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Aetna Medicare Signature Extra (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (HMO) in 2026, please refer to our full plan details page.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature Extra (HMO) is a HMO plan offered by Aetna Health of California Inc. available for the 2026 plan year to people living in San Diego County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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
Health deductible: information not available.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $2000.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $2000.00 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 Extra (HMO) prescription drug plan features an annual deductible of $615.00 before your initial coverage begins. Once this deductible is met, you will pay no copay for Tier 1 preferred generic drugs filled at preferred pharmacies or through preferred mail-order services, while standard pharmacies and mail-order services require a $12.00 copay. For Tier 2 standard generic drugs, the plan charges a 24% coinsurance regardless of the pharmacy type you choose. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both carry a 25% coinsurance for all pharmacy and mail options during the initial coverage phase. After your yearly out-of-pocket drug costs reach $2,100.00, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy, your Part D costs may be reduced to $0.00.
Additional Benefits
The Aetna Medicare Signature Extra (HMO) offers comprehensive medical coverage featuring no copays and no coinsurance for routine primary care, specialist consultations, and preventive services. For hospital care, inpatient stays require a $225 daily copay for the first five days followed by no copay, while outpatient hospital visits range from no copay up to a $200 copay. Emergency room visits incur a $150 copay, which is waived if you are admitted within 24 hours, and urgent care services are covered with no copay. The plan also includes valuable supplemental coverage, including routine dental, vision, and hearing exams with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually and eyewear is covered up to $100 annually, both with no copay or coinsurance. Additionally, comprehensive dental care is available with no copay and 20% to 50% coinsurance up to a $750 annual limit, while home health services are provided with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Extra (HMO) covers inpatient acute and psychiatric hospital stays with a $225 daily copay for days 1 through 5, no copay for days 6 through 90, and no coinsurance. Prior authorization is required, and certain services like hospital upgrades, non-Medicare-covered stays, and additional days for psychiatric stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Extra (HMO) with no coinsurance, including no copay for ambulatory surgical center services, blood services, and substance abuse sessions. Outpatient hospital services require a copay of $0 to $200, while observation services incur a $225 copay per stay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (HMO) covers partial hospitalization services with prior authorization, requiring either no copay or a $180 copay, and no coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Aetna Medicare Signature Extra (HMO), though transportation services to health-related locations are not covered. Covered ground ambulance services require a $245 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for all ambulance services.
Emergency Services See details
Aetna Medicare Signature Extra (HMO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with copays ranging from $150 to $245 and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature Extra (HMO) because podiatry services are not covered. Covered services like primary care visits, specialist consultations, and mental health services have no copay and no coinsurance, while additional telehealth services require a 20% coinsurance and no copay.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (HMO), offering annual physical exams, health education, and fitness benefits with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance. Multiple sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Extra (HMO), offering routine exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner, outer, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature Extra (HMO) covers vision services with no copay or coinsurance, including one routine eye exam per year. Covered eyewear, such as contacts and eyeglasses, is also available with no copay or coinsurance up to a combined maximum benefit of $100 annually.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (HMO), offering Medicare-covered dental, oral exams, cleanings, and x-rays with no copay and no coinsurance. Covered comprehensive services such as restorative care, endodontics, periodontics, prosthodontics, and oral surgery have no copay and a 20% to 50% coinsurance up to a $750 annual maximum, though fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (HMO) covers home infusion bundled services with prior authorization, featuring a $35 copay and no coinsurance for Part B insulin. Chemotherapy, radiation, and other Part B drugs require no copay and range from no coinsurance up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Signature Extra (HMO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive these services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Signature Extra (HMO), with prior authorization required for most services. Durable medical equipment and diabetic supplies have no copay and 0% to 20% coinsurance, prosthetic devices require 20% coinsurance with no copay, and medical supplies and diabetic shoes are available with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (HMO) with no copay and no coinsurance for lab services, outpatient X-rays, diagnostic tests, and diagnostic radiology. Therapeutic radiological services require a 20% coinsurance and no copay, with prior authorization and doctor referrals required for certain services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Extra (HMO) plan with no copay and no coinsurance. Prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under Aetna Medicare Signature Extra (HMO), as cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are all excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Signature Extra (HMO), as additional days beyond Medicare-covered care are not covered. For covered stays, there is no coinsurance, with no copay required for days 1 through 20 and a $100 daily copay for days 21 through 100.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Extra (HMO) with no copay and no coinsurance for acupuncture, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings. Over-the-counter items, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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