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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 Western KS: Saline and surrounding counties. 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. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order services, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications, costs are shared through coinsurance rather than flat copays. Tier 3 preferred brand-name drugs require a 24% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with no copay for primary care doctor visits, annual wellness exams, and routine home health services. For specialist visits, members will face a copay ranging from $0 to $65, while emergency room visits carry a $130 copay that is waived if admitted. Inpatient hospital stays require a daily copay of $410 for the first six days of acute care, with no copay or coinsurance for subsequent days. Routine vision and preventive dental care are covered with no copay or coinsurance, though comprehensive dental services require a 20% to 50% coinsurance up to a $500 annual limit. Hearing benefits include routine exams with no copay and up to $500 per ear annually for prescription hearing aids. Most diagnostic lab tests and outpatient x-rays also feature no copay, helping members keep out-of-pocket costs predictable.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a $410 daily copay for days 1 to 6 of acute stays and a $390 daily copay for days 1 to 6 of psychiatric stays, with no copay for subsequent covered days. This benefit is partially covered because 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 $0 to $375 copay, observation services have a $410 copay per stay, and outpatient substance abuse sessions carry a $65 copay, all with no coinsurance.
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 covered by Aetna Medicare Signature (PPO), featuring a $300 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services, both requiring prior authorization. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services 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 $50 copay and no coinsurance, while worldwide emergency and urgent services are covered up to a $250,000 limit with no coinsurance and copays of $130 for medical care and $300 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits, therapies, podiatry, and mental health services require a $0 to $65 copay and no coinsurance. Chiropractic services are not covered in practice, and additional telehealth benefits are available with a $0 to $65 copay and 20% coinsurance.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (PPO) are partially covered, featuring no copay and no coinsurance for annual exams, health education, and fitness benefits, though kidney disease education requires a 20% coinsurance and no copay. Uncovered sub-services include 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), offering Medicare-covered exams for a $65 copay and no coinsurance, alongside one routine exam and one fitting evaluation per year with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no copay, no coinsurance, and no deductible for exams and eyewear. The plan includes one routine eye exam per year up to a $50 limit and a $100 annual combined allowance for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), with preventive care like cleanings and exams requiring no copay and no coinsurance, though fluoride and implants are excluded. Comprehensive dental care is covered with no copay and 20% to 50% coinsurance up to a $500 annual limit, while Medicare-covered dental services require a $65 copay and no coinsurance.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan 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 copay, though prior authorization is required. Members will pay no coinsurance to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices and diabetic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Aetna Medicare Signature (PPO) plan. Lab services feature no copay and no coinsurance, while diagnostic tests range from a $0 to $65 copay with no coinsurance. Outpatient x-rays have no copay, diagnostic radiological services have a $0 minimum copay, and therapeutic radiological services require 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, but 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
Skilled nursing facility (SNF) services are covered by Aetna Medicare Signature (PPO) 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 three-day prior hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the Aetna Medicare Signature (PPO) are partially covered, offering acupuncture for up to 12 treatments per year with a $20 copay and no coinsurance, plus annual wellness exams and select screenings with no copay and no coinsurance. However, over-the-counter (OTC) items, meal benefits, and dual-eligible SNP services are not covered.
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