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Allina Health Aetna Medicare Eagle (PPO)

H3219 - 005 - 0
4 out of 5 stars (4 / 5)

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

This page features plan details for 2025 Allina Health Aetna Medicare Eagle (PPO) H3219 – 005 – 0 available in Twin Cities Metro and Select MN Counties.

Locations

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

Anoka County, Minnesota
Blue Earth County, Minnesota
Brown County, Minnesota

Click to see more locations

Plan Overview

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

Insurer:Allina Health Aetna Medicare
Health Plan Deductible:$0
MOOP:$7,000 In and Out-of-network
$4,900 In-network
Drugs Covered:No

Ready to sign up for Allina Health 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. 

Allina Health Aetna Medicare Eagle (PPO) qualifies for a monthly Medicare Give Back Benefit of $100.00.

Premium Reduction:$100.00

Premium Breakdown

Allina Health 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 $100.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.

Additional Benefits

Allina Health 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: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Prosthodontics, fixed
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Prosthodontics, removable
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Fluoride Treatment
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay (Limits Apply)
    • Out-of-Network: 20% Coins – No Copay (Limits Apply)

Diagnostic procedures/lab services/imaging

  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Outpatient x-rays
    • Out-of-Network: $60 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-250 copay (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $15 copay (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $0-20 copay (Authorization Required)
    • Out-of-Network: $60 copay (Authorization Required)
  • Lab services
    • Out-of-Network: $35 copay (Authorization Required)

Doctor visits

  • Primary
    • Out-of-Network: 30% coinsurance per visit
    • In-Network: $0 copay
  • Specialist
    • In-Network: $35 copay per visit
    • Out-of-Network: $60 copay per visit

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $35 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • In-Network: $35 copay
  • Routine foot care
    • In-Network: $35 copay (Limits Apply)
  • Foot exams and treatment
    • Out-of-Network: $60 copay

Ground ambulance

    • In-Network: $295 copay
    • Out-of-Network: $295 copay

Health plan deductible

    • $0

Hearing

  • Fitting/evaluation
    • Out-of-Network: $60 copay (Limits Apply)
    • In-Network: $0 copay (Limits Apply)
  • Hearing aids
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $35 copay
    • Out-of-Network: $60 copay
  • Hearing aids OTC
    • Not covered

Inpatient hospital coverage

    • Out-of-Network: 40% per stay (Authorization Required)
    • In-Network: $295 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)

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

    • $7,000 In and Out-of-network
      $4,900 In-network

Medical equipment/supplies

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

Medicare Part B drugs

  • Chemotherapy
    • Out-of-Network: 40% coinsurance (Authorization Required)
  • Other Part B drugs
    • Out-of-Network: 40% coinsurance (Authorization Required)
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Inpatient hospital – psychiatric
    • In-Network: $295 per day for days 1 through 5
      $0 per day for days 6 through 90 (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $30 copay (Authorization Required)
    • Out-of-Network: $60 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $30 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • Out-of-Network: 40% per stay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $30 copay (Authorization Required)
    • Out-of-Network: $60 copay (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $30 copay (Authorization Required)
    • Out-of-Network: $60 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: $60 copay (Authorization Required)

Optional supplemental benefits

    • No

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-350 copay per visit (Authorization Required)
    • Out-of-Network: 40% coinsurance per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: 0-40% coinsurance

Rehabilitation services

  • Occupational therapy visit
    • Out-of-Network: $60 copay
  • Physical therapy and speech and language therapy visit
    • In-Network: $35 copay
  • Occupational therapy visit
    • In-Network: $35 copay
  • Physical therapy and speech and language therapy visit
    • Out-of-Network: $60 copay

Skilled Nursing Facility

    • Out-of-Network: 40% per stay (Authorization Required)
    • In-Network: $0 per day for days 1 through 20
      $214 per day for days 21 through 43
      $0 per day for days 44 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Contact lenses
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Eyeglass 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)
  • Eyeglass lenses
    • In-Network: $0 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: $60 copay (Limits Apply)
  • Upgrades
    • In-Network: $0 copay (Limits Apply)
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Other
    • In-Network: $0 copay
    • Out-of-Network: $60 copay

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

    • Covered

Ready to sign up for Allina Health 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 Allina Health Aetna Medicare Eagle (PPO)? See 2025 Allina Health Aetna Medicare Eagle (PPO) at MedicareAdvantageRX.com.

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Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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