Aetna Medicare Eagle (PPO)

H3288 - 051 - 0
3.5 out of 5 stars (3.5 / 5)

aetna-medicare medicare provider logo

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

This page features plan details for 2025 Aetna Medicare Eagle (PPO) H3288 – 051 – 0 available in Select Oklahoma and Texas Counties.

Locations

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

Plan Overview

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

Insurer:Aetna Medicare
Health Plan Deductible:$0
MOOP:$8,950 In and Out-of-network
$4,900 In-network
Drugs Covered:No

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

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

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 (PPO) qualifies for a monthly Medicare Give Back Benefit of $110.00.

Premium Reduction:$110.00

Premium Breakdown

Aetna Medicare Eagle (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
$185.00 $0.00 $110.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

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

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

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: 20-50 Coins – No Co pay (Limits Apply)
  • Endodontics
    • In-Network: 20 Coins – No Co pay
    • Out-of-Network: 50% Coins – No Copay
  • Oral and Maxillofacial Surgery
    • In-Network: 20-50 Coins – No Co pay
  • Periodontics
    • In-Network: 20-50 Coins – No Co pay
  • Prosthodontics, fixed
    • In-Network: 50 Coins – No Co pay
  • Prosthodontics, removable
    • In-Network: 50 Coins – No Co pay
  • Restorative Services
    • In-Network: 20-50 Coins – No Co pay

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 50% Coins – No Copay
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 50% Coins – No Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: 50% Coins – No Copay

Diagnostic procedures/lab services/imaging

  • Lab services
    • In-Network: $0 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-375 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $0-50 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $0-40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Diagnostic tests and procedures
    • Out-of-Network: 30% coinsurance (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: 30% coinsurance per visit
  • Specialist
    • Out-of-Network: 30% coinsurance per visit
    • In-Network: $0-40 copay per visit
  • Primary
    • In-Network: $0 copay

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $55 copay per visit (always covered)

Foot care (podiatry services)

  • Routine foot care
    • Not covered
  • Foot exams and treatment
    • In-Network: $40 copay
    • Out-of-Network: 30% coinsurance

Ground ambulance

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

Health plan deductible

    • $0

Hearing

  • Hearing aids
    • Out-of-Network: $0 copay (Limits Apply)
  • Fitting/evaluation
    • In-Network: $0 copay (Limits Apply)
  • Hearing aids
    • In-Network: $0 copay (Limits Apply)
  • Fitting/evaluation
    • Out-of-Network: $0 copay (Limits Apply)
  • Hearing aids OTC
    • Not covered
  • Medicare-Covered Hearing Exam
    • In-Network: $40 copay
    • Out-of-Network: 30% coinsurance

Inpatient hospital coverage

    • In-Network: $445 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
    • Out-of-Network: 30% per stay (Authorization Required)

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

    • $8,950 In and Out-of-network
      $4,900 In-network

Medical equipment/supplies

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

Medicare Part B drugs

  • Other Part B drugs
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Chemotherapy
    • Out-of-Network: 30% coinsurance (Authorization Required)
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • Out-of-Network: 30% per stay (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $40 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $40 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • In-Network: $375 per day for days 1 through 6
      $0 per day for days 7 through 90 (Authorization Required)
  • Outpatient group therapy visit
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)
  • Outpatient individual therapy visit
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-395 copay per visit (Authorization Required)
    • Out-of-Network: 30% coinsurance per visit (Authorization Required)

Preventive care

    • Out-of-Network: 0-30% coinsurance
    • In-Network: $0 copay

Rehabilitation services

  • Occupational therapy visit
    • In-Network: $45 copay
    • Out-of-Network: 30% coinsurance
  • Physical therapy and speech and language therapy visit
    • In-Network: $45 copay
    • Out-of-Network: 30% coinsurance

Skilled Nursing Facility

    • In-Network: $10 per day for days 1 through 20
      $214 per day for days 21 through 100 (Authorization Required)
    • Out-of-Network: 30% per stay (Authorization Required)

Transportation

    • Not covered

Vision

  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
  • Other
    • In-Network: $0 copay
    • Out-of-Network: 30% coinsurance
  • Upgrades
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: 30% coinsurance (Limits Apply)
  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
  • Eyeglass lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply)
  • Upgrades
    • Out-of-Network: $0 copay (Limits Apply)

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

    • Covered

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

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

Need more information on Aetna Medicare Eagle (PPO)? See 2025 Aetna Medicare Eagle (PPO) at MedicareAdvantageRX.com.

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