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Aetna Medicare Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Iowa. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (PPO) 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 (PPO).
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 (PPO), 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 combined Maximum Out-Of-Pocket cost of $10000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 (PPO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order, Tier 1 drugs require a copay starting at $2.00, and Tier 2 drugs require a copay starting at $12.00 for a one-month supply. For higher-tier medications, costs are determined by 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 apply equally across both preferred and standard pharmacy and mail-order channels.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with predictable costs, featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. For inpatient hospital stays, members pay a daily copay for the first few days and no copay for subsequent days, while specialist visits require a copay of up to $40. Outpatient hospital services and diagnostic tests generally feature no coinsurance, with copays ranging depending on the specific service. This plan also includes key supplemental benefits, offering no copay or coinsurance for routine dental cleanings, annual eye exams, and hearing tests. Prescription hearing aids are covered up to $1,000 per ear annually with no copay, and members receive a $100 annual allowance for eyewear. Emergency care is accessible with a $130 copay that is waived if admitted, while urgent care visits require a $50 copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) inpatient hospital benefits are partially covered with no coinsurance, requiring prior authorization for both acute and psychiatric stays. For acute stays, you pay a $405 copay for days 1 through 6 and no copay for days 7 and beyond, whereas psychiatric stays require a $370 copay for days 1 through 5 and no copay for days 6 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $405, observation services have a $405 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature (PPO), which features ground ambulance services for a $335 copay and no coinsurance, and air ambulance services for a 20% coinsurance and no copay, with prior authorization required. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum limit with no coinsurance and copays ranging from $130 to $335.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits with no copay and no coinsurance, while specialist visits, therapy, and mental health services require a $0 to $40 copay and no coinsurance. Telehealth benefits are available with a $0 to $50 copay and 20% coinsurance, though podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), offering no copay and no coinsurance for annual physicals, glaucoma screenings, and diabetes training, while kidney disease education requires no copay and 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, 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, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO) with no copays, no coinsurance, and no deductibles for covered exams and prescription hearing aids. One routine exam and one fitting evaluation are covered annually, and prescription hearing aids are covered up to $1,000 per ear each year, though OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription devices, are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) vision services are covered with no copay and no coinsurance for eye exams and eyewear. The plan features a $50 maximum annual benefit for routine eye exams and a $100 combined annual allowance for contacts, eyeglasses, lenses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) dental benefits are partially covered, offering Medicare-covered dental services for a $40 copay and no coinsurance, and routine exams, cleanings, and x-rays with no copay and no coinsurance. Non-covered services include fluoride, restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, orthodontics, adjunctive general, and other diagnostic or preventive dental services.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers Home Infusion bundled Services with no copay and no coinsurance, subject to prior authorization. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays, with coinsurance ranging from no coinsurance up to 20% depending on the item. This benefit covers durable medical equipment, prosthetics, and diabetic supplies, which require prior authorization and may be subject to manufacturer limitations.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic tests have no coinsurance and a copay of up to $20, lab and diagnostic radiological services have no copay, while outpatient X-rays require a $15 copay plus coinsurance, and therapeutic radiological services carry a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Aetna Medicare Signature (PPO) with no coinsurance, but some services are covered while cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered and require copays ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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