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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 Wichita Kansas 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 generics and Tier 2 generics, you will pay no copay when using a preferred retail pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail order, copays start at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Higher-tier medications under this plan require coinsurance rather than flat copays. You will pay 24% coinsurance for Tier 3 preferred brand drugs and 25% coinsurance for Tier 4 non-preferred drugs at any network pharmacy. Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply through both preferred and standard options.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive medical coverage featuring no copay for primary care doctor visits, routine eye exams, and home health services. For specialized medical needs, members pay flat copayments, including up to $55 for specialist visits and a daily copay of $350 to $375 for the first six days of inpatient hospital stays. Emergency room visits carry a $130 copay, which is waived if admitted, while urgent care services require a $50 copay. Supplemental care is highly accessible, featuring preventive dental services with no copay and comprehensive dental covered up to $1,750 annually with 20% to 50% coinsurance. Vision benefits include a $175 annual eyewear allowance with no copay, and routine hearing exams are fully covered alongside a $1,250 yearly hearing aid allowance per ear. Diagnostic lab services, outpatient X-rays, and home infusion services are also covered with no copay, while durable medical equipment ranges up to 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays require a $375 daily copay for days 1-6 and no copay for days 7 and beyond, while psychiatric stays require a $350 daily copay for days 1-6 and no copay for days 7-90; however, this benefit is partially covered as 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 blood services. Outpatient hospital services require a copay of $0 to $375 ($375 per stay for observation services), while outpatient substance abuse sessions have a $55 copay, with prior authorization required for most services.
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 by Aetna Medicare Signature (PPO), which features a $280 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. Prior authorization is required for ambulance services, and transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, and worldwide emergency transportation has a $280 copay, with no coinsurance up to a maximum plan benefit of $250,000.
Primary Care See details
Primary care services under Aetna Medicare Signature (PPO) feature no copay and no coinsurance for primary care physician visits, while specialist, occupational, physical, and speech therapies require copays ranging from $0 to $55 with no coinsurance. Mental health, psychiatric, podiatry, and opioid treatment services carry a $55 copay and no coinsurance, telehealth services have a $0 to $55 copay and 20% coinsurance, and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) provides preventive services, with annual physical exams, glaucoma screenings, and diabetes self-management training covered with no copay and no coinsurance. Additional preventive services are partially covered, excluding options like in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and therapeutic massage. Kidney disease education is covered with no copay and 20% coinsurance.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams with a $55 copay and no coinsurance, and routine hearing 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 limit per ear, but inner ear, outer ear, over-the-ear, and OTC 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. This includes up to a $50 annual maximum for eye exams—featuring one routine exam per year—and a $175 combined yearly allowance for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), excluding fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services. Medicare-covered dental services require a $55 copay and no coinsurance, while covered preventive services have no copay and no coinsurance, and comprehensive services carry no copay and 20% to 50% coinsurance up to a $1,750 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Aetna Medicare Signature (PPO) with no copay, although prior authorization is required. Covered Medicare Part B insulin requires a $35 copay and no coinsurance, while other Part B drugs, including chemotherapy, have 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, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and coinsurance ranging from no coinsurance to 20% depending on the item. 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), requiring prior authorization for all services. Diagnostic procedures and tests have a copay ranging from $0 to $50 with no coinsurance, lab services and outpatient X-rays feature no copay, and therapeutic radiological services require a minimum 20% coinsurance.
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 under Aetna Medicare Signature (PPO) feature no coinsurance, but only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry a $5 copay.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under Aetna Medicare Signature (PPO) with no coinsurance, requiring a $10 copay per day for days 1 to 20 and a $218 copay per day for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, excluding meal benefits. Covered benefits include acupuncture with a $20 copay and no coinsurance, as well as over-the-counter items, annual wellness exams, and additional cancer screenings with no copay and no coinsurance.
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