2027 Medicare Advantage plan
Aetna Medicare Eagle (PPO): 2027 benefits and costs
Aetna Medicare PPO
CMS plan ID: H3288-051-0 · Plan year: 2027
Aetna Medicare Eagle (PPO) is a 2027 Medicare Advantage plan offered by Aetna Medicare. It is listed in Oklahoma, Texas.
2027 plan costs at a glance
- Organization
- Aetna Medicare
- Plan organization
- AETNA HEALTH AND LIFE INSURANCE COMPANY
- Parent company
- CVS Health Corporation
- Plan type
- PPO
- 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
- $99.50 (estimated)$209.50 standard premium less $110.00 plan reduction.
You must continue to pay your Medicare Part B premium.
- Annual medical deductible
- None
- In-network medical maximum
- $4,900.00
Applies to certain in-network supplemental services.
- Combined in/out-of-network medical maximum
- $8,950.00
Applies to certain out-of-network supplemental services and certain in-network supplemental services.
- Out-of-network medical maximum
- Not applicable
- Part B premium reduction
- $110.00
2027 benefit summary
Doctor visits and medical care
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Primary care doctor | $0.00 copay
| 30% coinsurance
| |
| Specialist visit | $0.00 to $40.00 copay
| 30% coinsurance
|
|
| Telehealth | $0.00 to $50.00 copay; 20% coinsurance
| Not summarized. Check coverage with the plan. |
|
| Emergency care | $130.00 copay | Not summarized. Check coverage with the plan. | |
| Urgent care | $50.00 copay | Not summarized. Check coverage with the plan. | |
| Home health | $0.00 copay
| 30% coinsurance
|
|
| Dialysis | 20% coinsurance
| 50% coinsurance
|
|
| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
| 30% coinsurance
|
|
| Other Part B drugs | 0% to 20% coinsurance
| 30% coinsurance
|
|
| Kidney disease education services | 20% coinsurance
| 30% coinsurance
|
|
| Medicare-covered chiropractic | $15.00 copay
| 30% coinsurance
|
|
| Medicare-covered foot care | $40.00 copay
| 30% coinsurance
|
|
| Other health professionals | $0.00 to $40.00 copay
| 0% to 30% coinsurance
|
|
Hospital, outpatient surgery and observation care
Inpatient stays and skilled nursing care
| Care | Your share of the cost | What to know |
|---|---|---|
| Inpatient hospital stay | $0.00 copay per stay Days 1–6: $445.00 copay per day Days 7–90: $0.00 copay per day |
|
| Inpatient mental health care | $0.00 copay per stay Days 1–6: $375.00 copay per day Days 7–90: $0.00 copay per day |
|
| Skilled nursing facility | Days 1–20: $10.00 copay per day Days 21–100: $221.00 copay per day |
|
See plan documents for out-of-network hospital and skilled nursing costs.
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Outpatient hospital care | $0.00 to $400.00 copay
| 30% coinsurance
| |
| Hospital observation services | $445.00 copay
| 30% coinsurance
| |
| Ambulatory surgical center | $0.00 to $350.00 copay
| 30% coinsurance
|
|
| Outpatient blood | $0.00 copay
| 30% coinsurance
|
|
Tests, imaging and laboratory services
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Diagnostic procedures and tests | $0.00 to $50.00 copay
| 30% coinsurance
|
|
| Laboratory services | $0.00 copay
| 30% coinsurance
|
|
| Diagnostic radiology (CT, MRI) | $0.00 to $250.00 copay
| 30% coinsurance
|
|
| Therapeutic radiology | 20% coinsurance
| 30% coinsurance
|
|
| X-rays | $0.00 to $40.00 copay
| 30% coinsurance
|
|
Mental health and substance use treatment
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Partial hospitalization | $85.00 copay
| 30% coinsurance
|
|
| Intensive outpatient program | $85.00 copay
| 30% coinsurance
|
|
| Substance use treatment, individual sessions | $40.00 copay
| 30% coinsurance
|
|
| Substance use treatment, group sessions | $40.00 copay
| 30% coinsurance
|
|
| Opioid treatment program | $40.00 copay
| 30% coinsurance
|
|
| Mental health, individual sessions | $40.00 copay
| 30% coinsurance
|
|
| Mental health, group sessions | $40.00 copay
| 30% coinsurance
|
|
| Psychiatry, individual sessions | $40.00 copay
| 30% coinsurance
|
|
| Psychiatry, group sessions | $40.00 copay
| 30% coinsurance
|
|
Therapy and rehabilitation
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Occupational therapy | $40.00 copay
| 30% coinsurance
|
|
| Physical and speech therapy | $40.00 copay
| 30% coinsurance
|
|
| Cardiac rehabilitation | $20.00 copay
| 30% coinsurance
|
|
| Intensive cardiac rehabilitation | $20.00 copay
| 30% coinsurance
|
|
| Pulmonary rehabilitation | $15.00 copay
| 30% coinsurance
|
|
| Supervised exercise for peripheral artery disease | $25.00 copay
| 30% coinsurance
|
|
Ambulance, medical equipment and supplies
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Ground ambulance | $320.00 copay
| $320.00 copay
|
|
| Air ambulance | 20% coinsurance
| 20% coinsurance
|
|
| Durable medical equipment | 20% coinsurance
| 30% coinsurance
|
|
| Prosthetic devices | 20% coinsurance
| 30% coinsurance
|
|
| Medical supplies | 0% to 20% coinsurance
| 30% coinsurance
|
|
| Diabetic supplies | 0% to 20% coinsurance
| 0% to 20% coinsurance
|
|
| Diabetic shoes and inserts | $0.00 copay
| 20% coinsurance
|
|
| Diabetic monitors | 0% to 20% coinsurance
| 0% to 30% coinsurance
|
|
Dental benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered dental | $40.00 copay | 30% coinsurance
| |
| Oral examsAdditional plan benefit | $0.00 copay | 50% coinsurance
| |
| Dental X-raysAdditional plan benefit | $0.00 copay | 50% coinsurance
| |
| Dental cleaningAdditional plan benefit | $0.00 copay | 50% coinsurance
| |
| Restorative dental careAdditional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Root canal treatment (endodontics)Additional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Gum treatment (periodontics)Additional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Removable dentures (prosthodontics)Additional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Fixed dental restorations (prosthodontics)Additional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Oral surgeryAdditional plan benefit | 50% coinsurance | 70% coinsurance
| |
| Other dental servicesAdditional plan benefit | 50% coinsurance | 70% coinsurance
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Diagnostic and preventive dental (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Comprehensive dental (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
Vision benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered eye exams | $0.00 copay
| 30% coinsurance
|
|
| Routine eye examsAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Medicare-covered eyewear | $0.00 copay
| 30% coinsurance
|
|
| Contact lensesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Eyeglasses, lenses and framesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Eyeglass lensesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Eyeglass framesAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Eye exams (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Other Eye Exam ServicesAdditional plan benefit | Out-of-network | 30% coinsurance
| |
| Eyewear (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| UpgradesAdditional plan benefit | Out-of-network | $0.00 copay
|
Hearing benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered hearing exams | $40.00 copay
| 30% coinsurance
|
|
| Routine hearing examsAdditional plan benefit | $0.00 copay | 30% coinsurance
|
|
| Hearing aid fitting and evaluationAdditional plan benefit | $0.00 copay | 30% coinsurance
|
|
| Prescription hearing aids (all types)Additional plan benefit | $0.00 copay
| $0.00 copay
|
|
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Hearing exams (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Prescription hearing aids (category)Additional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
Extra benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Supplemental acupunctureAdditional plan benefit | $20.00 copay
| 50% coinsurance
|
|
| Over-the-counter health itemsAdditional plan benefit | $0.00 copay
| $0.00 copay
| |
| Limited-duration mealsAdditional plan benefit | $0.00 copay
| $0.00 copay
|
|
| Annual physical examAdditional plan benefit | $0.00 copay
| 30% coinsurance
|
|
| Fitness benefitAdditional plan benefit | $0.00 copay
| $0.00 copay
|
|
Additional services and network costs
Additional network details
These costs apply to the listed service categories and networks.
| Service | Network | Your share of the cost | What to know |
|---|---|---|---|
| Chiropractic ServicesAdditional plan benefit | Out-of-network | Confirm with the plan (copay); Confirm with the plan (coinsurance) |
|
| Routine Chiropractic CareAdditional plan benefit | Out-of-network | 30% coinsurance
| |
| Medicare-covered preventive servicesMedicare-covered care | Out-of-network | 0% to 30% coinsurance
| |
| Health EducationAdditional plan benefit | Out-of-network | $0.00 copay
|
|
| Additional Sessions of Smoking and Tobacco Cessation CounselingAdditional plan benefit | Out-of-network | 30% coinsurance
|
|
| Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline)Additional plan benefit | Out-of-network | $0.00 copay
|
|
| Wigs for chemotherapy-related hair lossAdditional plan benefit | Out-of-network | $0.00 copay
|
|
| Glaucoma ScreeningMedicare-covered care | Out-of-network | 30% coinsurance
| |
| Diabetes Self-Management TrainingMedicare-covered care | Out-of-network | 30% coinsurance
| |
| Digital Rectal ExamsMedicare-covered care | Out-of-network | 30% coinsurance
| |
| EKG after a Welcome to Medicare visitMedicare-covered care | Out-of-network | 30% coinsurance
| |
| Medicare Part B insulinMedicare-covered care | Out-of-network | $35.00 copay
|
Prescription drug coverage
This plan does not include a Part D prescription drug benefit.
Where this plan is offered
CMS lists this plan in 2 states or territories. Availability can vary by county and ZIP code.
View all locations 63 county listings across 2 states or territories
Oklahoma
Texas
- Atascosa, Texas
- Bandera, Texas
- Bell, Texas
- Bexar, Texas
- Bowie, Texas
- Brazoria, Texas
- Cameron, Texas
- Collin, Texas
- Comal, Texas
- Dallas, Texas
- Ector, Texas
- El Paso, Texas
- Ellis, Texas
- Fort Bend, Texas
- Grayson, Texas
- Gregg, Texas
- Guadalupe, Texas
- Hale, Texas
- Harris, Texas
- Hays, Texas
- Hidalgo, Texas
- Hood, Texas
- Hunt, Texas
- Jefferson, Texas
- Johnson, Texas
- Kendall, Texas
- Kerr, Texas
- Kleberg, Texas
- Lubbock, Texas
- Maverick, Texas
- McLennan, Texas
- Medina, Texas
- Midland, Texas
- Montgomery, Texas
- Nueces, Texas
- Parker, Texas
- Potter, Texas
- Randall, Texas
- Smith, Texas
- Starr, Texas
- Tarrant, Texas
- Tom Green, Texas
- Travis, Texas
- Webb, Texas
- Wharton, Texas
- Willacy, Texas
- Williamson, Texas
- Wilson, Texas