A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (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 (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Charlotte Metro North Carolina. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (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 (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 (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 $5500.00 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) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when filling your prescriptions through a preferred pharmacy or preferred mail order service. If you use a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance at all pharmacies. These coinsurance rates apply to all available supply lengths, with Tier 5 specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers affordable coverage for core medical needs, featuring no copay and no coinsurance for primary care visits and routine preventive screenings. Specialist visits range from no copay to a $40 copay, while emergency room care has a $130 copay that is waived upon hospital admission. If you require inpatient hospital care, you will pay a daily copay for the first eight days of your stay with no coinsurance. Beyond standard medical care, this plan provides robust coverage for dental, vision, and hearing services. Routine dental cleanings, annual eye exams, and routine hearing exams are all available with no copay, and the plan includes allowances for prescription hearing aids and eyewear. Members also enjoy no copays for home health services and a $30 allowance every three months for over-the-counter products.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) inpatient hospital care is partially covered with no coinsurance, requiring a daily copay of $382 for days 1 through 8 of acute stays and $292 for days 1 through 8 of psychiatric stays, with no copay for days 9 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, featuring ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services have a copay ranging from $0 to $382, observation services require a $382 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under Aetna Medicare Signature (HMO) cover ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Aetna Medicare Signature (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with no copay to a $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while telehealth services have no copay to a $50 copay and 20% coinsurance. Podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Signature (HMO) offers partially covered preventive services with no copay and no coinsurance for annual physicals, screenings, fitness, and health education, while kidney disease education has no copay but has a 20% coinsurance. Sub-services not covered under this plan include in-home safety assessments, PERS, 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, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (HMO), featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear annually, but 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) with no coinsurance and a $0 to $40 copay for eye exams, including annual routine exams and follow-up diabetic exams with no copay. Eyewear is covered with no copay and no coinsurance, offering a $150 annual maximum allowance for contacts, eyeglasses, frames, and upgrades with no deductible.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), featuring Medicare-covered dental for a $40 copay and no coinsurance, alongside preventive care like cleanings and exams with no copay and no coinsurance. Comprehensive services are covered up to a $1,500 annual maximum with no copay and 20% to 50% coinsurance, though fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with no copay, subject to prior authorization. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs are covered with 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO) with no copays for durable medical equipment, prosthetics, and diabetic therapeutic shoes. Coinsurance ranges from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay ranging from $0 to $200, while lab services and outpatient X-rays feature no copay. Diagnostic radiological services start at a $0 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO) provides Cardiac Rehabilitation Services with no coinsurance, though only some services are covered. Specifically, cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring a $10 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, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services with no copay and no coinsurance for covered benefits, including annual wellness exams, screening mammographies, additional colorectal screenings, and over-the-counter items up to $30 every three months. Acupuncture and meal benefits are not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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