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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 2026 to people living in South 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 (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 $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 (PPO)
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Drug Coverage
The Aetna Medicare Signature (PPO) prescription drug plan features an annual drug deductible of $615. Members can minimize out-of-pocket costs by utilizing preferred pharmacies or preferred mail-order services, which offer no copay for both Tier 1 preferred generic and Tier 2 generic drugs. Standard pharmacies and standard mail-order services charge low copays starting at $2 for Tier 1 and $12 for Tier 2 drugs for a one-month supply. For higher-tier medications, the plan transitions to a coinsurance model across all pharmacy types. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs incur a 25% coinsurance. Tier 5 specialty drugs also carry a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive coverage with predictable costs, featuring no coinsurance for inpatient hospital stays, outpatient services, and primary care visits. Inpatient hospital stays require a $450 daily copay for the first six days and no copay thereafter, while primary care physician visits cost a low $5 copay and specialist visits require a $50 copay. Emergency care is accessible with a $130 copay, which is waived if you are admitted, and urgently needed services carry a $50 copay. For routine health needs, the plan provides no copay and no coinsurance for annual physicals, routine eye exams, and select preventive dental services like cleanings and x-rays. Vision hardware and hearing aids are also covered with no copay up to specified annual limits, helping to keep your out-of-pocket costs low. Additionally, home health services and lab tests require no copay, while prescription Part B insulin is available for a flat $35 copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient acute hospital stays with no coinsurance, requiring a $450 daily copay for days 1 through 6 and no copay for subsequent days. Inpatient psychiatric care is covered with no coinsurance at a $370 daily copay for days 1 through 5 and no copay for days 6 through 90. Prior authorization is required, and upgrades or non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services covered by the Aetna Medicare Signature (PPO) feature no coinsurance, including ambulatory surgical center and blood services which also have no copays. Outpatient hospital services require a copay of $0 to $450, observation services carry a $450 copay per stay, and outpatient substance abuse sessions have a $40 copay.
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 this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $325 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) 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, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays of $130, $130, and $325 respectively.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services for a $5 copay and specialist visits for a $50 copay, both with no coinsurance. Physical, occupational, and speech therapies require a $50 copay and no coinsurance, while podiatry and routine chiropractic services are not covered. Mental health, psychiatric, and opioid treatment services have a $40 copay and no coinsurance, whereas telehealth options range from no copay to a $50 copay with 20% coinsurance.
Preventive Services See details
Preventive services under the Aetna Medicare Signature (PPO) are partially covered, offering no copay and no coinsurance for annual physical exams, glaucoma screenings, and fitness benefits, while kidney disease education requires a 20% coinsurance and no copay. Several supplemental benefits are not covered under this plan, including personal emergency response systems, weight management programs, and nutritional or dietary benefits.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), offering no copay and no coinsurance for routine exams, fitting evaluations, and prescription hearing aids up to a $750 annual limit per ear. 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 both eye exams and eyewear. This benefit includes a $50 annual maximum for one routine eye exam and a $100 combined annual maximum for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), which offers Medicare-covered dental for a $50 copay and no coinsurance, and select preventive services like cleanings, exams, and x-rays with no copay and no coinsurance. However, other diagnostic services, fluoride, restorative care, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization and step therapy are required. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs incur a coinsurance of 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance, subject to prior authorization requirements.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic equipment, with no copay and prior authorization required. Depending on the specific item, you will pay between no coinsurance and 20% coinsurance, with diabetic supplies limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (PPO) with prior authorization required, featuring no copay or coinsurance for lab services and a $0 to $20 copay with no coinsurance for diagnostic tests. Diagnostic radiological services start at no copay, outpatient X-rays require a $20 copay, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, meaning some services are covered while cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, providing an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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