Your Aetna Enhanced PPO
Aetna Premier PPO has changed their name to Aetna Enhanced PPO for 2026
EyeMed link: AetnaMedicareVision.com
Nations Hearing Link: Aetna.Nationsbenefits.com/Hearing
Dental link: https://shorturl.at/RoEcQ
Find a Doc: Aetnamedicare.com/en/find-doctors-hospitals/find-provider.html
For a complete listing of benefits for 2026, visit http://AetnaMedicare.com/H5521-150
Aetna Customer Service: 1-833-570-6670
2025
2026
Premier PPO
Enhanced PPO
H5521-150
H5521-150
In Network / Out of Network
In Network / Out of Network
Premium
$16
$30
Primary Doctor
$0 / 50%
$0 / 50%
Specialist
$35 / $50
$35 / 50%
Physical Therapy
$30 / 50%
$35 / 50%
Urgent Care
$35
$35
Hospital
$265 days 1-8
$310 days 1-7
Out of Network
50%
50%
MOOP Cap
$4,500 / $10,100
(for in- and out-of-network services combined)
$5,000 / $10,100
(for in- and out-of-network services combined)
Outpatient Surgery
$265 / 50%
$310 / 50%
Ambulance
$280 / 20% (air)
$280 / 20% (air)
Emergency
$125
$130
Lab Services
$0 / 50%
$0 / 50%
X-Rays
$20 / 50%
$20 / 50%
Complex Diagnostic
$195 / 50%
$195 / 50%
Part D (Tiers 1-4)
$0 / $5 / 25% / 35%
$0 / $0 / 24% / 25%
100 Day- Mail Order
$0 / $15 / 25% / 35%
$0 / $0 / 24%/ 25%
Part D Deductible
$0
$615
(applies to 3,4,5)
Hearing Aid
$750 Allowance per
$500 Allowance per ear
OTC
$60 / quarter
N/A
Gym Membership
Silver Sneakers
Silver Sneakers
Dental
$1,750 DMR
$1,500
$0 Copay for preventive
20%-50% coinsurance for comprehensive services
Dental Network
Aetna Dental PPO Network/ 50% out of network
Aetna Dental PPO Network / 50% preventive coinsurance, 50%-70% comprehensive coinsurance
Vision
$200 (Eye Med)
$150 (Eye Med)
Your Aetna Enhanced PPO
Aetna Premier PPO has changed their name to Aetna Enhanced PPO for 2026
2025
2026
Premier PPO
Premier PPO
H5521-150
H5521-150
In Network / Out of Network
In Network / Out of Network
Premium
$16
$30
Primary Doctor
$0 / 50%
$0 / 50%
Specialist
$30 / 50%
$30 / 50%
Physical Therapy
$30 / 50%
$35 / 50%
Urgent Care
$35
$35
Hospital
$265 days 1-8
$310 days 1-7
Out of Network
50%
50%
MOOP Cap
$4,500 / $10,100
(for in- and out-of-network services combined)
$5,000 / $10,100
(for in- and out-of-network services combined)
Outpatient Surgery
$265 / 50%
$310 / 50%
Ambulance
$280 / 20% (air)
$280 / 20% (air)
Emergency
$125
$130
Lab Services
$0 / 50%
$0 / 50%
X-Rays
$20 / 50%
$20 / 50%
Complex Diagnostic
$195 / 50%
$195 / 50%
Part D
$0 / $5 / 25% / 35%
$0 / $0 / 24% / 25%
100 Day- Mail Order
$0 / $15 / 25% / 35%
$0 / $0 / 24% / 25%
Part D Deductible
$0
$615
(applies to 3,4,5)
Hearing Aid
$750 Allowance per
$500 Allowance per ear
OTC
$60 / quarter
N/A
Gym Membership
Silver Sneakers
Silver Sneakers
Dental
$1,750 DMR
$1,500
$0 Copay for preventive
20%-50% coinsurance for comprehensive services
Dental Network
Aetna Dental PPO Network/ 50% out of network
Aetna Dental PPO Network / 50% preventive coinsurance, 50%-70% comprehensive coinsurance
Vision
$200 (Eye Med)
$150 (Eye Med)
EyeMed link: AetnaMedicareVision.com
Nations Hearing Link: Aetna.Nationsbenefits.com/Hearing
Dental link: https://shorturl.at/RoEcQ
Find a Doc: Aetnamedicare.com/en/find-doctors-hospitals/find-provider.html
For a complete listing of benefits for 2026, visit http://AetnaMedicare.com/H5521-150
Aetna Customer Service: 1-833-570-6670