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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 Kansas City Metro Area. 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 Aetna Medicare Signature (HMO-POS) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using preferred pharmacies or preferred mail-order services. If standard pharmacies or standard mail order services are used, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply length. Higher-tier medications on this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These cost-sharing percentages remain consistent whether you utilize preferred or standard pharmacies and mail-order options.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits and routine preventive care. For specialist visits, copays range from $0 to $30 with no coinsurance, while emergency room visits carry a $150 copay that is waived if you are admitted. Inpatient hospital stays require a daily copay of $340 for the first six days, after which there is no copay. This plan also includes valuable supplemental benefits, such as no copay for routine dental, vision, and hearing exams. Prescription hearing aids are covered up to $1,250 per ear annually with no copay, and eyewear is covered up to a $150 annual limit with no copay or coinsurance. Comprehensive dental services are available with 20% to 50% coinsurance up to a $1,500 annual limit, while home health services are fully covered with no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, there is a $340 daily copay for days 1 through 6 and no copay for subsequent days, while psychiatric stays require a $350 daily copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $350 copay and observation services with a $340 copay per stay. Ambulatory surgical center and outpatient blood services are provided with no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature (HMO-POS), which offers ground ambulance services with a $325 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services to plan-approved or any other health-related locations are 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, and urgent care with a $30 copay and no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum with no coinsurance, requiring a $150 copay for emergency or urgent care and a $325 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist, therapy, psychiatric, and mental health services have copays ranging from $0 to $30 with no coinsurance. Chiropractic services are partially covered with a $20 copay and no coinsurance, as routine and other chiropractic care are not covered. Podiatry and opioid treatment are covered with copays up to $35 and no coinsurance, while telehealth services require a $0 to $30 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), offering annual physicals, health education, and various screenings with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but several supplemental services like weight management, nutritional benefits, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), featuring no coinsurance for all services and a $35 copay for Medicare-covered exams. Routine exams, fitting evaluations, and prescription hearing aids (up to $1,250 per ear annually) have no copay, but OTC hearing aids alongside inner-ear, outer-ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductible and no coinsurance, featuring a $25 copay for Medicare-covered eye exams and no copay for annual routine exams. Eyewear is covered with no copay and no coinsurance up to a $150 annual maximum for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (HMO-POS) dental services are partially covered, excluding fluoride treatment, other diagnostic or preventive services, maxillofacial prosthetics, implants, and orthodontics. Medicare-covered dental has a $35 copay and no coinsurance, while covered preventive services have no copay and no coinsurance. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $1,500 annual limit.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance and 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 (HMO-POS) plan with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and prior authorization required. Depending on the item, coinsurance ranges from no coinsurance up to 20%, with prosthetic devices and diabetic therapeutic shoes or inserts requiring a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $30 copay, while radiological services offer outpatient X-rays and diagnostic radiological services with no copay and therapeutic services with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO-POS) plan, as all sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy, are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (HMO-POS) 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, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO-POS), including acupuncture for a $20 copay and no coinsurance (up to 12 treatments per year) and OTC items with no copay or coinsurance up to $15 every three months. Annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings are also covered with no copay or coinsurance, while meal benefits are not covered.
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