Go Back

Aetna Medicare Eagle II (PPO)

H2293 - 012 - 0
Plan Not Rated

aetna-medicare medicare provider logo

Aetna Medicare Eagle II (PPO) is a Medicare Advantage (Part C) Plan by Aetna Medicare.

This page features plan details for 2023 Aetna Medicare Eagle II (PPO) H2293 – 012 – 0 available in Dallas and Surrounding Counties.

IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link below:
No 2024 version found. You can use the location links below to find 2024 plans in your area.

Locations

Aetna Medicare Eagle II (PPO) is offered in the following locations.

Collin County, Texas
Dallas County, Texas
Denton County, Texas

Click to see more locations

Plan Overview

Aetna Medicare Eagle II (PPO) offers the following coverage and cost-sharing.

Insurer:Aetna Medicare
Health Plan Deductible:$0.00
MOOP:$8,950 In and Out-of-network
$5,000 In-network
Drugs Covered:No

Ready to sign up for Aetna Medicare Eagle II (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Medicare Part B Give Back Benefit

The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans. 

Aetna Medicare Eagle II (PPO) qualifies for a monthly Medicare Give Back Benefit of $40.00.

Premium Reduction:$40.00

Premium Breakdown

Aetna Medicare Eagle II (PPO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.
Part B Part C Part B Give Back Total
$164.90 $0.00 $40.00 $124.90
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Aetna Medicare Eagle II (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-Network: No

Dental (comprehensive)

Diagnostic services:In-Network: $0 copay (limits may apply) (authorization required) (referral not required)
Diagnostic services:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Endodontics:In-Network: 20% coinsurance (limits may apply) (authorization required) (referral not required)
Endodontics:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Extractions:In-Network: 20-50% coinsurance (limits may apply) (authorization required) (referral not required)
Extractions:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Non-routine services:In-Network: 20-50% coinsurance (limits may apply) (authorization required) (referral not required)
Non-routine services:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Periodontics:In-Network: 20-50% coinsurance (limits may apply) (authorization required) (referral not required)
Periodontics:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services:In-Network: 50% coinsurance (limits may apply) (authorization required) (referral not required)
Prosthodontics, other oral/maxillofacial surgery, other services:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)
Restorative services:In-Network: 20-50% coinsurance (limits may apply) (authorization required) (referral not required)
Restorative services:Out-of-Network: 50-70% coinsurance (limits may apply) (authorization required) (referral not required)

Dental (preventive)

Cleaning:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Cleaning:Out-of-Network: 30% coinsurance (limits may apply) (authorization not required) (referral not required)
Dental x-ray(s):In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Dental x-ray(s):Out-of-Network: 30% coinsurance (limits may apply) (authorization not required) (referral not required)
Fluoride treatment: Not covered (no limits)
Oral exam:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Oral exam:Out-of-Network: 30% coinsurance (limits may apply) (authorization not required) (referral not required)

Diagnostic procedures/lab services/imaging

Diagnostic radiology services (e.g., MRI):In-Network: $0-375 copay (authorization required) (referral not required)
Diagnostic radiology services (e.g., MRI):Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Diagnostic tests and procedures:In-Network: $0-50 copay (authorization required) (referral not required)
Diagnostic tests and procedures:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Lab services:In-Network: $0 copay (authorization required) (referral not required)
Lab services:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient x-rays:In-Network: $40 copay (authorization required) (referral not required)
Outpatient x-rays:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Doctor visits

Primary:In-Network: $0 copay
Primary:Out-of-Network: 30% coinsurance per visit
Specialist:In-Network: $40 copay per visit (authorization not required) (referral not required)
Specialist:Out-of-Network: 30% coinsurance per visit (authorization not required) (referral not required)

Emergency care/Urgent care

Emergency: $110 copay per visit (always covered)
Urgent care: $0-60 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment:In-Network: $40 copay (authorization not required) (referral not required)
Foot exams and treatment:Out-of-Network: 30% coinsurance (authorization not required) (referral not required)
Routine foot care: Not covered

Ground ambulance

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

Health plan deductible

$0.00

Health plan deductibles (other)

In-Network: No

Hearing

Fitting/evaluation:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Fitting/evaluation:Out-of-Network: 30% coinsurance (limits may apply) (authorization not required) (referral not required)
Hearing aids:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Hearing aids:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Hearing exam:In-Network: $40 copay (authorization not required) (referral not required)
Hearing exam:Out-of-Network: 30% coinsurance (authorization not required) (referral not required)

Hospital coverage (inpatient)

In-Network: $365 per day for days 1 through 5
$0 per day for days 6 through 90 (authorization required) (referral not required)
Out-of-Network: 30% per stay (authorization required) (referral not required)

Hospital coverage (outpatient)

In-Network: $0-350 copay per visit (authorization required) (referral not required)
Out-of-Network: 30% coinsurance per visit (authorization required) (referral not required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$8,950 In and Out-of-network
$5,000 In-network

Medical equipment/supplies

Diabetes supplies:In-Network: 0-20% coinsurance per item (authorization required)
Diabetes supplies:Out-of-Network: 0-20% coinsurance per item (authorization required)
Durable medical equipment (e.g., wheelchairs, oxygen):In-Network: 20% coinsurance per item (authorization required)
Durable medical equipment (e.g., wheelchairs, oxygen):Out-of-Network: 30% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs):In-Network: 20% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs):Out-of-Network: 30% coinsurance per item (authorization required)

Medicare Part B drugs

Chemotherapy:In-Network: 20% coinsurance (authorization required)
Chemotherapy:Out-of-Network: 30% coinsurance (authorization required)
Other Part B drugs:In-Network: 20% coinsurance (authorization required)
Other Part B drugs:Out-of-Network: 30% coinsurance (authorization required)

Mental health services

Inpatient hospital – psychiatric:In-Network: $1,871 per stay (authorization required) (referral not required)
Inpatient hospital – psychiatric:Out-of-Network: 30% per stay (authorization required) (referral not required)
Outpatient group therapy visit:In-Network: $40 copay (authorization required) (referral not required)
Outpatient group therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist:In-Network: $40 copay (authorization required) (referral not required)
Outpatient group therapy visit with a psychiatrist:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient individual therapy visit:In-Network: $40 copay (authorization required) (referral not required)
Outpatient individual therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist:In-Network: $40 copay (authorization required) (referral not required)
Outpatient individual therapy visit with a psychiatrist:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Optional supplemental benefits

No

Preventive care

In-Network: $0 copay (authorization not required) (referral not required)
Out-of-Network: 0-30% coinsurance (authorization not required) (referral not required)

Rehabilitation services

Occupational therapy visit:In-Network: $40 copay (authorization required) (referral not required)
Occupational therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)
Physical therapy and speech and language therapy visit:In-Network: $40 copay (authorization required) (referral not required)
Physical therapy and speech and language therapy visit:Out-of-Network: 30% coinsurance (authorization required) (referral not required)

Skilled Nursing Facility

In-Network: $10 per day for days 1 through 20
$196 per day for days 21 through 100 (authorization required) (referral not required)
Out-of-Network: 30% per stay (authorization required) (referral not required)

Transportation

Not covered

Vision

Contact lenses:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Contact lenses:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglass frames:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglass frames:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglass lenses:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglass lenses:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglasses (frames and lenses):In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Eyeglasses (frames and lenses):Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Other:In-Network: $0 copay (no limits) (authorization not required) (referral not required)
Other:Out-of-Network: 30% coinsurance (no limits) (authorization not required) (referral not required)
Routine eye exam:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Routine eye exam:Out-of-Network: 30% coinsurance (limits may apply) (authorization not required) (referral not required)
Upgrades:In-Network: $0 copay (limits may apply) (authorization not required) (referral not required)
Upgrades:Out-of-Network: $0 copay (limits may apply) (authorization not required) (referral not required)

Wellness programs (e.g., fitness, nursing hotline)

Covered (authorization not required) (referral not required)

Ready to sign up for Aetna Medicare Eagle II (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 TTY 711.

8am – 11pm EST. 7 days a week

Table of Contents

SMID: MULTIPLAN_HCIHNDOGMED01_M

Factsonmedicare.com is a free-to-use informational website by Dog Media Solutions LLC. All insurance agents and enrollment platforms linked to this site have their own terms and conditions.

This is a promotional communication.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

HealthCompare Insurance Services does not offer every plan available in your area. Currently we represent 18 organizations, which offers 52,101 products in your area.

We do not feature every plan available in your area. Any information we provide is limited to those plans we do feature in your area. Enrollment is offered through our partners including HealthCompare Insurance Services Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

HealthCompare Insurance Services represents Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Medicare has neither approved nor endorsed any information on this site.

© All rights reserved | About | Contact | Legal and Privacy