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Aetna Medicare Signature Care (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (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 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (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 $13900.00 (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 $13900.00 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 Care (PPO)
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Drug Coverage
The Aetna Medicare Signature Care (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you pay no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose standard pharmacies or standard mail-order options, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, your costs are based on coinsurance 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. These coinsurance percentages remain the same whether you use preferred, standard, or mail-order pharmacy services.
Additional Benefits
The Aetna Medicare Signature Care (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, while specialist visits require a copay of $10 to $40. For hospital stays, inpatient acute care has a $388 copay for the first seven days and no copay thereafter, while outpatient hospital services feature copays ranging from no copay up to $450 with no coinsurance. Emergency care is accessible with a $115 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, featuring no copay and no coinsurance for routine dental, vision, and hearing exams, alongside allowance limits for eyewear and hearing aids. Skilled nursing facility stays feature no copay for the first 20 days, and home health services are fully covered with no copay. Additionally, members benefit from various preventive services, diagnostic lab tests, and a quarterly $15 over-the-counter item reimbursement with no copays.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature Care (PPO) with no coinsurance, requiring prior authorization. Under this plan, acute stays carry a $388 copay for days 1 to 7 and no copay for subsequent days, while psychiatric stays require a $407 copay for days 1 to 5 and no copay for subsequent days; however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Care (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $450, observation services have a $388 copay per stay, and outpatient substance abuse sessions carry a $40 copay, all with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Care (PPO) with a copay of $105.00 or $110.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under Aetna Medicare Signature Care (PPO), which features a $285 copay (no coinsurance) for ground ambulance services and a 20% coinsurance (no copay) for air ambulance services. Prior authorization is required for all ambulance services, and transportation to health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature Care (PPO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $285.
Primary Care See details
Primary care services under Aetna Medicare Signature Care (PPO) feature no copay and no coinsurance for primary care visits, and a $10 to $40 copay with no coinsurance for specialists. Telehealth services range from no copay to a $55 copay with 20% coinsurance, mental health and therapy services cost a $35 to $50 copay with no coinsurance, podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Preventive Services under Aetna Medicare Signature Care (PPO) are partially covered, offering no copay and no coinsurance for annual physical exams, diabetes training, and select supplemental benefits like fitness and health education, while kidney disease education requires a 20% coinsurance and no copay. Several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature Care (PPO) covers hearing services with no deductibles, featuring Medicare-covered exams for a $40 copay and no coinsurance, plus annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual limit per ear, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Care (PPO) with no deductible and no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for eyewear. Routine eye exams are covered up to a $50 annual limit, and eyewear benefits including lenses, frames, and contacts have a combined annual limit of $125.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (PPO), offering preventive care with no copay and no coinsurance, and Medicare-covered dental services with a $40 copay and no coinsurance. Comprehensive services are subject to no copay and 20% to 50% coinsurance up to a $1,500 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Care (PPO) covers home infusion bundled services with no copay, subject to prior authorization. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Aetna Medicare Signature Care (PPO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Care (PPO) with no copay and 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Covered diabetic supplies have no copay and 0% to 20% coinsurance, while diabetic therapeutic shoes or inserts carry a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Care (PPO) with prior authorization required for all services. Diagnostic services have no coinsurance, featuring no copay for lab services and a copay of up to $95 for diagnostic tests. Radiological services include outpatient x-rays with no copay, diagnostic radiology starting at no copay, and therapeutic radiology which requires a copay and a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature Care (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Care (PPO) covers some Cardiac Rehabilitation Services with no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Signature Care (PPO) with no coinsurance, requiring no copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, a three-day prior hospital stay is not required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Care (PPO) offers coverage for various other services with no copays and no coinsurance, including meal benefits for chronic illnesses, annual wellness exams, screening mammographies, and up to $15 every three months in over-the-counter (OTC) item reimbursements. Acupuncture is not covered under these additional services.
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