A non-government entity
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 2025 to people living in San Antonio and Surrounding Counties. This plan received an overall rating of 4 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 $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:
Sign up for Aetna Medicare Signature (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will have no copay when using a preferred pharmacy or preferred mail order service. If you utilize standard pharmacies or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs are based on a percentage of the drug cost rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy options. These coinsurance rates apply to both preferred and standard pharmacies as well as mail order services.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive healthcare coverage with predictable out-of-pocket costs, including no copay and no coinsurance for preventive care, routine vision exams, and basic dental cleanings. For standard medical visits, members will pay a low $5 copay for primary care doctors and up to a $60 copay for specialists, with no coinsurance required. Inpatient hospital stays require a $450 daily copay for the first six days with no copay thereafter, while emergency room visits carry a $130 copay. Additionally, the plan covers essential services like home health visits with no copay and no coinsurance, alongside diagnostic lab tests which also feature no copay. Specialized treatments, durable medical equipment, and dialysis services generally require up to a 20% coinsurance with no copay. While routine hearing exams have no copay, prescription hearing aids are covered up to a $500 annual limit, and comprehensive dental care is available with 20% to 50% coinsurance up to a $1,500 yearly maximum.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient acute hospital stays with no coinsurance, requiring prior authorization and a $450 daily copay for days 1-6, with no copay for days 7 and beyond. Inpatient psychiatric care is also covered with no coinsurance and a $375 daily copay for days 1-6, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $400 for outpatient hospital services, $450 per stay for observation services, and $50 for outpatient substance abuse sessions.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the service, you will pay a copayment of either $85.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) partially covers ambulance and transportation services, with ground ambulance requiring a $300 copay and no coinsurance, and air ambulance requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance transport, and transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services 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, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $300.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician visits for a $5 copay and specialist visits for no copay to a $60 copay, both with no coinsurance. Physical, occupational, and mental health therapies are covered with copays ranging from $50 to $70 and no coinsurance, while chiropractic care is only partially covered (routine and other chiropractic services are not covered) and podiatry is not covered.
Preventive Services See details
Preventive Services under Aetna Medicare Signature (PPO) are partially covered, offering an annual physical, health education, fitness benefits, and wellness screenings with no copay and no coinsurance, while kidney disease education is covered with no copay and a 20% coinsurance. Several supplemental benefits are not covered, including in-home safety assessments, personal emergency response systems, weight management programs, nutritional benefits, and alternative therapies.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams with a $60 copay and no coinsurance, while annual routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual maximum, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for both eye exams and eyewear. The plan features a $50 annual maximum for eye exams, which includes one routine exam per year, and a $125 yearly combined maximum allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by the Aetna Medicare Signature (PPO) plan, which features preventive services like cleanings and exams with no copay and no coinsurance, alongside Medicare-covered dental for a $60 copay and no coinsurance. Comprehensive services require no copay and 20% to 50% coinsurance up to a $1,500 annual limit, while fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, although prior authorization is required. Under this plan, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays and coinsurance ranging from no coinsurance up to 20% depending on the specific item. Prior authorization is required for durable medical equipment, prosthetics, and diabetic supplies, which are also limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with no coinsurance for diagnostic services, no copay for lab services, and diagnostic test copays ranging from $0 to $40. Outpatient X-rays require a $5 copay, diagnostic radiological services have copays starting at $0, and therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers Cardiac Rehabilitation Services with no coinsurance. Patients will pay a copay of $20 for cardiac and intensive cardiac rehabilitation, $15 for pulmonary rehabilitation, and $25 for supervised exercise therapy for symptomatic peripheral artery disease.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a three-day prior hospital stay is not needed, and 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 screenings with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved