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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 Southeast Missouri. 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)
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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 drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order, copays range from $2.00 to $6.00 for Tier 1 and $12.00 to $36.00 for Tier 2 depending on the supply. For higher-tier medications, the plan transitions from copays to coinsurance. Tier 3 preferred brand-name drugs require a 24% coinsurance across all pharmacy and mail-order channels. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance, with specialty tier medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust healthcare coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits and standard preventive services. Specialist visits, urgent care, and emergency services are accessible with low, flat copayments and no coinsurance. For hospital stays, members pay a daily copay for the first six days of inpatient care and no copay for the remaining covered days. This plan also includes valuable extra benefits to support your daily wellness, such as routine vision and hearing exams with no copay, alongside allowances for eyewear and prescription hearing aids. Preventive dental care is available with no copay, while comprehensive dental services require a 20% to 50% coinsurance up to a generous annual limit. Additionally, members benefit from covered home health services with no copay and a quarterly allowance for over-the-counter health products.
Inpatient Hospital See details
Inpatient Hospital benefits under the Aetna Medicare Signature (PPO) are partially covered with no coinsurance, requiring a $300 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and while unlimited additional acute care days are covered, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services under the Aetna Medicare Signature (PPO) are covered with no coinsurance, though copayments and prior authorization requirements vary by service. Patients will pay no copay and no coinsurance for ambulatory surgical center and outpatient blood services, while outpatient hospital services require a $0 to $300 copay, observation services cost a $300 copay per stay, and outpatient substance abuse sessions incur a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $60.00 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 $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by the Aetna Medicare Signature (PPO) with a $130 copay and no coinsurance, with the copay 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 of $130 for emergency or urgent care and $300 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, while specialists, physical and occupational therapies, and mental health services require copays up to $40 and no coinsurance. Telehealth services carry a copay from no copay to $40 with 20% coinsurance, and while some chiropractic services are covered, routine and other chiropractic care are not covered.
Preventive Services See details
Preventive services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for annual physical exams, health education, fitness, and standard screenings, while kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered, excluding in-home safety assessments, personal emergency response systems, 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 safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), which features Medicare-covered exams for a $40 copay and no coinsurance, and annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $1,250 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 eye exams and eyewear. There is no deductible, and the plan provides up to $50 annually for exams, including one routine visit, plus a combined $275 yearly allowance for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring Medicare-covered dental with a $40 copay and no coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Comprehensive dental care, including restorative and surgical services, is covered with no copay and 20% to 50% coinsurance up to a $2,000 yearly limit, though fluoride, implants, and orthodontics 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. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have 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, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices are covered with no copay and 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature (PPO), with prior authorization required. Diagnostic procedures and tests have no coinsurance and a copay of $0 to $40, while lab services, diagnostic radiological services, and outpatient X-rays have no copay. Therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (PPO) plan, as intensive cardiac, pulmonary, and SET for PAD rehabilitation sub-services are all excluded from coverage. While the plan features no coinsurance, these non-covered rehabilitation services 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 required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services with no copay and no coinsurance, providing a $60 quarterly over-the-counter allowance, annual wellness exams, and additional colorectal cancer screenings. Acupuncture, meal benefits, and dual-eligible SNP services are not covered under this plan.
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