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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 Greater Cincinnati Dayton OH 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 $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 $5500.00 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 has an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service. If you use a standard pharmacy or standard mail order, copays start at $2.00 for Tier 1 and $12.00 for Tier 2 for a one-month supply. For higher-tier medications, the plan charges a percentage of the drug cost instead of a flat copay. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These coinsurance rates remain the same whether you use preferred or standard pharmacies, or mail-order options.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with low out-of-pocket costs, including no copay for home health care and routine preventive services. For doctor visits, members pay a $5 copay for primary care providers and a $45 copay for specialists with no coinsurance. Inpatient hospital stays require a $380 daily copay for the first six days, while emergency room visits have a $130 copay that is waived upon admission. This plan also includes valuable dental, vision, and hearing benefits with no deductibles and no coinsurance for routine services. Routine eye exams, annual hearing exams, and preventive dental cleanings are covered with no copay. Additionally, members benefit from no copay on prescription hearing aids up to $1,000 per ear and a $125 annual allowance for eyewear.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) provides partially covered inpatient hospital benefits with no coinsurance, requiring a $380 daily copay for days 1 to 6 and no copay for days 7 to 90. Unlimited additional acute care days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services covered by Aetna Medicare Signature (HMO-POS) feature no coinsurance across all services, though prior authorization is required for some. Patients pay no copay for ambulatory surgical center and blood services, a $40 copay for outpatient substance abuse sessions, and copays ranging from $0 to $380 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required to access these benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $290 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay with no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum benefit with copays ranging from $130 to $290 and no coinsurance.
Primary Care See details
Primary care services under Aetna Medicare Signature (HMO-POS) are covered with no coinsurance, featuring a $5 copay for primary care physicians, a $45 copay for specialists, and $40 to $45 copays for physical, occupational, and mental health therapies. Chiropractic care is partially covered with routine visits requiring a $15 copay and no coinsurance, though other chiropractic services are not covered, and telehealth is available with no copay to a $50 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered under Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance for annual physical exams, glaucoma screenings, diabetes training, and fitness benefits, while kidney disease education has no copay but a 20% coinsurance. Supplemental benefits like chemotherapy wigs are covered up to $400 annually with no copay, but several services including in-home safety assessments, medical nutrition therapy, weight management, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS) with no deductible and no coinsurance. Medicare-covered exams require a $45 copay and no coinsurance, while annual routine exams, fitting evaluations, and prescription hearing aids (up to $1,000 per ear) require no copay and no coinsurance. 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 annual routine eye exams and diabetic eye exams with no copay. Medicare-covered eye exams have a copay of $0 to $45, and eyewear services—including contacts, lenses, and frames—are covered with no copay up to a $125 annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), offering preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental with a $45 copay and no coinsurance. Comprehensive services require no copay and 20% to 50% coinsurance up to a $1,000 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services 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 and step therapy may apply. Under this benefit, Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO-POS) with no copays, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices require a 20% coinsurance and diabetic therapeutic shoes or inserts feature no copay.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services, with prior authorization required for coverage. Diagnostic tests require a $0 to $250 copay with no coinsurance, lab services feature no copay and no coinsurance, and outpatient X-rays require a $15 copay plus coinsurance. Diagnostic radiological services have copays starting at $0, while therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided with no coinsurance under Aetna Medicare Signature (HMO-POS). Although some services are covered, specific sub-services are not covered, including cardiac rehabilitation (which has a $20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($25 copay).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, providing an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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