2027 Medicare Advantage plan
Aetna Medicare Eagle (PPO): 2027 benefits and costs
Aetna Medicare PPO
CMS plan ID: H5521-286-0 · Plan year: 2027
Aetna Medicare Eagle (PPO) is a 2027 Medicare Advantage plan offered by Aetna Medicare.
2027 plan costs at a glance
- Organization
- Aetna Medicare
- Plan organization
- AETNA 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
- $139.50 (estimated)$209.50 standard premium less $70.00 plan reduction.
You must continue to pay your Medicare Part B premium.
- Annual medical deductible
- None
- In-network medical maximum
- $5,200.00
Applies to certain in-network supplemental services.
- Combined in/out-of-network medical maximum
- $10,750.00
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
- $70.00
2027 benefit summary
Doctor visits and medical care
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Primary care doctor | $0.00 copay
| 50% coinsurance
| |
| Specialist visit | $40.00 copay
| 50% coinsurance
|
|
| Telehealth | $0.00 to $45.00 copay; 20% coinsurance
| Not summarized. Check coverage with the plan. |
|
| Emergency care | $130.00 copay | Not summarized. Check coverage with the plan. | |
| Urgent care | $45.00 copay | Not summarized. Check coverage with the plan. | |
| Home health | $0.00 copay
| 50% coinsurance
|
|
| Dialysis | 20% coinsurance
| 50% coinsurance
|
|
| Part B chemotherapy and radiation drugs | 0% to 20% coinsurance
| 50% coinsurance
|
|
| Other Part B drugs | 0% to 20% coinsurance
| 50% coinsurance
|
|
| Kidney disease education services | 20% coinsurance
| 50% coinsurance
|
|
| Medicare-covered chiropractic | $15.00 copay
| 50% coinsurance
|
|
| Medicare-covered foot care | $40.00 copay
| 50% coinsurance
|
|
| Other health professionals | $0.00 to $40.00 copay
| 0% to 50% 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: $300.00 copay per day Days 7–90: $0.00 copay per day |
|
| Inpatient mental health care | $0.00 copay per stay Days 1–6: $390.00 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 $300.00 copay
| 50% coinsurance
| |
| Hospital observation services | $300.00 copay
| 50% coinsurance
| |
| Ambulatory surgical center | $0.00 to $250.00 copay
| 50% coinsurance
|
|
| Outpatient blood | $0.00 copay
| 50% coinsurance
|
|
Tests, imaging and laboratory services
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Diagnostic procedures and tests | $0.00 to $75.00 copay
| 50% coinsurance
|
|
| Laboratory services | $0.00 copay
| 50% coinsurance
|
|
| Diagnostic radiology (CT, MRI) | $0.00 to $250.00 copay
| 50% coinsurance
|
|
| Therapeutic radiology | 20% coinsurance
| 50% coinsurance
|
|
| X-rays | $20.00 copay
| 50% coinsurance
|
|
Mental health and substance use treatment
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Partial hospitalization | $65.00 copay
| 50% coinsurance
|
|
| Intensive outpatient program | $65.00 copay
| 50% coinsurance
|
|
| Substance use treatment, individual sessions | $0.00 copay
| 50% coinsurance
|
|
| Substance use treatment, group sessions | $0.00 copay
| 50% coinsurance
|
|
| Opioid treatment program | $0.00 copay
| 50% coinsurance
|
|
| Mental health, individual sessions | $0.00 copay
| 50% coinsurance
|
|
| Mental health, group sessions | $0.00 copay
| 50% coinsurance
|
|
| Psychiatry, individual sessions | $0.00 copay
| 50% coinsurance
|
|
| Psychiatry, group sessions | $0.00 copay
| 50% coinsurance
|
|
Therapy and rehabilitation
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Occupational therapy | $40.00 copay
| 50% coinsurance
|
|
| Physical and speech therapy | $40.00 copay
| 50% coinsurance
|
|
| Cardiac rehabilitation | $15.00 copay
| 50% coinsurance
|
|
| Intensive cardiac rehabilitation | $15.00 copay
| 50% coinsurance
|
|
| Pulmonary rehabilitation | $15.00 copay
| 50% coinsurance
|
|
| Supervised exercise for peripheral artery disease | $25.00 copay
| 50% coinsurance
|
|
Ambulance, medical equipment and supplies
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Ground ambulance | $290.00 copay
| $290.00 copay
|
|
| Air ambulance | 20% coinsurance
| 20% coinsurance
|
|
| Durable medical equipment | 20% coinsurance
| 50% coinsurance
|
|
| Prosthetic devices | 20% coinsurance
| 50% coinsurance
|
|
| Medical supplies | 0% to 20% coinsurance
| 50% 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 50% coinsurance
|
|
Dental benefits
| Service | In-network | Out-of-network | What to know |
|---|---|---|---|
| Medicare-covered dental | $40.00 copay | 50% coinsurance
| |
| Oral examsAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Dental X-raysAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Other diagnostic dentalAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Dental cleaningAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| FluorideAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Other preventive dentalAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Restorative dental careAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Root canal treatment (endodontics)Additional plan benefit | $0.00 copay | 20% coinsurance
| |
| Gum treatment (periodontics)Additional plan benefit | $0.00 copay | 20% coinsurance
| |
| Removable dentures (prosthodontics)Additional plan benefit | $0.00 copay | 20% coinsurance
| |
| Fixed dental restorations (prosthodontics)Additional plan benefit | $0.00 copay | 20% coinsurance
| |
| Oral surgeryAdditional plan benefit | $0.00 copay | 20% coinsurance
| |
| Other dental servicesAdditional plan benefit | $0.00 copay | 20% 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 to $40.00 copay
| 50% coinsurance
|
|
| Routine eye examsAdditional plan benefit | $0.00 copay | $0.00 copay
|
|
| Medicare-covered eyewear | $0.00 copay
| 50% 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 | 50% 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
| 50% coinsurance
|
|
| Routine hearing examsAdditional plan benefit | $0.00 copay | 50% coinsurance
|
|
| Hearing aid fitting and evaluationAdditional plan benefit | $0.00 copay | 50% 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 |
|---|---|---|---|
| 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
| 50% 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 |
|---|---|---|---|
| Medicare-covered preventive servicesMedicare-covered care | Out-of-network | 0% to 50% coinsurance
| |
| Health EducationAdditional plan benefit | Out-of-network | $0.00 copay
|
|
| Additional Sessions of Smoking and Tobacco Cessation CounselingAdditional plan benefit | Out-of-network | 50% 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 | 50% coinsurance
| |
| Diabetes Self-Management TrainingMedicare-covered care | Out-of-network | 50% coinsurance
| |
| Digital Rectal ExamsMedicare-covered care | Out-of-network | 50% coinsurance
| |
| EKG after a Welcome to Medicare visitMedicare-covered care | Out-of-network | 50% 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 4 states or territories. Availability can vary by county and ZIP code.
View all locations 145 county listings across 4 states or territories
Illinois
- Boone, Illinois
- Bureau, Illinois
- Cook, Illinois
- DeKalb, Illinois
- DuPage, Illinois
- Grundy, Illinois
- Henderson, Illinois
- Henry, Illinois
- Jo Daviess, Illinois
- Kane, Illinois
- Kankakee, Illinois
- Kendall, Illinois
- Lake, Illinois
- Lee, Illinois
- McHenry, Illinois
- Ogle, Illinois
- Rock Island, Illinois
- Stephenson, Illinois
- Whiteside, Illinois
- Will, Illinois
- Winnebago, Illinois
Indiana
- Allen, Indiana
- Bartholomew, Indiana
- Benton, Indiana
- Blackford, Indiana
- Boone, Indiana
- Brown, Indiana
- Carroll, Indiana
- Clay, Indiana
- DeKalb, Indiana
- Dubois, Indiana
- Elkhart, Indiana
- Floyd, Indiana
- Franklin, Indiana
- Fulton, Indiana
- Greene, Indiana
- Hamilton, Indiana
- Hancock, Indiana
- Hendricks, Indiana
- Huntington, Indiana
- Jasper, Indiana
- Jay, Indiana
- Johnson, Indiana
- Knox, Indiana
- La Porte, Indiana
- Lake, Indiana
- Madison, Indiana
- Marion, Indiana
- Marshall, Indiana
- Martin, Indiana
- Miami, Indiana
- Montgomery, Indiana
- Newton, Indiana
- Orange, Indiana
- Parke, Indiana
- Posey, Indiana
- Putnam, Indiana
- Shelby, Indiana
- Spencer, Indiana
- St. Joseph, Indiana
- Starke, Indiana
- Sullivan, Indiana
- Wabash, Indiana
- Washington, Indiana
- Whitley, Indiana
Michigan
- Arenac, Michigan
- Barry, Michigan
- Bay, Michigan
- Benzie, Michigan
- Branch, Michigan
- Calhoun, Michigan
- Clinton, Michigan
- Crawford, Michigan
- Delta, Michigan
- Dickinson, Michigan
- Eaton, Michigan
- Emmet, Michigan
- Genesee, Michigan
- Grand Traverse, Michigan
- Gratiot, Michigan
- Hillsdale, Michigan
- Ingham, Michigan
- Ionia, Michigan
- Jackson, Michigan
- Kalamazoo, Michigan
- Kalkaska, Michigan
- Kent, Michigan
- Lake, Michigan
- Lenawee, Michigan
- Livingston, Michigan
- Macomb, Michigan
- Manistee, Michigan
- Marquette, Michigan
- Mason, Michigan
- Mecosta, Michigan
- Menominee, Michigan
- Missaukee, Michigan
- Montcalm, Michigan
- Muskegon, Michigan
- Newaygo, Michigan
- Oakland, Michigan
- Osceola, Michigan
- Ottawa, Michigan
- Roscommon, Michigan
- Saginaw, Michigan
- Sanilac, Michigan
- Shiawassee, Michigan
- St. Clair, Michigan
- Tuscola, Michigan
- Van Buren, Michigan
- Washtenaw, Michigan
- Wayne, Michigan
- Wexford, Michigan
Wisconsin
- Adams, Wisconsin
- Brown, Wisconsin
- Columbia, Wisconsin
- Dane, Wisconsin
- Florence, Wisconsin
- Forest, Wisconsin
- Green, Wisconsin
- Iowa, Wisconsin
- Kenosha, Wisconsin
- Kewaunee, Wisconsin
- La Crosse, Wisconsin
- Lafayette, Wisconsin
- Langlade, Wisconsin
- Manitowoc, Wisconsin
- Marinette, Wisconsin
- Marquette, Wisconsin
- Milwaukee, Wisconsin
- Monroe, Wisconsin
- Oconto, Wisconsin
- Outagamie, Wisconsin
- Ozaukee, Wisconsin
- Portage, Wisconsin
- Racine, Wisconsin
- Rock, Wisconsin
- Shawano, Wisconsin
- Sheboygan, Wisconsin
- Trempealeau, Wisconsin
- Vernon, Wisconsin
- Washington, Wisconsin
- Waukesha, Wisconsin
- Waushara, Wisconsin
- Winnebago, Wisconsin