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Aetna Medicare Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Metro St Louis - Missouri. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO-POS) 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 (HMO-POS).
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 (HMO-POS), 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 Maximum Out-Of-Pocket cost of $3400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 (HMO-POS) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay when utilizing a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options are also available, with Tier 1 copays starting at $2 and Tier 2 copays starting at $12 for a one-month supply. For brand-name and specialty medications, costs are structured as a percentage of the drug cost. 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 fill methods. These coinsurance rates apply equally to preferred and standard pharmacies as well as mail-order services.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with no copay for primary care visits and a low copay of up to $25 for specialist consultations. Inpatient hospital stays require a $330 daily copay for the first eight days, after which there is no copay, while emergency room visits incur a $150 copay that is waived if you are admitted. Outpatient and preventive services are highly accessible, with many routine screenings, annual physicals, and home health services carrying no copay or coinsurance. This plan also features valuable supplemental benefits to help manage your everyday health costs, including no copay for preventive dental cleanings and routine vision or hearing exams. Members can take advantage of a $150 annual eyewear allowance and up to $1,250 per ear annually for prescription hearing aids with no copay. Additionally, the plan provides a $30 quarterly allowance for over-the-counter items and covers comprehensive dental care with coinsurance ranging from 20% to 50%.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. For acute stays, you will pay a $330 daily copay for days 1 to 8 and no copay for days 9 and beyond, while psychiatric stays require a $325 daily copay for days 1 to 8 and no copay for days 9 to 90.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services, a $330 copay per stay for observation services, and a $25 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copay of either $75.00 or $180.00 and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ambulance services with prior authorization, requiring a $300 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $25 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 maximum with copays ranging from $150 to $300 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $25 copay and no coinsurance. Physical therapy, mental health, and podiatry services require a $25 copay and no coinsurance, while some chiropractic services are covered but routine chiropractic care and other chiropractic services are not.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), with most covered services—such as annual physicals, fitness benefits, and screenings—carrying no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), offering Medicare-covered exams with a $25 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $1,250 per ear annually with no copay and no coinsurance, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductibles, offering routine eye exams and follow-up diabetic exams with no copay or coinsurance, while Medicare-covered exams require a $25 copay and no coinsurance. Eyewear, including contacts and eyeglasses, is also covered with no copay or coinsurance up to a $150 annual maximum plan benefit.
Dental Services See details
Aetna Medicare Signature (HMO-POS) dental services are partially covered, featuring no copay and no coinsurance for preventive care such as cleanings and exams, and a $25 copay with no coinsurance for Medicare-covered dental. Comprehensive treatments are available with no copay and 20% to 50% coinsurance, though other diagnostic services, fluoride, other preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B insulin is covered under this benefit with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers durable medical equipment and medical supplies with no copay and no coinsurance to 20% coinsurance, while prosthetic devices require 20% coinsurance and no copay. Diabetic supplies have no coinsurance to 20% coinsurance, and diabetic therapeutic shoes or inserts require a $10 copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay of up to $25, while lab services, outpatient X-rays, and diagnostic radiological services have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (HMO-POS) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO-POS) covers some cardiac rehabilitation services with no coinsurance, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered in practice and require a $5 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 copayment per day for days 1 through 20 and a $218 copayment per day for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services with no copay and no coinsurance, including annual wellness exams, screening mammography, additional gFOBT and FIT, and a $30 quarterly over-the-counter (OTC) item allowance. Acupuncture and meal benefits are not covered under this plan.
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