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Aetna Medicare Signature Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Giveback (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 Giveback (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Giveback (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Central, East, and Northwest AR 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 Giveback (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 Giveback (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 Giveback (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. Additionally, this plan comes with a Part B Premium reduction of $45.00. You must continue to pay paying your reduced 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 $13900.00 (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 $13900.00 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 Giveback (PPO) features an annual prescription drug deductible of $615.00. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies. For Tier 2 standard generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, those who qualify for the low-income subsidy can receive a premium reduction down to $0.00.
Additional Benefits
The Aetna Medicare Signature Giveback (PPO) plan offers robust coverage for essential health services with no copay for primary care visits, home health care, and routine preventive services. For emergency situations, members pay a $115 copay for emergency room visits and a $300 copay for ground ambulance services, with no coinsurance required. Inpatient hospital stays require daily copays for the first several days before transitioning to no copay for longer stays, while specialist visits feature low copays ranging from no copay to $50. Ancillary benefits include routine dental, vision, and hearing exams with no copay, alongside annual allowances of up to $100 for eyewear and $500 for hearing aids. For complex care, diagnostic lab tests and outpatient x-rays have no copay, whereas durable medical equipment and dialysis services generally require a 20% coinsurance. While many essential benefits are covered, it is important to note that transportation, over-the-counter items, and cardiac rehabilitation are not covered under this plan.
Inpatient Hospital See details
Aetna Medicare Signature Giveback (PPO) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays require a $388 daily copay for days 1 to 7 and no copay for days 8 to 90, whereas psychiatric stays carry a $407 daily copay for days 1 to 5 and no copay for days 6 to 90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Giveback (PPO) covers outpatient services with no coinsurance. Patients pay no copay for ambulatory surgical center and blood services, a $40 copay for outpatient substance abuse sessions, a $388 copay per stay for observation services, and a copay ranging from no copay to $450 for outpatient hospital services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature Giveback (PPO) with a copay of $105 or $110 and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Aetna Medicare Signature Giveback (PPO). Ground ambulance services require a $300 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay, with prior authorization required. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with copays ranging from $115 to $300 and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature Giveback (PPO), as podiatry and routine chiropractic services are not covered. Covered services feature no copay and no coinsurance for primary care visits, copays from $0 to $50 with no coinsurance for specialists, and a 20% coinsurance with a $0 to $50 copay for telehealth.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Giveback (PPO), offering no copay and no coinsurance for most services like annual exams, though kidney disease education requires a 20% coinsurance and no copay. Sub-services that are not covered include In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Giveback (PPO) partially covers hearing services with no deductible or coinsurance. One routine hearing exam and fitting evaluation are covered annually with no copay, while Medicare-covered exams require a $50 copay; prescription hearing aids are covered up to $500 annually with no copay, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription aids are not covered.
Vision Services See details
Aetna Medicare Signature Giveback (PPO) covers vision services, offering routine annual eye exams and diabetic eye exams with no copay and no coinsurance. Other Medicare-covered eye exams require a copay of up to $50 with no coinsurance, while eyewear is covered up to a $100 annual limit with no copay or coinsurance.
Dental Services See details
Aetna Medicare Signature Giveback (PPO) partially covers dental services, offering preventive care with no copay and no coinsurance, and comprehensive services with no copay and 20% to 50% coinsurance up to a $1,500 annual limit. Medicare-covered dental services require a $50 copay and no coinsurance, while fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Giveback (PPO) partially covers home infusion bundled services with prior authorization, excluding Part D home infusion drugs. Covered Part B chemotherapy, radiation, and other Part B drugs carry no copay and range from no coinsurance to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature Giveback (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Signature Giveback (PPO) plan, featuring a 20% coinsurance and no copay for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies require a 0% to 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts are covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Giveback (PPO), though prior authorization is required. Lab services and outpatient X-rays have no copay or coinsurance, while diagnostic tests require a copay up to $95, diagnostic radiological services have a copay up to $300, and therapeutic radiological services incur a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered by the Aetna Medicare Signature Giveback (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Giveback (PPO) indicates that some services are covered for cardiac rehabilitation, but in practice, Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Since these services are not covered under the plan, there are no associated copays or coinsurance costs.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by the Aetna Medicare Signature Giveback (PPO) with prior authorization, featuring no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and no coinsurance. Additional days beyond the Medicare-covered limit are not covered under this plan.
Other Services See details
Aetna Medicare Signature Giveback (PPO) partially covers other services, providing select benefits like chronic illness meal services, annual wellness exams, and additional cancer screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and Dual Eligible SNPs with highly integrated services are not covered.
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