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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 Louisville KY. 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) prescription drug coverage includes an annual drug deductible of $615. You can enjoy no copay on Tier 1 preferred generic and Tier 2 generic drugs when filled through preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 medications depending on the supply fill. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. These coinsurance percentages remain the same regardless of whether you use preferred or standard pharmacies, or choose mail-order delivery.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with predictable cost-sharing, including a low $5 copay for primary care visits and no copay for key preventive services. Emergency care features a $130 copay that is waived upon hospital admission, while inpatient hospital stays require a $290 daily copay for the first eight days and no copay for days 9 through 90. Outpatient services and diagnostic labs are also highly accessible, typically requiring no coinsurance and low-to-no copays. Members also benefit from essential routine care, including preventive dental cleanings, annual eye exams, and hearing evaluations with no copays, alongside annual allowances for eyewear and hearing aids. Durable medical equipment and home health services are covered with no copays, though some equipment may require up to 20% coinsurance. Additionally, skilled nursing facility stays offer no copay for the first 20 days, and the plan provides a quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital services under the Aetna Medicare Signature (HMO-POS) plan feature no coinsurance, requiring a $290 daily copay for days 1 to 8 and no copay for days 9 to 90 for both acute and psychiatric stays. Prior authorization is required, and while unlimited additional acute days are covered with no copay, 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-POS) with no coinsurance, featuring a $0 to $290 copay for outpatient hospital services, a $40 copay for substance abuse sessions, and no copay for ambulatory surgical center and blood services. Prior authorization is required for most outpatient services, and there is no deductible for blood services.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copayment of either $40.00 or $145.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $295 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the Aetna Medicare Signature (HMO-POS) plan with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $295.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care physician services for a $5 copay and no coinsurance, and specialist, therapy, and psychiatric services for a $40 copay and no coinsurance. Chiropractic services are partially covered, offering routine care for a $15 copay and no coinsurance but excluding other chiropractic services. Additional telehealth benefits are also available with a copay ranging from no copay to $50 and 20% coinsurance.
Preventive Services See details
Preventive services under Aetna Medicare Signature (HMO-POS) are partially covered, offering key benefits like annual physicals, fitness programs, and diabetes self-management with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while other services, including in-home safety assessments, medical nutrition therapy, and weight management programs, are not covered.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (HMO-POS) with no deductible, including Medicare-covered exams for a $40 copay and no coinsurance, and routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $1,000 per ear annually, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, offering routine and follow-up diabetic eye exams with no copay and other eye exams with a copay of $0 to $40. Covered eyewear, including contacts, eyeglasses, lenses, and frames, has no copay and no coinsurance up to a combined maximum benefit of $100 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), where Medicare-covered dental services require a $40 copay and no coinsurance. Preventive services like oral exams, cleanings, and X-rays are covered with no copay and no coinsurance, but fluoride, other diagnostic or preventive services, restorative care, endodontics, periodontics, prosthodontics, implants, and oral surgery are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, although prior authorization is required. 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% (no coinsurance) to 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to access these services.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copays. Coinsurance for these covered items ranges from no coinsurance up to 20%, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance and a copay ranging from $0 to $200 for diagnostic procedures, while lab services require no copay. Outpatient X-rays require a $10 copay, diagnostic radiological services have no minimum copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under Aetna Medicare Signature (HMO-POS), though some services are covered while others are not in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered, carrying copays ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers skilled nursing facility (SNF) services 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, with no coverage for additional days beyond the Medicare standard.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance for annual wellness exams, additional gFOBT and FIT screenings, and over-the-counter items up to $15 every three months. Acupuncture, meal benefits, and Dual Eligible SNPs are not covered.
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