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Aetna Medicare Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO-POS). 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-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Lexington Area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO-POS) 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-POS).
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-POS), 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 $500.00 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 $4900.00 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-POS) plan features an annual drug deductible of $500. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when utilizing preferred pharmacies or preferred mail order services. Standard pharmacies and standard mail order options require copays starting at $2 for Tier 1 and $12 for Tier 2 one-month supplies. For higher-tier medications, costs are determined by coinsurance across all pharmacy and mail order options. Tier 3 preferred brand drugs require a 22% coinsurance, Tier 4 non-preferred drugs require 25%, and Tier 5 specialty drugs require 27% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage featuring no copay or coinsurance for primary care visits, annual physicals, and routine preventive screenings. For emergency medical needs, members pay a $130 copay for emergency room visits and a $50 copay for urgent care, with no coinsurance required. Inpatient hospital stays require a $315 daily copay for the first seven days, after which there is no copay for days eight through 90. Specialty benefits under this plan include routine vision and hearing exams with no copay, alongside allowances of up to $150 annually for eyewear and $1,250 per ear for hearing aids. Preventive dental services also feature no copay, while covered comprehensive dental care requires a 20% to 50% coinsurance up to a $1,000 annual limit. Additionally, members can access home health services and diagnostic laboratory tests with no copay, keeping out-of-pocket costs highly predictable.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute and psychiatric hospital services with prior authorization, featuring no coinsurance, a $315 daily copay for days 1 through 7, and no copay for days 8 through 90. This benefit is partially covered, as hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $315, observation services carry a $315 copay per stay, and outpatient substance abuse services require a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization with a copayment of either $40.00 or $145.00 and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (HMO-POS), with ground ambulance services requiring a $290 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and transportation services are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, and worldwide emergency transportation has a $290 copay, all with no coinsurance up to a $250,000 maximum benefit.
Primary Care See details
Primary care services are covered under Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance for primary care visits, and a $45 copay with no coinsurance for specialists. Therapy and mental health services generally require a $40 copay with no coinsurance, while chiropractic services are partially covered with routine care costing a $15 copay and no coinsurance, but other chiropractic services are not covered.
Preventive Services See details
Preventive services under Aetna Medicare Signature (HMO-POS) are covered with no copay and no coinsurance for annual physicals and screenings, though kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered, as the plan excludes in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) covers Medicare-covered hearing exams with a $45 copay and no coinsurance, while routine hearing exams and fitting evaluations have no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear every year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, offering eye exams with a copay ranging from no copay to $45. Routine eye exams and eyewear—including contacts, lenses, and frames—are covered with no copay, with eyewear benefits capped at a combined maximum of $150 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), with Medicare-covered dental care requiring a $45 copay and no coinsurance, and preventive services requiring no copay and no coinsurance. Covered comprehensive services have no copay and 20% to 50% coinsurance up to a $1,000 annual limit, but fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO-POS) with no copays, though prior authorization is required for most items. Durable medical equipment, prosthetics, and medical supplies feature no copay and 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts have no copay and diabetic supplies carry 0% to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization required. Outpatient diagnostic tests have no coinsurance and a copay ranging from no copay to $100, while lab services have no copay. Radiological services require a $10 copay for X-rays, a minimum of no copay for diagnostic radiology, and at least 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Signature (HMO-POS) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature (HMO-POS) with no coinsurance, but some services are covered while cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation (with a $20 copay), pulmonary rehabilitation (with a $15 copay), and supervised exercise therapy for symptomatic peripheral artery disease services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items up to $30 every three months, annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered under this benefit.
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