Aetna Medicare Eagle Giveback (PPO) Medicare Advantage Plan H5521-323 • 2027 • Columbia County, NY
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- −$100.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Columbia County, NY
- Local Enrollment
- 17 beneficiaries in Columbia County
Aetna Medicare Eagle Giveback (PPO) Introduction
CMS Plan ID H5521-323 identifies Aetna Medicare Eagle Giveback, a Medicare Advantage PPO plan offered by Aetna Medicare. The plan uses a Preferred Provider Organization (PPO) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket.
This plan is available to eligible beneficiaries who live in Columbia County, New York. CMS reports local enrollment of 17 beneficiaries for this plan in Columbia County. New members can contact the plan at (844)509-6254 (TTY 711) for help and additional plan information.
Compare Similar Plans in Columbia County
Compare this plan with the two most-enrolled PPO plans available in Columbia County, New York. Enrollment is based on CMS local enrollment data.
| Plan Detail | Aetna Medicare Eagle Giveback | AARP Medicare Advantage from UHC NY-0015 | Wellcare Simple Open |
|---|---|---|---|
| CMS Plan ID | H5521-323-0 |
H3418-004-0 |
H2775-106-0 |
| Local Enrollment | 17 | 475 | 40 |
| Monthly Premium | $0.00 | $44.00 | $0.00 |
| Medical Deductible | $0.00 | $1,000 | $300 |
| Maximum Out-of-Pocket | $9,850.00 | $8,900.00 | $9,850.00 |
| Part B Giveback | −$100.00 reduction | Not offered | Not offered |
| Primary Care | $0 copay | $0 copay | $0 copay |
| Specialist | $0-$35 copay | $0-$60 copay | $50 copay |
| Part D Deductible | Not Applicable | $685.00 | $700.00 |
| CMS Star Rating | 4.0 | 3.0 | 3.0 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Columbia County, or compare Medicare Advantage plans across New York, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Aetna Medicare Eagle Giveback includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H5521-323.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5521-323-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
Out-of-network: $25 copay - Specialist
- In-network: $0-$35 copay
Out-of-network: 30% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
Out-of-network: 50% coinsurance - Telehealth benefit
- In-network: $0-$40 copay, 20% coinsurance
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- In-network: $0 copay
Out-of-network: $0 copay - Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
Out-of-network: $0 copay - Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0-$300 copay
Out-of-network: 50% coinsurance - Lab services
- In-network: $0 copay
Out-of-network: $30 copay - Outpatient x-rays
- In-network: $35 copay
Out-of-network: 50% coinsurance - Diagnostic tests and procedures
- In-network: $0-$35 copay
Out-of-network: 50% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$375 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Out-of-network:
30% per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
25% per stay - Ground ambulance
- In-network: $300 copay
Out-of-network: $300 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $35 copay
Out-of-network: 50% coinsurance - Outpatient group therapy
- In-network: $35 copay
Out-of-network: 50% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$375 per day for days 1-6
$0 per day for days 7-90
$0 per stay
Out-of-network:
30% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $25 copay
Out-of-network: 50% coinsurance - Occupational therapy
- In-network: $25 copay
Out-of-network: 50% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: 0%-20% coinsurance
Out-of-network: 0%-20% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
Out-of-network: 20% coinsurance - Dental x-rays
- In-network: $0 copay
Out-of-network: 20% coinsurance - Cleaning
- In-network: $0 copay
Out-of-network: 20% coinsurance - Periodontics
- In-network: $0 copay
Out-of-network: 20% coinsurance - Endodontics
- In-network: $0 copay
Out-of-network: 20% coinsurance - Restorative services
- In-network: $0 copay
Out-of-network: 20% coinsurance - Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- In-network: $0 copay
Out-of-network: 20% coinsurance
Vision Services
- Routine eye exam
- In-network: $0 copay
Out-of-network: $0 copay - Contact lenses
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglass frames only
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglass lenses only
- In-network: $0 copay
Out-of-network: $0 copay - Eyeglasses (frames & lenses)
- In-network: $0 copay
Out-of-network: $0 copay - Upgrades
- In-network: $0 copay
Out-of-network: $0 copay
Hearing Services
- Hearing exam
- In-network: $0 copay
Out-of-network: 30% coinsurance - Fitting/evaluation
- In-network: $0 copay
Out-of-network: 30% coinsurance - Prescription hearing aids
- In-network: $0-$1700 copay
Out-of-network: $0-$1700 copay - OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Aetna Medicare Eagle Giveback as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H5521)
Medicare Advantage (Part C) and Part D plans are rated each year by CMS on a 5-star scale. Ratings summarize plan performance across clinical care and member experience measures.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Aetna Medicare
- Website
- Aetna Medicare Plan Page
- Providers
- Aetna Medicare Providers Page
- Formulary
- Aetna Medicare Formulary Page
- Pharmacy
- Aetna Medicare Pharmacy Page
- New Member Health Plan Help
- (844)509-6254
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Aetna Medicare (official source) | http://www.aetna.com/medicare | October 4, 2026 |
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
MedicarePlans.com is an independent informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.