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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature (PPO) is a PPO plan offered by Coventry Health and Life Insurance Company available for the 2026 plan year to people living in Central 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 (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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9250.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $13900.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. After meeting this deductible, you enter the initial coverage phase where Tier 1 preferred generic drugs have no copay at standard pharmacies. For Tier 2 standard generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance at standard pharmacies during this phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs. Additionally, beneficiaries who qualify for the full low-income subsidy will pay $0.00 for their Part D costs.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with no copay for primary care doctor visits, home health services, and routine preventive care. Specialist visits feature low copays ranging from no copay to $55, while emergency services require a $115 copay with no coinsurance. For inpatient hospital stays, members pay a daily copay of $388 for the first seven days, after which there is no copay for the remainder of a covered stay. Routine vision, hearing, and preventive dental services are covered with no copays, though comprehensive dental requires a 20% to 50% coinsurance up to a $1,500 annual limit. Diagnostic lab tests and outpatient X-rays are also available with no copay or coinsurance, whereas durable medical equipment and dialysis require a 20% coinsurance. Additionally, prescription hearing aids are covered with no copay up to a $500 annual limit per ear to help lower your out-of-pocket expenses.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered under the Aetna Medicare Signature (PPO) plan, featuring no coinsurance for covered stays. Acute inpatient care requires a $388 daily copay for days 1 to 7 and no copay for days 8 to 90, while psychiatric care requires a $407 daily copay for days 1 to 5 and no copay for days 6 to 90. Non-Medicare-covered stays, acute upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring copays of $0 to $395 for hospital services, $388 per stay for observation services, and $40 for substance abuse sessions. There is no copay for ambulatory surgical center and outpatient blood services, though prior authorization is required for several of these benefits.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay ranging from $105.00 to $110.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) partially covers ambulance and transportation services, as transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $295 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $115 copay and urgently needed services with a $40 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 lifetime maximum with copays ranging from $115 to $295 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and specialist visits with a copay of $0 to $55, though podiatry is not covered and chiropractic care is only partially covered. Other services like physical, occupational, and psychiatric therapies require copays ranging from $35 to $40, while additional telehealth benefits include a 20% coinsurance and copays up to $50.
Preventive Services See details
Aetna Medicare Signature (PPO) partially covers preventive services, offering annual physicals, health education, glaucoma screenings, and fitness benefits with no copays and no coinsurance. Kidney disease education services are covered with a 20% coinsurance and no copay. Sub-services not covered include in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), offering routine hearing exams and fitting evaluations with no copay or coinsurance, while other exams require a $55 copay. Prescription hearing aids are covered with no copay up to a $500 annual limit per ear, but OTC hearing aids as well as 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 deductibles and no coinsurance, offering routine eye exams and eyewear like contacts and eyeglasses with no copay. Other covered eye exams have a copay ranging from $0 to $55, with annual benefit limits of $50 for exams and $100 for eyewear.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering no copays for preventive care like exams, cleanings, and x-rays, and a $55 copay for Medicare-covered dental. Comprehensive options require a 20% to 50% coinsurance up to a $1,500 annual maximum, while fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with prior authorization, featuring no copay and a coinsurance ranging from no coinsurance to 20% for chemotherapy, radiation, and other Part B drugs. Medicare Part B insulin drugs are covered under this benefit with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies, with a 20% coinsurance and no copay. Diabetic supplies are covered with no coinsurance to 20% coinsurance and no copay, while diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization, offering no copay and no coinsurance for lab services and outpatient X-rays. Diagnostic tests and radiological services feature no coinsurance and copays ranging from no copay up to $95 and $300 respectively, while therapeutic radiology requires a 20% coinsurance with no copay.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Signature (PPO) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) partially covers Skilled Nursing Facility (SNF) services, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coinsurance. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (PPO) with no copay or coinsurance for covered benefits, including over-the-counter items up to fifteen dollars every three months, meal benefits for chronic illnesses, and select wellness exams and screenings. Acupuncture and dual-eligible SNP services are not covered under this plan benefit.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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