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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 Non-Metro Counties. This plan received an overall rating of 4 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 $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:
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Drug Coverage
The Aetna Medicare Signature Extra (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when filled at preferred pharmacies or through preferred mail order. Standard pharmacies and standard mail order services charge copays starting at $2 for Tier 1 and $12 for Tier 2 medications for a one-month supply. For Tier 3 preferred brand drugs, you will pay a 24% coinsurance regardless of the pharmacy or mail order service you choose. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for a one-month supply across all standard and preferred pharmacy networks.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, routine physicals, and home health services. Specialist visits feature a low copay ranging from $0 to $35, while inpatient hospital stays require daily copays for the first seven days before transitioning to no copay. Emergency care is available with a $130 copay, which is waived if you are admitted, and urgent care carries a $50 copay. Routine vision and preventive dental services are highly accessible with no copays or coinsurance, including a $275 annual eyewear allowance and a $2,500 limit on comprehensive dental. Routine hearing exams and prescription hearing aids up to $500 per ear are also covered with no copay or coinsurance. For specialized medical needs, diagnostic lab services require no copay, while medical equipment and dialysis generally require no copay but carry a coinsurance of up to 20 percent.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute stays require a $350 daily copay for days 1 to 7 and no copay for days 8 and beyond, while psychiatric stays require a $275 daily copay for days 1 to 7 and no copay for days 8 to 90. This benefit is partially covered as upgrades, non-Medicare-covered stays, 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 $275 copay for outpatient hospital services and a $350 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while individual and group outpatient substance abuse sessions require a $35 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Extra (PPO) with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature Extra (PPO), with ground ambulance services requiring a $330 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $330.
Primary Care See details
Aetna Medicare Signature Extra (PPO) features no copay and no coinsurance for primary care visits, and a $0 to $35 copay with no coinsurance for specialists. Physical, occupational, mental health, and psychiatric therapies have a $35 copay and no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Podiatry is not covered, and although some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, wellness screenings, and select supplemental benefits, though kidney disease education requires a 20% coinsurance with no copay. Covered supplemental perks include health education, smoking cessation, memory fitness, remote access, and chemotherapy wigs up to $400 annually with no copay and no coinsurance. Non-covered services include in-home safety assessments, PERS, 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 safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) offers partially covered hearing services, with a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for yearly routine exams, fitting evaluations, and prescription hearing aids up to a $500 annual limit per ear. However, 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 Extra (PPO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. This benefit includes one routine eye exam per year up to a $50 maximum and a $275 annual allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (PPO), with preventive care such as cleanings and exams requiring no copay and no coinsurance, and Medicare-covered dental requiring a $35 copay and no coinsurance. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $2,500 annual limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, subject to prior authorization. Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while other Part B chemotherapy and prescription drugs have no copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature Extra (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic tests and lab services have no coinsurance, with lab services and X-rays requiring no copay, while other diagnostic procedures have a $0 to $50 copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Extra (PPO) covers some cardiac rehabilitation services with no coinsurance, but several specific sub-services are not covered in practice. Specifically, cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy (SET) for peripheral artery disease (PAD) services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, requiring a $10 daily copay for days 1-20 and a $218 daily copay for days 21-100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required before admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, providing an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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