Aetna Medicare Enhanced Extra (PPO)

3.5 out of 5 stars
$52.00
Monthly Premium

Aetna Medicare Enhanced Extra (PPO) is a PPO plan offered by Aetna Inc.

Plan ID: H1608-118

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.


Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as Aetna Medicare Enhanced Extra (PPO) - H1608-118 by Aetna Inc. as well as other Medicare Advantage plans available in your area.

$52.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $615
Out of Pocket Max In-Network: $5000
Out-of-Network: N/A
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit
Out-of-Network|$35
Specialty Doctor Visit
Out-of-Network|$65
Inpatient Hospital Care
Out-of-Network|40% per stay
Urgent Care

Urgent Care:
Copayment for Urgent Care $50

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $130
Maximum Plan Benefit of $250,000
Emergency Room Visit
$130 If you are admitted to the hospital within 24 hours your cost share may be waived
Ambulance Transportation
Out-of-Network|$245

Health Care Services and Medical Supplies

Aetna Medicare Enhanced Extra (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services

Out-of-Network:

Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 40%
In-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network|0% for Roche/Accu-Chek and TRUE/Trividia diabetic supplies|20% for other covered diabetic supplies
Durable Medical Equipment (DME)
Out-of-Network|40%
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Lab Services: Out-of-Network|$30
Diagnostic Procedures: Out-of-Network|40%
Imaging: Out-of-Network|40%
Home Health Care
Out-of-Network|40%
Mental Health Inpatient Care
In-Network:

Psychiatric Hospital Services:
$370 per day for days 1 to 5
$0 per day for days 6 to 90
Prior Authorization Required for Psychiatric Hospital Services
Mental Health Outpatient Care
Out-of-Network|40% for Mental Health Services- Group Sessions|40% for Mental Health Services - Individual Sessions|40% for Psychiatric Services - Group Sessions|40% for Psychiatric Services - Individual Sessions
Outpatient Services / Surgery
Ambulatory Surgical Center: In-Network|$0 for preventive and diagnostic colonoscopy|$275 all other ambulatory surgical center services
Outpatient Substance Abuse Care
In-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $40
Copayment for Medicare-covered Group Sessions $40
Prior Authorization Required for Outpatient Substance Abuse Services

Out-of-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual Sessions 40%
Coinsurance for Medicare Covered Group Sessions 40%
Over-the-counter (OTC) Items
Over-the-Counter (OTC) Wallet with a $50 quarterly benefit amount (allowance) on the Extra Benefits Card to help pay for approved OTC health and wellness products like first aid supplies, cold and allergy medicine, pain relievers, and more. Approved products can be purchased in-store at participating locations including CVS retail locations (excluding locations inside other stores), and online or by phone through CVS OTC Health Solutions.
Podiatry Services
In-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $35

Out-of-Network:

Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 40%
Skilled Nursing Facility Care
Out-of-Network|40% per stay

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
Out-of-Network||Preventive dental services:|50% for oral exams|50% for cleanings|50% for fluoride treatments|50% for x-rays|50% for other diagnostic dental services|50% for other preventive dental services||Comprehensive dental services:|50% for restorative services|50% for endodontic services|50% for periodontic services|50% for removeable prosthodontics|50% for fixed prosthodontics|50% for oral and maxillofacial surgery|50% for adjunctive services||$2,000 benefit amount (allowance) every year in and out-of-network for covered preventive and comprehensive dental services combined. Medical necessity requirements vary by covered dental service.||ADA recognized dental services are covered up to the benefit amount excluding implants and implant related services, orthodontics, cosmetic services, those considered medical in nature, and administrative charges. See EOC for a full list of exclusions.

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
Out-of-Network||Eye Exams:|40% for Medicare-covered eye exams|0% for non-Medicare covered eye exams|Maximum one non-Medicare covered routine eye exam every calendar year in or out-of-network (out of network covered up to $50)||Eyewear:|40% for Medicare-covered prescription eyewear|$0 for Contacts|$0 for Eyeglass Frames|$0 for Eyeglass Lenses|$0 for Eyeglass Lenses and Frames|$0 for Upgrades||$250 annual benefit amount (allowance) for non-Medicare covered prescription eyewear.

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network||Hearing Exams:|$0 for Medicare-covered hearing exams|$0 for non-Medicare covered hearing exams|(Maximum one non-Medicare covered hearing exam every year in or out-of-network)|$0 for fitting/evaluation for hearing aids|(Maximum one hearing aid fitting/evaluation every year)||Hearing Aids:|$0 for hearing aids|$1,250 benefit amount (allowance) per ear, every year for hearing aids|(Maximum two hearing aids every year)

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
Out-of-Network|0% for the pneumonia, influenza, Hepatitis B, and Covid-19 vaccines|40% for all other preventive services covered under Original Medicare

Prescription Drug Costs and Coverage

The Aetna Medicare Enhanced Extra (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $615 (excludes Tiers 1 and 2) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $615 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $2.00
  • Standard mail order $2.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $12.00
  • Standard mail order $12.00
  • Preferred cost-share retail $0.00
Annual Drug Deductible $615 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $4.00
  • Standard mail order $4.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $24.00
  • Standard mail order $24.00
  • Preferred cost-share retail $0.00
Annual Drug Deductible $615 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $6.00
  • Standard mail order $6.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $36.00
  • Standard mail order $36.00
  • Preferred cost-share retail $0.00
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