Aetna Medicare Eagle Giveback (PPO) Medicare Advantage Plan H5521-724 • 2027
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $7900.00In-network
- Part B Giveback
- −$100.00 reduction
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- See List
- Total Enrollment
- 0 beneficiaries
Aetna Medicare Eagle Giveback (PPO) Introduction
CMS Plan ID H5521-724 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 $7900.00 in-network maximum out-of-pocket.
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 H5521-724.
Compare 2027 plan benefits with 2026.
Office Visits
| Covered Service | 2027 | 2026 |
|---|---|---|
| Primary care | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Specialist | In-network: $0-$30 copay Out-of-network: 50% coinsurance |
Coming soon |
Preventive and Wellness Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Annual wellness exam | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Telehealth benefit | In-network: $0-$40 copay, 20% coinsurance | Coming soon |
| Routine chiropractic | Not covered | Coming soon |
| Fitness benefits | Coming soon | Coming soon |
| Health education | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Counseling services | Not covered | Coming soon |
| Over-the-counter drug benefits | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Health transportation (non-emergency) | Coming soon | Coming soon |
Diagnostic, Lab, and Imaging Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diagnostic radiology services | In-network: $0-$300 copay Out-of-network: 50% coinsurance |
Coming soon |
| Lab services | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Outpatient x-rays | In-network: $0-$50 copay Out-of-network: 50% coinsurance |
Coming soon |
| Diagnostic tests and procedures | In-network: $0-$50 copay Out-of-network: 50% coinsurance |
Coming soon |
Emergency and Urgent Care Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Emergency room care | $115 copay | Coming soon |
| Worldwide emergency care | Coming soon | Coming soon |
| Urgent care | $40 copay | Coming soon |
| Inpatient hospital care | In-network: Tier 1 $345 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: 50% per stay |
Coming soon |
| 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 |
Coming soon |
| Ground ambulance | In-network: $265 copay Out-of-network: $265 copay |
Coming soon |
Mental Health Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Outpatient individual therapy | In-network: $30 copay Out-of-network: 50% coinsurance |
Coming soon |
| Outpatient group therapy | In-network: $30 copay Out-of-network: 50% coinsurance |
Coming soon |
| Inpatient psychiatric hospital care | In-network: Tier 1 $345 per day for days 1-7 $0 per day for days 8-90 $0 per stay Out-of-network: 50% per stay |
Coming soon |
Rehabilitation Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Physical therapy and speech and language therapy | In-network: $20 copay Out-of-network: 50% coinsurance |
Coming soon |
| Occupational therapy | In-network: $20 copay Out-of-network: 50% coinsurance |
Coming soon |
Medical Equipment and Supplies
| Covered Service | 2027 | 2026 |
|---|---|---|
| Diabetes supplies | In-network: 0%-20% coinsurance Out-of-network: 0%-20% coinsurance |
Coming soon |
| Durable medical equipment | In-network: 20% coinsurance Out-of-network: 35% coinsurance |
Coming soon |
| Prosthetics | In-network: 20% coinsurance Out-of-network: 35% coinsurance |
Coming soon |
Medicare Part B Drugs
| Covered Service | 2027 | 2026 |
|---|---|---|
| Chemotherapy | In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
Coming soon |
| Other Part B drugs (Medicare-covered) | In-network: 0%-20% coinsurance Out-of-network: 50% coinsurance |
Coming soon |
Dental Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Oral exam | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Dental x-rays | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Cleaning | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Periodontics | In-network: 50% coinsurance Out-of-network: 70% coinsurance |
Coming soon |
| Endodontics | In-network: 50% coinsurance Out-of-network: 70% coinsurance |
Coming soon |
| Restorative services | In-network: 50% coinsurance Out-of-network: 70% coinsurance |
Coming soon |
| Implant services | Not covered | Coming soon |
| Orthodontics | Not covered | Coming soon |
| Oral/Maxillofacial surgery | In-network: 50% coinsurance Out-of-network: 70% coinsurance |
Coming soon |
Vision Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Routine eye exam | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Contact lenses | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Eyeglass frames only | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Eyeglass lenses only | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Eyeglasses (frames & lenses) | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| Upgrades | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
Hearing Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Hearing exam | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Fitting/evaluation | In-network: $0 copay Out-of-network: 50% coinsurance |
Coming soon |
| Prescription hearing aids | In-network: $0 copay Out-of-network: $0 copay |
Coming soon |
| OTC hearing aids | Not covered | Coming soon |
Additional and Special Needs Services
| Covered Service | 2027 | 2026 |
|---|---|---|
| Adult day health services | Not covered | Coming soon |
| Home-based palliative care | Not covered | Coming soon |
| Personal emergency response system | Coming soon | Coming soon |
| Weight management programs | Not covered | Coming soon |
| Wigs for chemotherapy-related hair loss | Coming soon | Coming soon |
| Alternative therapies | Not covered | Coming soon |
| Massage therapy | Not covered | Coming soon |
| Home/bathroom safety devices | Not covered | Coming soon |
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.
Plan Availability
Aetna Medicare Eagle Giveback (H5521-724-0) 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)
How much does plan H5521-724 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 2027 in-network MOOP is $7900.00. Once this limit is reached, covered in-network costs are fully covered.
What is the total enrollment for plan H5521-724?
The plan has 0 enrolled beneficiaries according to CMS.
Is there a Part D deductible for this plan?
The plan’s Part D deductible is $0.00, applied to covered prescription drug costs.
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 |
|---|---|---|
| Aetna Medicare (official source) | http://www.aetna.com/medicare | 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 | Your coverage options | 25 May, 2025 |
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Data provenance is documented in accordance with 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.