Aetna Medicare Eagle Giveback (PPO) Medicare Advantage Plan H5521-320 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- Coming soon
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Coming soon
- Prescription Coverage
- Not Included
- Additional Benefits
- None
- Service Area
- See List
- Total Enrollment
- 1,623 beneficiaries
Aetna Medicare Eagle Giveback (PPO) Introduction
This Medicare Advantage PPO plan, Aetna Medicare Eagle Giveback, is offered by Aetna Medicare and uses a Preferred Provider Organization (PPO) provider network. It comes without prescription drug coverage. For the 2027 plan year, the monthly premium is $0.00, the medical deductible is Coming soon, and the in-network maximum out-of-pocket is $9850.00. The plan is identified by CMS Plan ID H5521-320.
Plan Benefits
Cost-sharing for Aetna Medicare Eagle Giveback includes out-of-pocket expenses for covered healthcare services. The following tables provide a summary of typical in-network out-of-pocket costs for plan H5521-320.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | Coming soon | In-network: $0 copay Out-of-network: $50 copay |
| Specialist | Coming soon | In-network: $0-$35 copay Out-of-network: $60 copay |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | Coming soon | In-network: $0 copay |
| Telehealth benefit | Coming soon | In-network: $0-$40 copay, 20% coinsurance |
| Routine chiropractic | Coming soon | Not covered |
| Fitness benefits | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Health education | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Counseling services | Coming soon | Not covered |
| Over-the-counter drug benefits | Coming soon | 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 | Coming soon | In-network: $0-$325 copay Out-of-network: 50% coinsurance |
| Lab services | Coming soon | In-network: $0 copay Out-of-network: $30 copay |
| Outpatient x-rays | Coming soon | In-network: $35 copay Out-of-network: 50% coinsurance |
| Diagnostic tests and procedures | Coming soon | In-network: $0-$35 copay Out-of-network: 50% coinsurance |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | Coming soon | $115 copay |
| Worldwide emergency care | Coming soon | $115 copay |
| Urgent care | Coming soon | $40 copay |
| Inpatient hospital care | Coming soon | In-network: Tier 1 $395 per day for days 1-6 $0 per day for days 7-90 $0 per stay Out-of-network: 50% per stay |
| Skilled Nursing Facility | Coming soon | In-network: Tier 1 $0 per day for days 1-20 $218 per day for days 21-100 Out-of-network: 20% per stay |
| Ground ambulance | Coming soon | In-network: $285 copay Out-of-network: $285 copay |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | Coming soon | In-network: $35 copay Out-of-network: 50% coinsurance |
| Outpatient group therapy | Coming soon | In-network: $35 copay Out-of-network: 50% coinsurance |
| Inpatient psychiatric hospital care | Coming soon | In-network: Tier 1 $395 per day for days 1-6 $0 per day for days 7-90 $0 per stay Out-of-network: 50% per stay |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | Coming soon | In-network: $40 copay Out-of-network: 50% coinsurance |
| Occupational therapy | Coming soon | In-network: $35 copay Out-of-network: 50% coinsurance |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | Coming soon | In-network: 0%-20% coinsurance Out-of-network: 0%-20% coinsurance |
| Durable medical equipment | Coming soon | In-network: 0%-20% coinsurance Out-of-network: 20% coinsurance |
| Prosthetics | Coming soon | In-network: 20% coinsurance Out-of-network: 20% coinsurance |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | Coming soon | In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
| Other Part B drugs (Medicare-covered) | Coming soon | In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Dental x-rays | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Cleaning | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Periodontics | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Endodontics | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Restorative services | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
| Implant services | Coming soon | Not covered |
| Orthodontics | Coming soon | Not covered |
| Oral/Maxillofacial surgery | Coming soon | In-network: $0 copay Out-of-network: 20% coinsurance |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Contact lenses | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass frames only | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Eyeglass lenses only | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Eyeglasses (frames & lenses) | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Upgrades | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | Coming soon | In-network: $0 copay Out-of-network: $60 copay |
| Fitting/evaluation | Coming soon | In-network: $0 copay Out-of-network: $60 copay |
| Prescription hearing aids | Coming soon | In-network: $0-$1700 copay Out-of-network: $0-$1700 copay |
| OTC hearing aids | Coming soon | Not covered |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Coming soon | Not covered |
| Home-based palliative care | Coming soon | Not covered |
| Personal emergency response system | Coming soon | Not covered |
| Weight management programs | Coming soon | Not covered |
| Wigs for chemotherapy-related hair loss | Coming soon | In-network: $0 copay Out-of-network: $0 copay |
| Alternative therapies | Coming soon | Not covered |
| Massage therapy | Coming soon | Not covered |
| Home/bathroom safety devices | Coming soon | 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)
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 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.
Plan Availability
Aetna Medicare Eagle Giveback (H5521-320-0) 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 Aetna Medicare Eagle Giveback (PPO)
What is the monthly premium for Aetna Medicare Eagle Giveback (PPO)?
The plan’s monthly premium is $0.00 for 2027. The Part B premium is not included.
What is the in-network MOOP for plan H5521-320?
The 2027 in-network MOOP is $9850.00. Once this limit is reached, covered in-network costs are fully covered.
What is the total enrollment for plan H5521-320?
The plan has 1,623 enrolled beneficiaries according to CMS.
What is the Part D deductible for plan H5521-320?
For 2027, the prescription drug deductible is $0.00.
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 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
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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.