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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 Peoria/Tazewell. 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 $4200.00 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 prescription drug coverage for the Aetna Medicare Signature (HMO-POS) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, members pay no copay when filling prescriptions through preferred pharmacies or preferred mail-order services. If standard pharmacies or standard mail-order services are used instead, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply length. For brand-name and specialty medications, costs are structured as coinsurance across all pharmacy options. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. Specialty tier medications are limited to a one-month supply under this plan.
Additional Benefits
Aetna Medicare Signature (HMO-POS) offers affordable core medical services, featuring no copay and no coinsurance for primary care visits, home health services, and annual preventive physicals. Specialist visits, urgent care, and diagnostic tests are also highly accessible, requiring low copays of up to $35 with no coinsurance. For major medical needs, inpatient hospital stays require a $340 daily copay for the first six days and no copay thereafter, while emergency room visits carry a $150 copay. This plan also provides valuable coverage for routine specialty care, including annual vision exams and eyewear with no copay and a $100 yearly allowance. Preventive dental and routine hearing services feature no copay, with additional allowances of up to $2,000 for comprehensive dental care and $500 per ear for prescription hearing aids. Durable medical equipment and diagnostic services are covered with little to no copays and coinsurance ranging from 0% to 20%.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring a $340 daily copayment for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and some services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient hospital services with a $0 to $325 copay and no coinsurance, and outpatient observation services with a $340 copay per stay and no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 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 for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. While transportation is technically covered, some services are covered but transportation to plan-approved or any health-related locations is not covered.
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 require a $35 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $150 to $275.
Primary Care See details
Primary care and professional services are covered by Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance for primary care doctor visits. Specialist visits, mental health sessions, and physical therapies generally require a $0 to $35 copay and no coinsurance, while telehealth services carry a 20% coinsurance and routine chiropractic care is not covered.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) partially covers preventive services, offering annual physical exams, health education, and select screenings with no copay and no coinsurance, while kidney disease education requires no copay and a 20% coinsurance. However, 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 (HMO-POS) partially covers hearing services, offering Medicare-covered exams for a $35 copay and no coinsurance, while routine exams and fittings have no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no copay and no coinsurance for both eye exams and eyewear. This benefit includes one routine eye exam every year and a combined maximum allowance of $100 annually for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), featuring preventive care with no copay and no coinsurance, and Medicare-covered dental for a $35 copay and no coinsurance. Comprehensive dental options are covered up to a $2,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, subject to prior authorization. Covered Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered under Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance to 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies and therapeutic shoes are also covered with a $10 copay for shoes and up to 20% coinsurance, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services, offering lab services and diagnostic radiological services with no copay and no coinsurance. Diagnostic tests and procedures carry a copay of $0 to $35 with no coinsurance, while therapeutic radiological services require 20% coinsurance and outpatient X-rays have no copay but require 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
Cardiac rehabilitation services are offered with no coinsurance under Aetna Medicare Signature (HMO-POS). Although some services are covered, specific benefits including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered 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 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and although a three-day prior hospital stay is not needed, additional days beyond Medicare-covered limits are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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