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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in North Dakota. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 $10000.00 (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 $10000.00 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 Extra (PPO)
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Drug Coverage
The Aetna Medicare Signature Extra (PPO) plan has an annual prescription 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 choose a standard pharmacy or standard mail-order service, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the supply length. Higher-tier medications are subject to coinsurance rather than flat copayments under this plan. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance at both preferred and standard pharmacies. Note that Tier 5 specialty prescriptions are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, routine annual physicals, and home health services. Specialist visits, physical therapy, and outpatient substance abuse sessions require a $40 copay, while inpatient acute hospital stays require a $350 daily copay for the first six days before transitioning to no copay. Emergency room visits carry a $130 copay that is waived if you are admitted, and urgent care is available for a $50 copay. Members also benefit from comprehensive routine dental, vision, and hearing care with no copays or coinsurance, including a $200 annual eyewear allowance and up to $1,250 per ear annually for prescription hearing aids. Skilled nursing facility stays feature no copay for the first 20 days, and the plan provides extra perks like chronic illness meals and a $30 quarterly over-the-counter reimbursement with no copay.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute hospital stays require a $350 daily copay for days 1 to 6 and no copay for days 7 and beyond, while psychiatric stays require a $370 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 Extra (PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $350 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature Extra (PPO) covers partial hospitalization services with a copay of $55.00 or $145.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ambulance services with prior authorization, requiring a $310 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $130 copay—waived if admitted to the hospital within 24 hours—and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency services are covered up to $250,000 with no coinsurance, carrying a $130 copay for emergency or urgent care and a $310 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature Extra (PPO) offers primary care physician visits with no copay and no coinsurance, while specialist, mental health, and physical therapy services require a $40 copay and no coinsurance. Telehealth benefits are covered with a copay ranging from $0 to $50 and 20% coinsurance, but podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (PPO), offering annual physicals, screenings, and fitness benefits with no copay and no coinsurance, while kidney disease education has no copay and 20% coinsurance. Sub-services not covered under this plan 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, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services covered by Aetna Medicare Signature Extra (PPO) feature no copayments or coinsurance for exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to a maximum of $1,250 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. This includes one routine eye exam per year (up to a $50 limit) and a combined annual allowance of $200 for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (PPO), which features a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for routine exams, cleanings, and X-rays. Non-covered services include fluoride, orthodontics, restorative care, endodontics, periodontics, prosthodontics, implants, and oral surgery.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Extra (PPO) with no copay, though prior authorization is required. Under this benefit, 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.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature Extra (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (PPO) with no copay and coinsurance ranging from no coinsurance to 20%, depending on the specific item, with prior authorization required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance and a $0 to $20 copay for diagnostic tests, while lab and diagnostic radiological services have no copay. Outpatient X-rays require a $15 copay, therapeutic radiological services carry a minimum 20% coinsurance, and prior authorization is required.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature Extra (PPO) with no coinsurance, although only some services are covered. The plan does not cover cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($25 copay).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers skilled nursing facility (SNF) services with no coinsurance and no prior three-day hospital stay requirement, though prior authorization is required. You will pay no copay for days 1 through 20 and a $207 daily copay for days 21 through 100, but additional days beyond the standard Medicare limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) provides coverage for select other services with no copay and no coinsurance, including chronic illness meal benefits, annual wellness exams, screening mammography, and a $30 quarterly over-the-counter reimbursement. This benefit is partially covered, as acupuncture is not covered under the plan.
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