A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Sacramento, San Joaquin and Yolo Counties. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Aetna Medicare Signature (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Aetna Medicare Signature (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2000.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Aetna Medicare Signature (HMO) prescription drug plan features an annual deductible of $615.00 before initial coverage begins. During this initial phase, Tier 1 preferred generic drugs have no copay at preferred pharmacies and preferred mail order, but require a $12.00 copay at standard pharmacies and standard mail. For higher tiers, you will pay a 24% coinsurance for Tier 2 standard generics and a 25% coinsurance for both Tier 3 preferred brands and Tier 4 non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, beneficiaries who qualify for the low-income subsidy can reduce their Part D costs to zero.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust medical coverage with no copays or coinsurance for primary care, specialist visits, mental health services, and physical therapy. Inpatient hospital stays require a $175 daily copay for the first five days and no copay for days six through ninety, while emergency services carry a $150 copay. Outpatient care features no coinsurance and copays ranging from no copay up to $175. Additionally, members benefit from routine vision, hearing, and preventive dental services with no copays or coinsurance, including hearing aid coverage up to $1,250 per ear. Comprehensive dental care requires a 20% to 50% coinsurance, and skilled nursing facility stays are covered with no copay for the first 20 days. Diagnostic lab tests, x-rays, and home health care are also available with no copays.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital benefits, requiring a $175 copay per day for days 1 through 5, no copay for days 6 through 90, and no coinsurance for covered acute and psychiatric stays. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance, featuring copays ranging from $0 to $175 for outpatient hospital services and a $125 copay for ambulatory surgical center services. Observation services require a $175 copay per stay, while outpatient blood services and substance abuse sessions are provided with no copay.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by the Aetna Medicare Signature (HMO) plan, though prior authorization is required. Depending on the service, you will pay either no copay or a $180 copay, with no coinsurance required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under Aetna Medicare Signature (HMO), as transportation services to plan-approved or any health-related locations are not covered. Ground ambulance services require a $250 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for both.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $10 copay and no coinsurance, while worldwide emergency care and transportation are covered up to a $250,000 maximum with copays ranging from $150 to $250 and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature (HMO), featuring no copays and no coinsurance for primary care, specialist visits, mental health, and physical therapy, while podiatry services are not covered. Covered telehealth benefits require a 20% coinsurance and a copay between $0 and $10.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), with no copay and no coinsurance for annual physicals, health education, and screenings, while kidney disease education requires a 20% coinsurance and no copay. Non-covered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), providing routine exams, fitting evaluations, and general prescription hearing aids with no copay or coinsurance up to a $1,250 annual limit per ear. Over-the-counter (OTC) hearing aids and prescription hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance for annual routine eye exams and follow-up diabetic eye exams. Covered eyewear, including contact lenses and eyeglasses, also features no copay and no coinsurance up to a $125 combined maximum benefit limit per year.
Dental Services See details
Aetna Medicare Signature (HMO) partially covers dental services, offering no copay and no coinsurance for Medicare dental services, oral exams, cleanings, and x-rays. Covered comprehensive services like restorative care and endodontics require a 20% to 50% coinsurance and no copay, subject to a $750 annual maximum. Fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with prior authorization required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO), with prior authorization required for durable medical equipment, prosthetics, and diabetic supplies. Members will pay no copays for these services, with coinsurance ranging from no coinsurance up to 20% depending on the specific item.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with no coinsurance. There is no copay for lab services, diagnostic tests, outpatient X-rays, and diagnostic radiology, while therapeutic radiological services require a $60 copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO) plan, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Signature (HMO), with prior authorization required and no coinsurance. There is no copay for days 1 through 20 and a $50 daily copay for days 21 through 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO), offering acupuncture, over-the-counter items with a $30 quarterly limit, annual wellness exams, and additional cancer screenings with no copay and no coinsurance. Meal benefits and Dual Eligible SNPs with Highly Integrated Services are not covered.
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