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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 Eastern 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 $6300.00 (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 $6300.00 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) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options require small copays, ranging from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the fill supply. Higher-tier medications are subject to coinsurance instead of flat copays under this plan. You will pay a 24% coinsurance for Tier 3 preferred brand drugs across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive coverage for core medical services, featuring no coinsurance for many key benefits. Primary care doctor visits, preventive care, and home health services are available with no copay, while specialist visits and outpatient procedures carry low copayments. Emergency care and inpatient hospital stays require set copays, with inpatient costs structured as a daily copay for the first six days of acute care. For supplemental care, the plan offers routine dental, vision, and hearing exams with no copay, alongside annual allowances for eyewear and prescription hearing aids. Specialized treatments like dialysis, as well as durable medical equipment, typically require up to a 20% coinsurance. Medicare Part B prescription drugs also carry up to a 20% coinsurance, though Part B insulin is covered with a $35 copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital services under the Aetna Medicare Signature (PPO) are partially covered with no coinsurance, though prior authorization is required. For acute care, you pay a $450 daily copay for days 1-6 and no copay for days 7 and beyond, while psychiatric stays cost a $410 daily copay for days 1-6 and no copay for days 7-90. 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, including no copay for ambulatory surgical center and blood services. Outpatient hospital services have a copay ranging from $0 to $425, observation services require a $450 copay per stay, and outpatient substance abuse sessions carry a $60 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature (PPO) plan with a copay of either $85.00 or $180.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (PPO), which requires prior authorization and charges a $300 copay (with no coinsurance) for ground transport and a 20% coinsurance (with no copay) for air transport. While some transportation services are covered, trips to plan-approved or any other health-related locations are not covered in practice.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $60 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays of $150 for urgent or emergency 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, and specialist, physical therapy, and mental health services with copays ranging from $0 to $60 and no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance, excluding routine care, while telehealth benefits are available with a $0 to $60 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) covers preventive services, including annual physical exams and glaucoma screenings, with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. This benefit is partially covered as supplemental services like fitness benefits and chemotherapy wigs (up to $400 annually) have no copay and no coinsurance, but personal emergency response systems, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) partially covers hearing services, offering routine exams and hearing aid fittings with no copay and no coinsurance, and Medicare-covered exams with a $60 copay and no coinsurance. Prescription hearing aids are covered up to $1,250 per ear annually with no copay and no coinsurance, but 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, no coinsurance, and no deductible for both eye exams and eyewear. Beneficiaries receive a $50 annual maximum for eye exams, which includes one routine exam, and a $100 yearly allowance for eyewear like contacts and eyeglasses.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), which offers Medicare-covered dental care for a $60 copay and no coinsurance, alongside select preventive services like exams, cleanings, and X-rays with no copay and no coinsurance. However, fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, 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, subject to prior authorization. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers durable medical equipment, medical supplies, and diabetic supplies with no copay and no coinsurance to 20% coinsurance. 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
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services feature no coinsurance, with no copay for lab services and a copay of up to $60 for procedures, while radiological services offer no copay for X-rays and diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
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 provided by Aetna Medicare Signature (PPO) with no coinsurance and no copay, though only some services are covered as 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 $20 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a three-day prior hospital stay is not needed, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering an annual wellness exam, 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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