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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 IL Chicago. The overall rating for this plan is not yet available for 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 $5900.00 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 $615. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy no copay when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options incur a small copay starting at $2 for Tier 1 and $12 for Tier 2 medications for a one-month supply. For higher-tier medications, the plan transitions to a coinsurance-based cost-sharing model. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance across all pharmacy and mail-order channels. This structure helps beneficiaries plan their healthcare expenses by offering no-cost options for common generics alongside clear cost-sharing for brand-name and specialty prescriptions.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and routine lab work. For specialized care, members pay a $40 copay for specialist visits and urgent care, while emergency room visits carry a $130 copay with no coinsurance. Inpatient hospital stays require daily copays for the first seven days, after which there is no copay, and outpatient hospital services range from no copay up to a $350 copay. This plan also provides valuable dental, vision, and hearing benefits to help reduce out-of-pocket expenses. Routine vision and preventive dental services are available with no copay, alongside an annual eyewear allowance of up to $150 and up to $750 per ear for prescription hearing aids. Additionally, Medicare Part B insulin is capped at a $35 copay, while durable medical equipment and dialysis require no copay and up to 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient hospital services with no coinsurance, though prior authorization is required, and non-Medicare-covered stays and upgrades are not covered. Acute care stays require a $350 daily copay for days 1 to 7 and no copay for day 8 and beyond, while psychiatric stays require a $325 daily copay for days 1 to 7 and no copay for days 8 to 90.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, including no copays for ambulatory surgical center and blood services. Outpatient hospital services require copays ranging from no copay to $350 (with a $350 copay per stay for observation services), while outpatient substance abuse sessions have a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $285 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgent care with a $40 copay, both with no coinsurance and costs that do not count toward the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $285.
Primary Care See details
Aetna Medicare Signature (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require a $40 copay and no coinsurance. Telehealth benefits are covered with a 20% coinsurance and a $0 to $40 copay, but podiatry is not covered, and chiropractic care is only partially covered with routine and other chiropractic services excluded.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (HMO-POS) are partially covered, offering annual physicals, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance, while kidney disease education has no copay but a 20% coinsurance. Supplemental services such as personal emergency response systems, medical nutrition therapy, weight management programs, and in-home safety assessments are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), with Medicare-covered exams requiring a $40 copay and no coinsurance, while annual routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are covered up to $750 per ear annually with no copay or coinsurance, though 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 annual routine eye exams and eyewear with no copay. Eyewear benefits, including lenses, frames, and contacts, are covered up to a $150 annual maximum, while Medicare-covered eye exams carry a copay of $0 to $40.
Dental Services See details
Aetna Medicare Signature (HMO-POS) partially covers dental services, offering Medicare-covered dental for a $40 copay and no coinsurance, and preventive care with no copay and no coinsurance. Comprehensive services are covered up to a $2,250 annual limit with no copay and 20% to 50% coinsurance, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or 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 and no coinsurance, although prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (HMO-POS), with prior authorization required for all services. Outpatient diagnostic procedures and tests carry a copay of $0 to $95 with no coinsurance, while lab services have no copay. Radiological services require a $10 copay and coinsurance for X-rays, a minimum 20% coinsurance for therapeutic services, and no copay for diagnostic radiology.
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.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature (HMO-POS) with no coinsurance, meaning some services are covered, but standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a 3-day prior hospital stay is not needed, and additional days beyond the standard 100 days 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 under these services.
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