral required No Benefit period Per Admission or Per Stay
Skilled nursing facility	Days 1–20: $10.00 copay per day Days 21–100: $221.00 copay per day	Approval required Yes Referral required No Benefit period Original Medicare

See plan documents for out-of-network hospital and skilled nursing costs.

Hospital, outpatient surgery and observation care and member costs
Service	In-network	What to know
Outpatient hospital care	$0.00 to $250.00 copay Service-specific deductible No
Hospital observation services	$250.00 copay Service-specific deductible No
Ambulatory surgical center	$0.00 to $200.00 copay Service-specific deductible No	Approval required Yes Referral required No
Outpatient blood	$0.00 copay Service-specific deductible No	Approval required No Referral required No

Tests, imaging and laboratory services

Tests, imaging and laboratory services and member costs
Service	In-network	What to know
Diagnostic procedures and tests	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Laboratory services	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Diagnostic radiology (CT, MRI)	$0.00 to $275.00 copay Service-specific deductible No	Approval required Yes Referral required No
Therapeutic radiology	20% coinsurance Service-specific deductible No	Approval required Yes Referral required No
X-rays	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No

Mental health and substance use treatment

Mental health and substance use treatment and member costs
Service	In-network	What to know
Partial hospitalization	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Intensive outpatient program	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Substance use treatment, individual sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Substance use treatment, group sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Opioid treatment program	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Mental health, individual sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Mental health, group sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Psychiatry, individual sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No
Psychiatry, group sessions	$0.00 copay Service-specific deductible No	Approval required Yes Referral required No

Therapy and rehabilitation

Therapy and rehabilitation and member costs
Service	In-network	What to know
Occupational therapy	$10.00 copay Service-specific deductible No	Approval required No Referral required No
Physical and speech therapy	$10.00 copay Service-specific deductible No	Approval required No Referral required No
Cardiac rehabilitation	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Intensive cardiac rehabilitation	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Pulmonary rehabilitation	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Supervised exercise for peripheral artery disease	$0.00 copay Service-specific deductible No	Approval required No Referral required No

Ambulance, medical equipment and supplies

Ambulance, medical equipment and supplies and member costs
Service	In-network	What to know
Ground ambulance	$250.00 copay Service-specific deductible No	Approval required Yes
Air ambulance	20% coinsurance Service-specific deductible No	Approval required Yes
Durable medical equipment	20% coinsurance Service-specific deductible No	Approval required Yes
Prosthetic devices	20% coinsurance Service-specific deductible No	Approval required Yes
Medical supplies	0% to 20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic supplies	0% to 20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic shoes and inserts	20% coinsurance Service-specific deductible No	Approval required Yes
Diabetic monitors	0% to 20% coinsurance Service-specific deductible No	Approval required Yes

Dental benefits

Dental benefits and member costs
Service	In-network	Point-of-service
Medicare-covered dental	$10.00 copay	Not summarized. Check coverage with the plan.
Oral examsAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Dental X-raysAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Other diagnostic dentalAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Dental cleaningAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
FluorideAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Other preventive dentalAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Restorative dental careAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Root canal treatment (endodontics)Additional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Gum treatment (periodontics)Additional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Removable dentures (prosthodontics)Additional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Fixed dental restorations (prosthodontics)Additional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Oral surgeryAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No
Other dental servicesAdditional plan benefit	$0.00 copay	50% coinsurance Deductible applies No Dollar benefit limit applies No

Vision benefits

Vision benefits and member costs
Service	In-network	What to know
Medicare-covered eye exams	$0.00 to $10.00 copay Service-specific deductible No	Approval required No Referral required No
Routine eye examsAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Medicare-covered eyewear	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Contact lensesAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Eyeglasses, lenses and framesAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Eyeglass lensesAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Eyeglass framesAdditional plan benefit	$0.00 copay	Approval required No Referral required No

Hearing benefits

Hearing benefits and member costs
Service	In-network	What to know
Medicare-covered hearing exams	$10.00 copay Service-specific deductible No	Approval required No Referral required No
Routine hearing examsAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Hearing aid fitting and evaluationAdditional plan benefit	$0.00 copay	Approval required No Referral required No
Prescription hearing aids (all types)Additional plan benefit	$0.00 copay Service-specific deductible No	Approval required No Referral required No

Extra benefits

Extra benefits and member costs
Service	In-network	What to know
Over-the-counter health itemsAdditional plan benefit	$0.00 copay Service-specific deductible No
Limited-duration mealsAdditional plan benefit	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Annual physical examAdditional plan benefit	$0.00 copay Service-specific deductible No	Approval required No Referral required No
Fitness benefitAdditional plan benefit	$0.00 copay Service-specific deductible No	Approval required No Referral required No

Allowances and optional benefits

Benefits for qualifying members

Cancer Care

The plan must confirm eligibility, including any qualifying condition.

Qualifying conditions: Other 1
Qualifying conditions: Cancer
To qualify: High value provider
Covered package services cost $0 until the package limit is reached: No
Benefits that apply to reduced cost sharing: Medicare-covered benefits
Medicare benefits that apply to reduced cost sharing: Physician Specialist Services; Additional Telehealth Benefits
Does your MA Uniformity Flexibility/SSBCI cost reduction cover all or some Specialists under Physician Specialist Services?: Some specialists
Applies to out-of-network or point-of-service care: No
Some package benefits are exempt from the deductible: Yes
Benefits that apply to being exempt from the plan-level deductible: Medicare-covered benefits
Medicare benefits that are exempt from the plan level deductible: Physician Specialist Services; Additional Telehealth Benefits
Do you offer reduced Coinsurance?: No
Service-specific deductible: No
Reduced Copayment?: Yes
Types of benefits that apply to the copayment cost sharing: Medicare-covered benefits
Medicare-covered benefits that will receive reduced Copayment: Additional Telehealth Benefits
Minimum Copayment for Additional Telehealth Benefits: $0.00
Maximum Copayment for Additional Telehealth Benefits: $0.00
Specialists reduced coinsurance?: No
Specialists reduced copayment?: Yes
Specialists with the reduced copayment: Oncology - Medical, Surgical; Oncology - Radiation/Radiation Oncology
Minimum Copayment Amount for Oncology - Medical, Surgical: $0.00
Maximum Copayment Amount for Oncology - Medical, Surgical: $0.00
Minimum Copayment Amount for Oncology - Radiation/Radiation Oncology: $0.00
Maximum Copayment Amount for Oncology - Radiation/Radiation Oncology: $0.00

Full package terms are not summarized here.

SSBCI Pkg

The plan must confirm eligibility, including any qualifying condition.

Qualifying conditions: Chronic alcohol use disorder and other substance use disorders (SUDs); Autoimmune disorders; Cancer; Cardiovascular disorders; Chronic heart failure; Dementia; Diabetes mellitus; Overweight, obesity, and metabolic syndrome; Chronic gastrointestinal disease; Chronic kidney disease (CKD); Severe hematologic disorders; HIV/AIDS; Chronic lung disorders; Chronic and disabling mental health conditions; Neurologic disorders; Stroke; Post-organ transplantation; Immunodeficiency and Immunosuppressive disorders; Conditions associated with cognitive impairment; Conditions with functional challenges; Chronic conditions that impair vision, hearing (deafness), taste, touch, and smell; Conditions that require continued therapy services in order for individuals to maintain or retain functioning; Other 1; Other 2; Other 3; Other 4
Qualifying conditions: Anemia
Qualifying conditions: Chronic Hyperlipidemia
Qualifying conditions: Chronic Hypertension
Qualifying conditions: Chronic Pain
Included services: Transportation to health-related locations; Over-the-counter health items; Food and produce; Transportation for non-medical needs; Support for daily living; Other 1 Non-Primarily Health Related Benefit
Applies to out-of-network or point-of-service care: No
Some package benefits are exempt from the deductible: Yes
Services exempt from the deductible: Transportation to health-related locations; Over-the-counter health items; Food and produce; Transportation for non-medical needs; Support for daily living; Other 1 Non-Primarily Health Related Benefit
Package limit: $175.00
How often this limit applies: Every three months
How benefits are provided: Debit Card
Services sharing the package limit: Transportation to health-related locations; Over-the-counter health items; Food and produce; Transportation for non-medical needs; Support for daily living; Other 1 Non-Primarily Health Related Benefit

Full package terms are not summarized here.

Prescription drug coverage

This plan does not include a Part D prescription drug benefit.

Where this plan is offered

CMS lists this plan in 1 state or territory. Availability can vary by county and ZIP code.

View all locations 62 county listings across 1 state or territory