Allina Health Aetna Medicare Eagle (PPO) Medicare Advantage Plan H3219-005 • 2027
CMS Rating:
Not yet rated by CMS.
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $5500.00In-network
- Part B Giveback
- −$135.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 2,504 beneficiaries
Last update:
Allina Health Aetna Medicare Eagle (PPO) Introduction
CMS Plan ID H3219-005 identifies Allina Health Aetna Medicare Eagle, a Medicare Advantage PPO plan offered by Allina Health 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 $5500.00 in-network maximum out-of-pocket.
Plan Benefits
Allina Health Aetna Medicare Eagle has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H3219-005.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $0 copay Out-of-network: 50% coinsurance |
| Specialist | In-network: $45 copay Out-of-network: 50% coinsurance |
In-network: $35 copay Out-of-network: 50% coinsurance |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $0 copay |
| Telehealth benefit | In-network: $0-$45 copay, 20% coinsurance | In-network: $0-$35 copay, 20% coinsurance |
| Routine chiropractic | In-network: $15 copay Out-of-network: 50% coinsurance |
In-network: $15 copay Out-of-network: 50% coinsurance |
| Fitness benefits | Coming soon | In-network: $0 copay Out-of-network: 0% coinsurance |
| Health education | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Counseling services | Not covered | Not covered |
| Over-the-counter drug benefits | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Health transportation (non-emergency) | Coming soon | Not covered |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0-$250 copay Out-of-network: 50% coinsurance |
In-network: $0-$250 copay Out-of-network: 50% coinsurance |
| Lab services | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $0 copay Out-of-network: 50% coinsurance |
| Outpatient x-rays | In-network: $25 copay Out-of-network: 50% coinsurance |
In-network: $15 copay Out-of-network: 50% coinsurance |
| Diagnostic tests and procedures | In-network: $0-$30 copay Out-of-network: 50% coinsurance |
In-network: $0-$20 copay Out-of-network: 50% coinsurance |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $130 copay | $130 copay |
| Worldwide emergency care | Coming soon | $130 copay |
| Urgent care | $45 copay | $35 copay |
| Inpatient hospital care | In-network: Tier 1 $300 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: 50% per stay |
In-network: Tier 1 $295 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 50% per stay |
| Skilled Nursing Facility | In-network: Tier 1 $0 per day for days 1-20 $221 per day for days 21-100 Out-of-network: 50% per stay |
In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-43 $0 per day for days 44-100 Out-of-network: 50% per stay |
| Ground ambulance | In-network: $295 copay Out-of-network: $295 copay |
In-network: $295 copay Out-of-network: $295 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $30 copay Out-of-network: 50% coinsurance |
| Outpatient group therapy | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $30 copay Out-of-network: 50% coinsurance |
| Inpatient psychiatric hospital care | In-network: Tier 1 $300 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: 50% per stay |
In-network: Tier 1 $295 per day for days 1-5 $0 per day for days 6-90 $0 per stay Out-of-network: 50% per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $45 copay Out-of-network: 50% coinsurance |
In-network: $35 copay Out-of-network: 50% coinsurance |
| Occupational therapy | In-network: $45 copay Out-of-network: 50% coinsurance |
In-network: $35 copay Out-of-network: 50% coinsurance |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: 0%-16% coinsurance Out-of-network: 0%-20% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 0%-20% coinsurance |
| Durable medical equipment | In-network: 16% coinsurance Out-of-network: 50% coinsurance |
In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 50% coinsurance |
In-network: 20% coinsurance Out-of-network: 50% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
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 |
In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Dental x-rays | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Cleaning | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Periodontics | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Endodontics | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Restorative services | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
| Implant services | Not covered | Not covered |
| Orthodontics | Not covered | Not covered |
| Oral/Maxillofacial surgery | In-network: $0 copay Out-of-network: 20% coinsurance |
In-network: $0 copay Out-of-network: 20% coinsurance |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: 0% coinsurance |
| Contact lenses | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass frames only | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass lenses only | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Eyeglasses (frames & lenses) | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| Upgrades | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $0 copay Out-of-network: 50% coinsurance |
| Fitting/evaluation | In-network: $0 copay Out-of-network: 50% coinsurance |
In-network: $0 copay Out-of-network: 50% coinsurance |
| Prescription hearing aids | In-network: $0 copay Out-of-network: $0 copay |
In-network: $0 copay Out-of-network: $0 copay |
| OTC hearing aids | Not covered | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Not covered |
| Home-based palliative care | Not covered | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Not covered | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Alternative therapies | Not covered | Not covered |
| Massage therapy | Not covered | Not covered |
| Home/bathroom safety devices | Not covered | Not covered |
Certain preventive services are covered 100% by Allina Health Aetna Medicare Eagle 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: H3219)
The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage (Part C) and Part D prescription drug plans each year using a 5-star system. These ratings measure plan performance in areas such as preventive care, management of chronic conditions, and member experience.
| 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 Allina Health Aetna Medicare
- Website
- Allina Health Aetna Medicare Plan Page
- Providers
- Allina Health Aetna Medicare Providers Page
- Formulary
- Allina Health Aetna Medicare Formulary Page
- Pharmacy
- Allina Health Aetna Medicare Pharmacy Page
- New Member Health Plan Help
- (844)622-5862
- 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.
Plan Availability
Allina Health Aetna Medicare Eagle (H3219-005-0) is available in the following locations:
Frequently Asked Questions
Here are some of the most frequently asked questions about this plan (click to open).
Frequently Asked Questions About Allina Health Aetna Medicare Eagle (PPO)
How much does plan H3219-005 cost per month?
The plan’s monthly premium is $0.00 for 2027. The Part B premium is not included.
What is the annual out-of-pocket maximum (MOOP) for this plan?
The annual in-network MOOP is $5500.00 for 2027. After this limit is reached, covered in-network services are fully paid.
What is the current enrollment for Allina Health Aetna Medicare Eagle?
The plan has 2,504 enrolled beneficiaries according to CMS.
What is the prescription drug deductible for 2027?
For 2027, the prescription drug deductible is $0.00.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Allina Health Aetna Medicare (official source) | http://www.AllinaHealthAetnaMedicare. | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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