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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 2026 to people living in Metro St Louis - Illinois. 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) plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will have no copay when filling your prescription at a preferred pharmacy or through preferred mail-order services. If you use standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36, depending on the supply duration. For higher-tier medications, the plan transitions from copays to coinsurance. You will pay a 24% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for Tier 4 non-preferred drugs and Tier 5 specialty drugs. These coinsurance rates apply to both preferred and standard pharmacy options, with Tier 5 specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust coverage featuring no copays and no coinsurance for primary care visits, home health services, and annual preventive screenings. For hospital care, inpatient stays require daily copays with no coinsurance, while outpatient services range from no copay for surgical centers to up to $400 for outpatient hospital services. Specialist visits, diagnostic tests, and emergency services are also covered with no coinsurance and predictable copays. Routine vision, dental, and hearing benefits are highly affordable, offering no copays or coinsurance for routine exams and select preventive dental care. Additionally, the plan covers eyewear up to a $100 annual limit and prescription hearing aids up to $500 per ear with no copay or coinsurance. Other essential services like laboratory tests and home infusion are covered with no copay, though dialysis and durable medical equipment may require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a copay of $395 per day for days 1 through 8 of acute stays and $350 per day for days 1 through 6 of psychiatric stays, with no copay for the remaining days. The benefit is partially covered, as 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, offering no copays for ambulatory surgical center and blood services. Outpatient hospital services require copays ranging from no copay to $400 (with a $395 copay per stay for observation services), while outpatient substance abuse sessions have a $55 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, though prior authorization is required. Depending on the specific service, you will pay a copay of either $75.00 or $180.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $335 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $150 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $55 copay, both featuring no coinsurance and costs that do not apply to the plan deductible. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 lifetime maximum with no coinsurance, requiring copays of $150 for emergency or urgent care and $335 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist, mental health, therapy, and podiatry services require copays ranging from $0 to $55 and no coinsurance. Chiropractic services are partially covered, as routine and other chiropractic care are not covered, and telehealth benefits require a 20% coinsurance with copays from $0 to $55.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), offering annual physicals and screenings with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance with no copay. Sub-services not covered include 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, 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 covered by Aetna Medicare Signature (HMO-POS) feature no deductible, with Medicare-covered exams requiring a $55 copay and no coinsurance, while annual routine exams and fittings have no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance for eye exams, including one routine exam per year and unlimited follow-up diabetic eye exams. Eyewear, such as contacts, eyeglasses, and upgrades, is also covered with no copay and no coinsurance up to a $100 annual maximum limit.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (HMO-POS), featuring Medicare-covered dental services for a $55 copay and no coinsurance, and select preventive care with no copay and no coinsurance. Covered preventive care includes up to four oral exams, one dental x-ray, and two cleanings per year, while services like fluoride, orthodontics, restorative care, endodontics, periodontics, and implants are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry a 0% to 20% coinsurance.
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
Medical equipment is covered by Aetna Medicare Signature (HMO-POS), with durable medical equipment, prosthetics, and medical supplies requiring no copay and coinsurance ranging from no coinsurance to 20%. Diabetic supplies carry no coinsurance to 20% coinsurance, while diabetic therapeutic shoes and inserts have a $10 copay. Prior authorization is required for these covered medical equipment benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services, with prior authorization required for these benefits. Diagnostic procedures and tests have a $0 to $55 copay with no coinsurance, lab services and outpatient X-rays have no copay, and therapeutic radiological services require 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO-POS) offers cardiac rehabilitation benefits where some services are covered with no coinsurance and no copay. However, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry 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, a prior three-day hospital stay is not necessary for admission, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, providing 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 under this plan.
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