Aetna Medicare Eagle Giveback (PPO) Medicare Advantage Plan H5521-322 • 2026 • Brunswick County, VA

Aetna Medicare Eagle Giveback Overview

Plan Details for Aetna Medicare Eagle Giveback

This Medicare Advantage Preferred Provider Organization (PPO) plan provides access to Medicare-approved providers and covers Medicare Part A and Part B services. The monthly premium is $0.00, with lower costs when using in-network providers.

Primary care visits have a $0 copay | Out-of-network: $10 copay, specialist visits come with a $0-$35 copay | Out-of-network: $45 copay, urgent care services carry a $50 copay, and ambulance transportation is $275 copay | Out-of-network: $275 copay. These costs apply toward the annual maximum out-of-pocket (MOOP) limit of $6750.00. Once this limit is reached, in-network services are fully covered.

This plan is listed by CMS under Plan ID H5521-322. Cost-sharing details for key services are provided below.

Out-of-Pocket Costs

Aetna Medicare Eagle Giveback includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The table below outlines the most common in-network out-of-pocket costs associated with plan H5521-322.

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 Star Ratings

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.