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Aetna Medicare Eagle Plus (PPO) - H5521-229-000
$0.00
Monthly Premium
Aetna Medicare Eagle Plus (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Aetna Inc.
Plan ID: H5521-229-000
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$0.00
Monthly Premium
Alabama Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover.
Learn more about Alabama Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.
Basic Costs and Coverage
| Coverage | Details |
|---|---|
| Monthly plan premium | $0.00 |
| Vision coverage | |
| Dental coverage | |
| Hearing coverage | |
| Prescription drugs | |
| Medical deductible | -$1.00 |
| Out-of-pocket maximum | $7,900.00 |
| Initial drug coverage limit | $0.00 |
| Catastrophic drug coverage limit | $2,100.00 |
| Primary care doctor visit | Out-of-Network|$5 |
| Specialty doctor visit | In-Network $0 for services provided in a nursing home $25 for services provided outside a nursing home Out-of-Network $30 |
| Inpatient hospital care | Out-of-Network|50% per stay |
| Urgent care | Urgent Care: Copayment for Urgent Care $40 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $115 Maximum Plan Benefit of $250,000 |
| Emergency room visit | $115 If you are admitted to the hospital within 24 hours your cost share may be waived |
| Ambulance transportation | Out-of-Network|$270 |
Health Care Services and Medical Supplies
Aetna Medicare Eagle Plus (PPO) covers a range of additional benefits. Learn more about Aetna Medicare Eagle Plus (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
| Coverage | Details |
|---|---|
| Chiropractic services | In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 |
| Diabetes supplies, training, nutrition therapy and monitoring | In-Network 0% for Roche/Accu-Chek and TRUE/Trividia diabetic supplies 20% for other covered diabetic supplies Out-of-Network 0% for Roche/Accu-Chek and TRUE/Trividia diabetic supplies 20% for other covered diabetic supplies |
| Durable medical equipment (DME) | Out-of-Network|20% |
| Diagnostic tests, lab and radiology services, and X-rays | Lab Services: Out-of-Network|$10 Diagnostic Procedures: Out-of-Network|35% Imaging: Out-of-Network|Xray: 40%|Diagnostic Radiology: 35% |
| Home health care | In-Network $0 Out-of-Network 35% |
| Mental health inpatient care | Out-of-Network: Psychiatric Hospital Services: Coinsurance for Psychiatric Hospital per Stay 50% |
| Mental health outpatient care | In-Network $30 for Mental Health - Group Sessions $30 for Mental Health - Individual Sessions $30 for Psychiatric Services - Group Sessions $30 for Psychiatric Services - Individual Sessions Out-of-Network $50 for Mental Health Services- Group Sessions $50 for Mental Health Services - Individual Sessions $50 for Psychiatric Services - Group Sessions $50 for Psychiatric Services - Individual Sessions |
| Outpatient services/surgery | Ambulatory Surgical Center: In-Network $0 for preventive and diagnostic colonoscopy $225 all other ambulatory surgical center services Out-of-Network $295 |
| Outpatient substance abuse care | Out-of-Network: Outpatient Substance Abuse Services: Coinsurance for Medicare Covered Individual Sessions 35% Coinsurance for Medicare Covered Group Sessions 35% |
| Over-the-counter items | Over-the-Counter (OTC) Wallet with a $180 quarterly benefit amount (allowance) on the Extra Benefits Card to help pay for approved OTC health and wellness products like first aid supplies, cold and allergy medicine, pain relievers, and more. Approved products can be purchased in-store at participating locations including CVS retail locations (excluding locations inside other stores), and online or by phone through CVS OTC Health Solutions. |
| Podiatry services | In-Network: Podiatry Services: Copayment for Medicare-Covered Podiatry Services $25 |
| Skilled Nursing Facility (SNF) care | In-Network $0 per day, days 1-20; $218 per day, days 21-100 Out-of-Network 50% per stay |
Dental Benefits
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Dental care | In-Network Preventive dental services: $0 for oral exams $0 for cleanings $0 for x-rays Comprehensive dental services: 20%-50% for restorative services 20% for endodontic services 20%-50% for periodontic services 50% for removeable prosthodontics 50% for fixed prosthodontics 20% - 50% for oral and maxillofacial surgery 20% - 50% for adjunctive services Out-of-Network Preventive dental services: 50% for oral exams 50% for cleanings 50% for x-rays Comprehensive dental services: 50% - 70% for restorative services 50% for endodontic services 50% - 70% for periodontic services 70% for removeable prosthodontics 70% for fixed prosthodontics 50% - 70% for oral and maxillofacial surgery 50% - 70% for adjunctive services $4,000 benefit amount (allowance) every year in and out-of-network for covered comprehensive dental services. Frequencies and medical necessity requirements vary by covered dental service. Covered preventive dental services do not count towards your annual benefit amount. See EOC for additional details on exclusions and limitations. |
Vision Benefits
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage
| Coverage | Details |
|---|---|
| Vision care | Out-of-Network||Eye Exams:|$50 for Medicare-covered eye exams|0% for non-Medicare covered eye exams|Maximum one non-Medicare covered routine eye exam every calendar year in or out-of-network (out of network covered up to $50)||Eyewear:|35% for Medicare-covered prescription eyewear|$0 for Contacts|$0 for Eyeglass Frames|$0 for Eyeglass Lenses|$0 for Eyeglass Lenses and Frames|$0 for Upgrades||$300 annual benefit amount (allowance) for non-Medicare covered prescription eyewear. |
Hearing Benefits
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Hearing care | Out-of-Network:||Hearing Exams:|$50 for Medicare-covered hearing exams|$50 for non-Medicare covered hearing exam every year in or out-of-network||Hearing Aids: You must purchase hearing aids through NationsHearing |
Preventive Services and Health/Wellness Education Programs
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
| Coverage | Details |
|---|---|
| Preventive services and health/wellness education programs | Out-of-Network|$0 for all preventive services covered under Original Medicare |
When reviewing Alabama Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Alabama that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
Plan Documents
| Links to plan documents |
Alabama Counties Served
- Autauga
- Barbour
- Bibb
- Blount
- Bullock
- Butler
- Calhoun
- Cherokee
- Chilton
- Choctaw
- Clarke
- Clay
- Cleburne
- Coffee
- Coosa
- Covington
- Crenshaw
- Cullman
- Dale
- Fayette
- Franklin
- Greene
- Hale
- Houston
- Jackson
- Jefferson
- Lauderdale
- Lowndes
- Macon
- Madison
- Marengo
- Marion
- Marshall
- Mobile
- Perry
- Pickens
- Pike
- Russell
- Saint Clair
- Shelby
- Talladega
- Walker
- Washington
- Wilcox
- Winston
We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Healthspring, Wellcare, or Kaiser Permanente.
Enrollment may be limited to certain times of the year. See why you may be able to enroll today.