Medicare Advantage · Local PPO
Aetna Medicare
Plan year 2026

Aetna Medicare Eagle Plus (PPO) H5521-324

4.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$0
+ your Part B premium
Max out-of-pocket
$9,250
in-network annual cap
Primary care
$0
per visit copay
Specialist
$35
per visit
This plan does not include Part D drug coverage
Before enrolling, confirm how your prescriptions will be covered. Whether you can add a standalone Part D plan depends on the Medicare Advantage plan type; pairing one with most MA HMO or PPO plans can disenroll you from Medicare Advantage. A gap in creditable drug coverage may lead to a Part D late enrollment penalty later.

Part D late enrollment penalty

If you go 63 days or more in a row after your Part D initial enrollment period without Part D or other creditable prescription drug coverage, you may owe a penalty if you join Part D later. The penalty is 1% of the national base beneficiary premium ($38.99 in 2026) for each full uncovered month. It is added to your monthly Part D premium for as long as you have Part D, and the base premium can change each year.

Who this type of plan may fit

MA-Only plans are generally considered by people who already have creditable prescription drug coverage, such as coverage from the VA, TRICARE, or a current or former employer or union. Your coverage provider—not this page—must tell you whether your current drug coverage is creditable.

Before you enroll
  • Find your current plan's annual Notice of Creditable Coverage or ask its benefits administrator.
  • Confirm in this plan's official documents whether adding a standalone drug plan is allowed.
  • Do not drop existing drug coverage until you understand how the change affects both coverages.
Review the creditable coverage checklist

Your costs at a glanceIn-network, for the 2026 plan year

Drug coverage
Not included
Inpatient hospital
Days 1-7: $380/day, Days 8-90: $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $407/day, Days 6-90: $0/day
Outpatient surgery
$380
Emergency room
$115
Urgent care
$20

What's included, and what it's actually worth4 benefits included. Tap any card for the detail

Hearing

$500/yr hearing aid allowance
Hearing aid allowance$500/yr hearing aid allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$350/yr eyewear allowance
Eyewear allowance$350/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$35 copay
In-network$35 copay per visit
Inpatient Hospital$380/day, days 1–7
In-networkDays 1-7: $380/day, Days 8-90: $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$380 copay
In-network$380 copay per procedure
Mental HealthDays 1-5: $407/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $407/day, Days 6-90: $0/day
Fitness$0 fitness benefit
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors you added

Our take

Where this plan shines

This plan has a $0 monthly premium.
See your primary doctor for $0.
Highly rated by CMS (4.5 stars).

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Does not include prescription drug coverage — confirm whether you can keep other creditable coverage or pair this plan with a standalone Part D plan.
Late enrollment penalty risk if you go without creditable drug coverage for 63+ days.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about Aetna Medicare Eagle Plus (PPO) (Local PPO)

What does Aetna Medicare Eagle Plus (PPO) (Local PPO) cover?

Aetna Medicare Eagle Plus (PPO) (Local PPO) is a Medicare Advantage plan that the current plan record identifies as not including Part D prescription drug coverage. The plan record does not identify Part D prescription drug coverage. Published supplemental benefits include vision ($350/yr eyewear allowance), hearing ($500/yr hearing aid allowance), fitness ($0 fitness benefit), and meals (Meal benefit). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does Aetna Medicare Eagle Plus (PPO) (Local PPO) cost in 2026?

The published 2026 monthly plan premium for Aetna Medicare Eagle Plus (PPO) (Local PPO) is $0. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The in-network medical out-of-pocket maximum is $9,250; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $35. These figures are plan data, not a personal yearly-cost estimate.

Can I use my current doctors with Aetna Medicare Eagle Plus (PPO) (Local PPO)?

CMS lists Aetna Medicare Eagle Plus (PPO) (Local PPO) as a Local PPO plan. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

Does Aetna Medicare Eagle Plus (PPO) (Local PPO) include prescription drug coverage?

Aetna Medicare Eagle Plus (PPO) (Local PPO) is listed in the current plan record as a Medicare Advantage plan without Part D prescription drug coverage. Do not assume that a separate standalone Part D plan can be added: many Medicare Advantage plans cannot be paired with a PDP, and joining one can affect Medicare Advantage enrollment. Confirm this plan's rules and how your prescriptions will be covered before enrolling.

Browse standalone Part D plans

What extra benefits does Aetna Medicare Eagle Plus (PPO) (Local PPO) offer beyond Original Medicare?

The current plan record for Aetna Medicare Eagle Plus (PPO) (Local PPO) lists vision ($350/yr eyewear allowance), hearing ($500/yr hearing aid allowance), fitness ($0 fitness benefit), and meals (Meal benefit). The current data does not list dental, over-the-counter (OTC), and transportation as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

When can I enroll in Aetna Medicare Eagle Plus (PPO) (Local PPO)?

Aetna Medicare Eagle Plus (PPO) (Local PPO) is a 2026 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage without drug coverage directory. This plan is offered in Mississippi. Plan availability can vary by county.

Helpful next steps

Aetna Medicare Eagle Plus H5521-324 (PPO) — 2026 Costs & Benefits