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 Select Counties in GA. This plan received an overall rating of 4.5 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 $7900.00 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) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, copays range from $2 to $6 for Tier 1 drugs and $12 to $36 for Tier 2 drugs, depending on the supply length. For higher-tier medications, costs transition from flat copays to coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy options. Tier 5 specialty drugs also require a 25% coinsurance and are limited to a 1-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers affordable medical coverage with no copay for primary care visits, home health services, and routine preventive care. For specialist visits and emergency room care, members can expect predictable copays of up to $45 and $115 respectively, with no coinsurance. Inpatient hospital stays require daily copays for the first several days of a stay, after which subsequent covered days have no copay. Essential wellness benefits like routine vision exams, annual hearing evaluations, and diagnostic lab services are also available with no copay. The plan covers prescription hearing aids and eyewear up to specified annual limits, while dental services, diagnostic tests, and rehabilitation feature low copays and minimal coinsurance. Durable medical equipment and dialysis services are covered with no copay and a standard twenty percent coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) covers inpatient hospital services with no coinsurance, requiring a $388 daily copay for days 1-7 of acute stays and a $407 daily copay for days 1-5 of psychiatric stays, with no copay for subsequent covered days. The benefit is partially covered as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by Aetna Medicare Signature (HMO) feature no coinsurance across all services, with no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $388, observation services carry a $388 copay per stay, and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Signature (HMO) require prior authorization, offering ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. For transportation services, only some services are covered, but trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 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 $115 to $250.
Primary Care See details
Aetna Medicare Signature (HMO) offers primary care physician visits with no copay and no coinsurance, and specialist visits with a copay of up to $45 and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while telehealth is available with a copay of up to $50 and 20% coinsurance; chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), offering annual physicals and screenings with no copay and no coinsurance, while kidney disease education has a 20% coinsurance and no copay. Non-covered 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, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (HMO), including annual routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $45 copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no coinsurance, offering routine and diabetic follow-up eye exams with no copay, and Medicare-covered exams with a $0 to $45 copay. Eyewear, including lenses, frames, and contacts, is covered with no copay and no coinsurance up to a $200 annual maximum benefit.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (HMO), featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay with no coinsurance to 50% coinsurance for other covered services up to a $1,500 annual limit. Other diagnostic dental services, fluoride treatment, other preventive dental services, 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 no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment, including durable medical equipment (DME) and prosthetics, is covered by Aetna Medicare Signature (HMO) with no copay and 20% coinsurance, subject to prior authorization. Diabetic supplies are covered with 0% to 20% coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay and coinsurance from specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with prior authorization, offering no coinsurance and a copay ranging from $0 to $95 for diagnostic tests and procedures. Lab services, diagnostic radiological services, and outpatient X-rays have no copay, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO) covers cardiac rehabilitation services with no coinsurance, featuring a $25 copay for standard and intensive cardiac rehabilitation. Pulmonary rehabilitation services have a $15 copay, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) requires a $20 copay, both with no coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but waiving the prior 3-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 benefit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO), excluding acupuncture and select other services. Covered benefits, including chronic illness meals, annual wellness exams, screening mammography, additional gFOBT and FIT screenings, and a $30 quarterly over-the-counter item allowance, are all offered with no copay and no coinsurance.
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