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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 Nebraska. 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 $8950.00 (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 $8950.00 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) plan has an annual prescription 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. Standard pharmacies and standard mail-order options charge copays ranging from $2 to $6 for Tier 1, and $12 to $36 for Tier 2 drugs depending on the supply length. Brand-name and specialty medications require coinsurance rather than flat copays under this plan. Tier 3 preferred brand drugs incur a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance regardless of the pharmacy type. Tier 5 specialty drugs also have a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for everyday medical needs, including primary care doctor visits, preventive care, and home health services with no copays or coinsurance. Specialist visits, diagnostic tests, and outpatient hospital services generally feature low out-of-pocket costs, while inpatient hospital stays require set copayments with no coinsurance. Emergency and urgent care are also accessible with predictable flat copays and no coinsurance, protecting you from unexpected medical bills. For specialized care, this plan provides routine dental, vision, and hearing exams with no copays or coinsurance, alongside annual allowances for eyewear and hearing aids to help manage your health expenses. Other essential services like Medicare Part B prescription drugs, dialysis, and durable medical equipment typically require coinsurance up to 20% with no copays. Additionally, skilled nursing facility stays are covered with no copay for the first 20 days of care.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $405 copay for days 1 to 6 of acute stays and a $370 copay for days 1 to 5 of psychiatric stays, with no copays for subsequent days. Prior authorization is required, and 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, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $405, while individual and group outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by the Aetna Medicare Signature (PPO) plan with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $315 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both featuring no coinsurance. Worldwide emergency and urgent care are covered with a $130 copay, while worldwide emergency transportation has a $315 copay, all with no coinsurance up to a maximum plan benefit of $250,000.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician visits with no copay and no coinsurance, while specialists, physical therapy, and mental health services range from a $0 to $40 copay with no coinsurance. Telehealth services are available with a $0 to $50 copay and 20% coinsurance, but podiatry and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) partially covers preventive services, offering annual physicals, glaucoma screenings, and fitness benefits with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Several supplemental benefits are not covered, including weight management, nutritional/dietary benefits, and in-home safety assessments.
Hearing Services See details
Aetna Medicare Signature (PPO) provides hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 maximum per ear annually, while over-the-counter (OTC) hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered under the Aetna Medicare Signature (PPO) with no copay, no coinsurance, and no deductible for eye exams and eyewear. The plan includes one routine eye exam per year with a $50 annual limit and a combined maximum eyewear allowance of $175 per year for contacts, eyeglasses, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring Medicare-covered dental care for a $40 copay and no coinsurance, alongside preventive cleanings and exams with no copay and no coinsurance. Covered comprehensive services like restorative care and oral surgery have no copay and 20% to 50% coinsurance up to a $1,250 yearly limit, though fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these covered benefits, and diabetic equipment is limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, with prior authorization required for both. Diagnostic tests, lab services, and diagnostic radiology feature no coinsurance and copays ranging from $0 to $20, while outpatient X-rays carry a $15 copay and therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, though only some services are covered. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, while days 21 through 100 require a $218 daily copay, with no coverage provided for additional days beyond the standard 100-day benefit period.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering annual wellness exams, 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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