A non-government entity
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 Kansas City Metro Area. 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 $10100.00 (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 $10100.00 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:
Sign up for Aetna Medicare Signature (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature (PPO) plan has an annual prescription drug deductible of $615. You will pay no copay for Tier 1 preferred generic and Tier 2 generic medications when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options require a copay, starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Brand-name and specialty drugs are subject to coinsurance rather than flat copays under this plan. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance regardless of pharmacy type. Specialty medications are limited to a one-month supply at this 25% coinsurance rate.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits and routine preventive services. For hospital care, inpatient stays require a $455 copay for the first six days with no copay thereafter, while outpatient services range from no copay to a $450 copay. Emergency room visits carry a $130 copay, and urgent care is available for a $50 copay, both with no coinsurance. Routine dental cleanings, annual vision exams, and routine hearing evaluations are covered with no copay or coinsurance. Other specialized benefits like home health services feature no copay, while durable medical equipment and dialysis require no copay and up to 20% coinsurance. Skilled nursing facility care is also available with no coinsurance, charging a $10 daily copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient acute hospital stays with no coinsurance and a $455 copay for days 1 through 6, followed by no copay for days 7 and beyond. Inpatient psychiatric stays are also covered with no coinsurance and a $390 copay for days 1 through 6, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient hospital services with a $0 to $450 copay and observation services with a $455 copay per stay, both with no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $55 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization benefits are covered by the Aetna Medicare Signature (PPO) plan with no coinsurance, though prior authorization is required. Depending on the service, you will pay a copay of either $55.00 or $145.00.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Signature (PPO) require prior authorization, charging a $360 copay plus coinsurance for ground transport, and a 20% coinsurance plus a copay for air transport. These fees are not waived upon hospital admission, and transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance and costs that do not apply to the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum limit with no coinsurance and copays of $130, $130, and $360 respectively.
Primary Care See details
Aetna Medicare Signature (PPO) provides primary care physician services with no copay and no coinsurance, while specialist visits require a $0 to $55 copay and no coinsurance. Most other covered benefits, including therapy, podiatry, and mental health services, feature a $50 to $55 copay and no coinsurance, though chiropractic services are not covered and telehealth options require a $0 to $45 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by the Aetna Medicare Signature (PPO) plan, featuring no copay and no coinsurance for annual physicals, health education, fitness benefits, and most screenings, though kidney disease education requires a 20% coinsurance with no copay. Supplemental services not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing Services are covered by Aetna Medicare Signature (PPO), which offers Medicare-covered exams for a $55 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for exams and eyewear. Patients receive one routine eye exam per year (up to a $50 limit) and a combined $100 annual allowance for contact lenses, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Signature (PPO), offering Medicare-covered dental care for a $55 copay and no coinsurance, as well as preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. However, fluoride, restorative, endodontic, periodontic, prosthodontic, implant, orthodontic, and oral surgery services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Covered Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have 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 with no copays, though prior authorization is required and coinsurance ranges from no coinsurance to 20%. Covered items include durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with diabetic supplies limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Members pay no copay for lab services and outpatient X-rays, no coinsurance and a $0 to $45 copay for diagnostic procedures, and a minimum 20% coinsurance plus a copay for therapeutic radiological services.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers some cardiac rehabilitation services with no coinsurance, although standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require a $5 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers skilled nursing facility (SNF) services 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 prior three-day inpatient hospital stay is not necessary, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) covers acupuncture with a $20 copay and no coinsurance for up to 12 treatments per year, as well as select wellness and screening exams with no copay or coinsurance. Over-the-counter items and meal benefits are not covered under these additional services.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved