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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 Upstate and Midlands South 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 $500.00 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 $8200.00 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) prescription drug plan features an annual drug deductible of $500. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when filling your prescription through preferred pharmacies or preferred mail order services. If you choose standard pharmacies or standard mail order services, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2. For brand-name and specialty medications, costs are structured as a percentage of the drug cost rather than a flat copay. You will pay a 22% coinsurance for Tier 3 preferred brands, a 25% coinsurance for Tier 4 non-preferred drugs, and a 27% coinsurance for Tier 5 specialty drugs.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive medical coverage with predictable costs, including primary care visits, routine dental and vision exams, and home health services with no copays. For more intensive care, members pay flat copayments but no coinsurance for inpatient hospital stays and outpatient services, while specialist visits and emergency care require low copays. Emergency transport and diagnostic services are also covered, though some specialized treatments require coinsurance or prior authorization. This plan also features valuable supplemental benefits, providing no-copay preventive dental care, annual eye exams with a $100 eyewear allowance, and prescription hearing aid coverage up to $1,250 per ear. Additionally, members benefit from a $30 quarterly over-the-counter item reimbursement and no copays for the first 20 days of skilled nursing facility care. Overall, this plan minimizes out-of-pocket costs by eliminating coinsurance for many everyday healthcare needs.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (HMO) with no coinsurance, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Acute inpatient stays require a $388 copay for days 1 through 7 and no copay for days 8 and beyond, while psychiatric stays carry a $260 copay for days 1 through 8 and no copay for days 9 through 90.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance, featuring a $0 to $388 copay for outpatient hospital services and a $388 copay per stay for observation services. Patients will pay a $12 copay for outpatient substance abuse sessions, while ambulatory surgical center and outpatient blood services are covered with no copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground ambulance services with a $285 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay (waived if admitted within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered with no coinsurance, featuring a $115 copay for emergency or urgent care and a $285 copay for emergency transportation, up to a $250,000 maximum benefit.
Primary Care See details
Aetna Medicare Signature (HMO) offers primary care physician visits with no copay and no coinsurance, and specialist services with a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay with no coinsurance, while mental health and psychiatric sessions have a $12 copay with no coinsurance. Chiropractic and podiatry services are not covered, but telehealth is available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (HMO) covers many preventive services with no copay and no coinsurance, including annual physical exams, glaucoma screenings, and fitness benefits, while kidney disease education has a 20% coinsurance and no copay. The benefit is partially covered, as sub-services such as medical nutrition therapy, weight management programs, and in-home safety assessments are not covered.
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 fitting evaluations. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $1,250 maximum per ear yearly, though OTC hearing aids, as well as inner ear, outer ear, and over the ear prescription models, are not covered.
Vision Services See details
Vision Services under Aetna Medicare Signature (HMO) are covered with no deductible and no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for eyewear. This includes one routine eye exam per year and follow-up diabetic eye exams at no copay, plus a $100 annual maximum allowance for contacts, eyeglasses, and upgrades.
Dental Services See details
Aetna Medicare Signature (HMO) covers Medicare-covered dental services for a $40 copay and no coinsurance, while preventive services like exams and cleanings have no copay or coinsurance. Comprehensive services are partially covered up to a $1,250 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (HMO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers durable medical equipment, prosthetics, and diabetic supplies with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO), with prior authorization required for most services. Lab services and outpatient X-rays feature no copay, diagnostic tests have a copay of $0 to $200 with no coinsurance, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO) covers Cardiac Rehabilitation Services with no coinsurance, though copayments apply depending on the specific service. Members will pay a $20 copay for cardiac rehabilitation, intensive cardiac rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), and a $15 copay for pulmonary rehabilitation services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior 3-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 copay for days 21 through 100, and additional days beyond the standard Medicare-covered days are not covered.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services with no copay and no coinsurance, including annual wellness exams, screening mammography, additional colorectal screenings, and a $30 quarterly over-the-counter item reimbursement. Acupuncture and meal benefits are not covered by the 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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