Aetna Medicare Eagle Plan (HMO)

H4982 - 013 - 0
3 out of 5 stars (3 / 5)

aetna-medicare medicare provider logo

Aetna Medicare Eagle Plan (HMO) is a Medicare Advantage Plan by Aetna Medicare.

This page features plan details for 2024 Aetna Medicare Eagle Plan (HMO) H4982 – 013 – 0 available in California.

IMPORTANT: This page features the 2024 version of this plan. See the 2025 version using the link below:

No 2025 version found. You can use the location links below to find 2025 plans in your area.

Locations

Aetna Medicare Eagle Plan (HMO) is offered in the following locations.

Plan Overview

Aetna Medicare Eagle Plan (HMO) offers the following coverage and cost-sharing.

Insurer:Aetna Medicare
Health Plan Deductible:$0.00
MOOP:$4,200 In-network
Drugs Covered:No

Ready to sign up for Aetna Medicare Eagle Plan (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Premium Breakdown

Aetna Medicare Eagle Plan (HMO) 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
$174.70 $0.00 $0.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Aetna Medicare Eagle Plan (HMO) also provides the following benefits.

Health plan deductible

$0

Other health plan deductibles?

In-network No

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

$4,200 In-network

Optional supplemental benefits

No

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

In-network No

Outpatient hospital coverage

$0-50 copay per visit (Authorization is required.) (Referral is not required.)

Doctor visits

Primary$0 copay (Not applicable.) (Not applicable.)
Specialist$10 copay per visit (Authorization is not required.) (Referral is required.)

Preventive care

$0 copay (Authorization is not required.) (Referral is not required.)

Emergency care/Urgent care

Emergency$110 copay per visit (always covered) (Not applicable.) (Not applicable.)
Urgent care$10 copay per visit (always covered) (Not applicable.) (Not applicable.)

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures$0 copay (Authorization is required.) (Referral is required.)
Lab services$0 copay (Authorization is required.) (Referral is required.)
Diagnostic radiology services (e.g., MRI)$0-100 copay (Authorization is required.) (Referral is not required.)
Outpatient x-rays$0 copay (Authorization is required.) (Referral is not required.)

Hearing

Hearing exam$0 copay (Authorization is not required.) (Referral is required.)
Fitting/evaluation$0 copay (Limits may apply.) (Authorization is not required.) (Referral is required.)
Hearing aids$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Preventive dental

Oral exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Cleaning$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Fluoride treatment$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Dental x-ray(s)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Comprehensive dental

Non-routine services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Diagnostic services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Restorative services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Endodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Periodontics$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Extractions$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)
Prosthodontics, other oral/maxillofacial surgery, other services$0 copay (Limits may apply.) (Authorization is required.) (Referral is not required.)

Vision

Routine eye exam$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Other$0 copay (There are no limits.) (Authorization is not required.) (Referral is not required.)
Contact lenses$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglasses (frames and lenses)$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglass frames$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Eyeglass lenses$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)
Upgrades$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Rehabilitation services

Occupational therapy visit$10 copay (Authorization is not required.) (Referral is required.)
Physical therapy and speech and language therapy visit$10 copay (Authorization is not required.) (Referral is required.)

Ground ambulance

$275 copay (Not applicable.) (Not applicable.)

Transportation

$0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.)

Foot care (podiatry services)

Foot exams and treatment$10 copay (Authorization is not required.) (Referral is required.)
Routine foot careNot covered (Not applicable.) (Not applicable.)

Medical equipment/supplies

Durable medical equipment (e.g., wheelchairs, oxygen)0-20% coinsurance per item (Authorization is required.) (Not applicable.)
Prosthetics (e.g., braces, artificial limbs)20% coinsurance per item (Authorization is required.) (Not applicable.)
Diabetes supplies0-20% coinsurance per item (Authorization is required.) (Not applicable.)

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

Covered (Authorization is not required.) (Referral is not required.)

Medicare Part B drugs

Chemotherapy0-20% coinsurance (Authorization is required.) (Not applicable.)
Other Part B drugs0-20% coinsurance (Authorization is required.) (Not applicable.)
Part B Insulin drugs$35 copay (Authorization is required.) (Not applicable.)

Inpatient hospital coverage

$50 per day for days 1 through 3
$0 per day for days 4 through 90 (Authorization is required.) (Referral is not required.)

Mental health services

Inpatient hospital – psychiatric$370 per day for days 1 through 5
$0 per day for days 6 through 90 (Authorization is required.) (Referral is not required.)
Outpatient group therapy visit with a psychiatrist$25 copay (Authorization is required.) (Referral is required.)
Outpatient individual therapy visit with a psychiatrist$25 copay (Authorization is required.) (Referral is required.)
Outpatient group therapy visit$25 copay (Authorization is required.) (Referral is required.)
Outpatient individual therapy visit$25 copay (Authorization is required.) (Referral is required.)

Skilled Nursing Facility

$0 per day for days 1 through 20
$196 per day for days 21 through 100 (Authorization is required.) (Referral is not required.)

Ready to sign up for Aetna Medicare Eagle Plan (HMO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

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