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Aetna Medicare Value Plus Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Value Plus 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 Value Plus Signature (PPO) in 2025, please refer to our full plan details page.
Aetna Medicare Value Plus Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in GA. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Aetna Medicare Value Plus 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 Value Plus 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 Value Plus Signature (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $16.30. 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 $590.00 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 $14000.00 (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 $14000.00 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 Value Plus Signature (PPO) plan has an "Enhanced Alternative" drug benefit type. The plan has a deductible of $590.00. After the deductible, you will pay a copay for your prescriptions. For example, you will pay a $5.00 copay for preferred generic drugs at a preferred pharmacy. Non-preferred drugs have a 25% coinsurance.
Additional Benefits
The Aetna Medicare Value Plus Signature (PPO) plan offers a variety of benefits with varying costs. The plan covers inpatient hospital stays with a copay, outpatient services with copays ranging from $0 to $380, and emergency services for a $110 copay. The plan also provides coverage for primary care, preventive services, hearing, vision, and dental services with no or low copays for many services. Home health services and medical equipment are covered, and there is coverage for skilled nursing facilities with a copay.
Inpatient Hospital See details
Inpatient Hospital services are covered by the Aetna Medicare Value Plus Signature (PPO) plan, with a copay of $380 for days 1-7 and no copay for days 8-90 for Inpatient Hospital-Acute. Inpatient Hospital Psychiatric services have a copay of $678 for days 1-3 and no copay for days 4-90. Non-Medicare-covered stay and Upgrades for Inpatient Hospital-Acute and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with copays ranging from $0 to $380, and observation services with a $380 copay. Ambulatory Surgical Center (ASC) Services and Outpatient Blood Services have no copay, and Outpatient Substance Abuse Services have a $40 copay for both individual and group sessions.
Partial Hospitalization See details
Partial hospitalization is covered by the Aetna Medicare Value Plus Signature (PPO) plan, but requires prior authorization. You will have an $80 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Value Plus Signature (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $280 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services are covered under the Aetna Medicare Value Plus Signature (PPO) plan, with a $110 copay and no coinsurance. Urgently Needed Services have a $40 copay and no coinsurance, and Worldwide Emergency Services include a $110 copay for Worldwide Emergency and Urgent Coverage, and a $280 copay for Worldwide Emergency Transportation, with no coinsurance.
Primary Care See details
The Aetna Medicare Value Plus Signature (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $25 copay, and specialist services with a $10-$15 copay. Mental health specialty services, individual and group psychiatric sessions, and opioid treatment program services have a $40 copay, while physical therapy and speech-language pathology services have a $25 copay. Additional telehealth benefits have a 20% coinsurance and a $0-$40 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for annual physical exams with no copay, as well as additional services like glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit, all with no copay. Other benefits include kidney disease education services with 20% coinsurance, and wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, and fitness benefits with no copay. Some services, such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, enhanced disease management, telemonitoring services, home and bathroom safety devices and modifications, counseling services, adult day health services, nutritional/dietary benefits, home-based palliative care, and in-home support services, are not covered.
Hearing Services See details
Hearing exams are covered with a $15 copay, and routine hearing exams and fitting/evaluation for hearing aids have no copay. Prescription hearing aids are covered up to $500 per ear annually, with no copay for prescription hearing aids of all types. However, prescription hearing aids for the inner, outer, and over the ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
The Aetna Medicare Value Plus Signature (PPO) plan covers vision services, including eye exams with a copay of $0-$15, and eyewear with no copay. Eyewear has a combined maximum benefit of $250 per year.
Dental Services See details
Dental services are covered by Aetna Medicare Value Plus Signature (PPO), with a $15 copay for Medicare dental services, and no copay for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery. Maxillofacial prosthetics, implant services, and orthodontics are not covered, and there is a $2,150 maximum plan benefit coverage amount per year.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Value Plus Signature (PPO) plan, but require prior authorization. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has no copay and a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and no copay, and Diabetic Supplies have no copay and between 0-20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay between $0 and $95, and lab services with no copay. Radiological Services include diagnostic services with a copay up to $300, therapeutic services with up to 20% coinsurance, and outpatient X-rays with no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Value Plus Signature (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Value Plus Signature (PPO) plan. Although Cardiac Rehabilitation Services are generally covered, specific services like Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Value Plus Signature (PPO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The Aetna Medicare Value Plus Signature (PPO) plan does not cover acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, Self-Directed Personal Assistance Services, or Dual Eligible SNPs with Highly Integrated Services. Over-the-counter items and meal benefits are covered with no copay, and other services, including annual wellness exams and screening mammography, and gFOBT, FIT, are also covered with no copay.
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