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Aetna Medicare Signature Care (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (HMO). 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 (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select AR HVP Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (HMO) 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 (HMO).
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 (HMO), 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 $6750.00 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 Care (HMO) plan offers an enhanced alternative drug benefit with a yearly prescription drug deductible of $615. After meeting your deductible, you will pay no copay for Tier 1 preferred generic drugs at standard pharmacies. For Tier 2 standard generics, Tier 3 preferred brands, and Tier 4 non-preferred drugs, you will pay a 25% coinsurance at a standard pharmacy during the initial coverage phase. If you qualify for Extra Help or the low-income subsidy, your prescription costs are reduced to $0. Additionally, once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D prescription drugs.
Additional Benefits
The Aetna Medicare Signature Care (HMO) plan offers affordable coverage featuring no copay and no coinsurance for primary care doctor visits, annual physicals, and home health services. Specialist visits require a copay between $10 and $35, while inpatient hospital stays require daily copays for the first several days of your stay. Emergency and urgent care services are also covered with fixed copays and no coinsurance, ensuring predictable costs for unexpected medical needs. This plan also provides excellent ancillary benefits, including no copay for routine dental, vision, and hearing exams, as well as generous allowances for eyewear and prescription hearing aids. Comprehensive dental care is covered with a 20% to 50% coinsurance up to $2,500 annually, while durable medical equipment and dialysis require a 20% coinsurance. Members also enjoy extra perks like a $30 quarterly over-the-counter allowance and meal benefits with no copay.
Inpatient Hospital See details
Inpatient Hospital benefits are partially covered by Aetna Medicare Signature Care (HMO), requiring a $399 daily copay for days 1 through 7 of acute stays and a $407 daily copay for days 1 through 5 of psychiatric stays, with no copay for subsequent days and no coinsurance. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under Aetna Medicare Signature Care (HMO) are covered with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Other outpatient benefits require copays, ranging from $30 for substance abuse sessions up to $399 for hospital and observation services.
Partial Hospitalization See details
Aetna Medicare Signature Care (HMO) covers partial hospitalization benefits with a copay ranging from $140.00 to $145.00 and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature Care (HMO), though transportation services to health-related locations are not covered. Covered ground ambulance services require a $305 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for all ambulance services.
Emergency Services See details
Aetna Medicare Signature Care (HMO) covers emergency services with a $130 copay and urgently needed services with a $40 copay, both featuring no coinsurance. Worldwide emergency care, urgent care, and emergency transportation are also covered with no coinsurance, requiring copays ranging from $130 to $305 up to a $250,000 maximum benefit.
Primary Care See details
Aetna Medicare Signature Care (HMO) covers primary care doctor visits with no copay and no coinsurance, while specialist visits require a $10 to $35 copay. Therapy, mental health, and psychiatric services have copays ranging from $30 to $45, and telehealth is covered with a 20% coinsurance and copays up to $40, though podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Care (HMO), offering annual physical exams and other preventive screenings with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature Care (HMO) partially covers hearing services, providing annual routine hearing exams and fitting evaluations with no copay and no coinsurance, and other hearing exams for a $35 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear each year with no copay and no coinsurance, though OTC hearing aids and prescription aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance or deductibles. Eye exams feature a copay ranging from $0 to $35, which includes one annual routine exam with no copay, while eyewear is fully covered with no copay up to a $225 annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (HMO), excluding fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics. Preventive care features no copay or coinsurance, Medicare-covered dental requires a $35 copay and no coinsurance, and other comprehensive services have no copay and 20% to 50% coinsurance up to a $2,500 annual limit.
Home Infusion bundled Services See details
Aetna Medicare Signature Care (HMO) covers home infusion bundled services, featuring Medicare Part B insulin for a $35 copay and no coinsurance, which does not apply to the plan deductible. Other covered Part B chemotherapy, radiation, and infusion drugs require no copay and range from no coinsurance up to 20% coinsurance, subject to prior authorization.
Dialysis Services See details
Dialysis Services are covered under Aetna Medicare Signature Care (HMO) with a 20% coinsurance and no copay. Prior authorization is required to receive this benefit.
Medical Equipment See details
Medical Equipment benefits are covered by Aetna Medicare Signature Care (HMO) with no copays, though prior authorization is required. Members pay a 20% coinsurance for durable medical equipment, prosthetic devices, medical supplies, and diabetic therapeutic shoes, while diabetic supplies require between no coinsurance and 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature Care (HMO) with prior authorization. This plan features no copay for lab and outpatient X-ray services, a $0 to $95 copay for diagnostic procedures, a $0 to $300 copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Care (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature Care (HMO) plan, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage. Consequently, there are no copays or coinsurance benefits available for these services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Care (HMO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, featuring no coinsurance for covered stays. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond Medicare-covered SNF care are not covered.
Other Services See details
Aetna Medicare Signature Care (HMO) partially covers other services with no copay and no coinsurance for covered benefits like meal benefits, select wellness screenings, and a $30 quarterly over-the-counter item allowance. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered.
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