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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 SW MO / SE KS 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:
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Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you use standard pharmacies or standard mail order, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For brand-name and specialty medications, your costs are determined by coinsurance rather than flat copays. 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 carry a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive coverage for essential medical needs, featuring no copay or coinsurance for primary care doctor visits and annual physical exams. Specialist visits range from no copay to a $40 copay, while inpatient hospital stays require a daily copay for the first six days before transitioning to no copay for subsequent days. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care services require a $40 copay with no coinsurance. For supplemental care, this plan provides preventive dental, routine vision exams, eyewear up to $100, and annual hearing exams with no copay or coinsurance. Comprehensive dental services are covered with no copay and a 20% to 50% coinsurance up to a $1,000 annual limit, and prescription hearing aids are covered up to $500. Additionally, home health services have no copay or coinsurance, while durable medical equipment and dialysis require coinsurance but no copays.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital care with no coinsurance, requiring prior authorization for both acute and psychiatric stays. For acute stays, there is a $400 daily copay for days 1 through 6 and no copay for day 7 and beyond, whereas psychiatric stays require a $310 daily copay for days 1 through 6 and no copay for days 7 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 copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $375, while observation services require a $400 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 under the Aetna Medicare Signature (PPO) plan, with prior authorization required for all ambulance services. Medicare-covered ground ambulance services require a $350 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Transportation services to plan-approved or any other health-related locations are not covered by this plan.
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 require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $350.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care doctor visits with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Therapy, mental health, psychiatric, opioid treatment, and podiatry services have a $40 copay with no coinsurance, telehealth features a $0 to $40 copay and 20% coinsurance, and chiropractic services are not covered since routine and other chiropractic care are excluded.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (PPO), offering most services—including annual physical exams, glaucoma screenings, and fitness benefits—with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. Sub-services not covered under this plan include in-home safety assessments, PERS, 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
Aetna Medicare Signature (PPO) hearing services are partially covered, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to a $500 annual limit 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 (PPO) covers vision services with no copay and no coinsurance for both eye exams and eyewear. Covered services include one routine eye exam per year up to a $50 maximum, and eyewear options like glasses and contacts up to a combined yearly limit of $100.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (PPO), featuring preventive care like cleanings and exams with no copay and no coinsurance, and comprehensive care with no copay and 20% to 50% coinsurance up to a $1,000 annual limit. Medicare-covered dental services require a $40 copay and no coinsurance, while fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays, though prior authorization is required. Durable medical equipment, prosthetics, and diabetic supplies are covered with coinsurance ranging from no coinsurance up to 20%.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (PPO) with prior authorization, featuring no copay for lab services and outpatient X-rays. Diagnostic procedures and tests require a $0 to $40 copay and no coinsurance, while therapeutic radiological services carry 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, though only some services are covered because standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation 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 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not mandatory for admission, and additional days beyond the standard 100 days 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 annual wellness exams and select screenings with no copay or coinsurance. Over-the-counter (OTC) items and meal benefits are not covered under this plan.
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