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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 Topeka and surrounding areas. 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 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 choose standard pharmacies or standard mail order services, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier prescriptions, cost-sharing transitions to coinsurance across both preferred and standard network pharmacies. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Additionally, Tier 5 specialty tier medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with no copay and no coinsurance for primary care visits, annual physicals, and most preventive services. Specialist visits, diagnostic tests, and therapy sessions feature low copays ranging from $0 to $40 with no coinsurance, while inpatient hospital stays require a daily copay for the first six days. Emergency room visits have a $130 copay, which is waived if you are admitted, and urgent care services require a $40 copay with no coinsurance. For routine care, this plan provides dental, vision, and hearing benefits with no copay for routine exams, cleanings, and fittings. Prescription hearing aids are covered up to a $1,250 annual maximum per ear with no copay, while comprehensive dental services require a 20% to 50% coinsurance up to a $1,000 yearly limit. Additionally, home health services and laboratory tests are covered with no copay and no coinsurance, helping to keep your out-of-pocket costs predictable.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $375 for days 1 through 6 of acute stays and $310 for days 1 through 6 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and non-Medicare-covered stays, acute upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance across all categories. Patients pay no copay for ambulatory surgical center and blood services, a $0 to $350 copay for outpatient hospital services, a $40 copay for substance abuse sessions, and a $375 copay per stay for observation services.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of $55.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $320 copay and air ambulance services with a 20% coinsurance, with prior authorization required for all ambulance services. Transportation services to plan-approved or health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered under Aetna Medicare Signature (PPO) 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 limit with no coinsurance and copays ranging from $130 to $320.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, and podiatry services generally require a $0 to $40 copay and no coinsurance. Telehealth benefits are available with a $0 to $40 copay and 20% coinsurance, but chiropractic services are not covered in practice since routine and other chiropractic services are excluded.
Preventive Services See details
Aetna Medicare Signature (PPO) covers annual physical exams and most preventive services with no copays and no coinsurance, though kidney disease education requires a 20% coinsurance with no copay. Additional supplemental benefits are only partially covered, excluding services such as in-home safety assessments, nutritional benefits, and weight management programs.
Hearing Services See details
Hearing services under Aetna Medicare Signature (PPO) feature Medicare-covered exams for a $40 copay and no coinsurance, alongside annual routine 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 annual maximum per ear, though OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copays, no coinsurance, and no deductibles for both eye exams and eyewear. The plan features a $50 annual maximum benefit for eye exams, which includes one routine exam per year, and a combined $100 annual maximum allowance for eyewear like contact lenses, eyeglasses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, excluding fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic services. Medicare-covered dental requires a $40 copay and no coinsurance, while preventive services like exams and cleanings have no copay and no coinsurance. Covered comprehensive dental services have no copay and 20% to 50% coinsurance, subject to a $1,000 annual maximum.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers Home Infusion bundled Services with no copay, though prior authorization is required. 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 0% to 20% coinsurance.
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 benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), featuring no coinsurance and a $0 to $40 copay for diagnostic tests, alongside no copays for lab services, outpatient X-rays, and diagnostic radiology. Therapeutic radiological services require a minimum 20% coinsurance, and prior authorization is required for all services.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (PPO) 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 coinsurance, though only some services are covered because standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered and require a $5 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $5 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 inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), featuring up to 12 acupuncture treatments per year for a $20 copay and no coinsurance, as well as annual wellness exams and additional cancer screenings with no copay and no coinsurance. Over-the-counter (OTC) items and meal benefits are not covered.
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