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Aetna Medicare Signature Extra (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Southern NJ, Middlesex and Monmouth Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 $9250.00 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 Extra (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when filled through preferred pharmacies or 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 fill. Higher tier medications are subject to coinsurance rather than copays under this plan. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy and mail-order options. Tier 5 specialty drugs also carry a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (HMO) plan offers robust medical coverage featuring no coinsurance for many core services, including inpatient hospital stays, outpatient care, and specialist visits. Primary care visits require a low $10 copay, while routine preventive services, home health care, and annual physicals are available with no copay and no coinsurance. For hospital care, inpatient stays feature no coinsurance and require a daily copay for the first six days, after which there is no copay. This plan also includes essential dental, vision, and hearing benefits, offering routine exams, cleanings, and annual eye exams with no copay and no coinsurance. Prescription hearing aids and eyewear are partially covered, while emergency and urgent care services are available with set copays and no coinsurance. Many diagnostic services, including laboratory tests, also feature no copay and no coinsurance, helping members manage their out-of-pocket costs effectively.
Inpatient Hospital See details
Aetna Medicare Signature Extra (HMO) covers inpatient hospital services with no coinsurance, requiring prior authorization for both acute and psychiatric stays. For acute stays, there is a $395 copay per day for days 1 through 6 and no copay for days 7 and beyond, while psychiatric stays require a $346 copay per day for days 1 through 6 and no copay for days 7 through 90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Extra (HMO) with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $450, observation services have a $395 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (HMO) covers partial hospitalization services with a copay of either $60.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services under the Aetna Medicare Signature Extra (HMO) require a $285 copay and no coinsurance for ground and air ambulance services, which also require prior authorization. Routine transportation services to health-related locations are not covered by this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (HMO) with a $115 copay—waived if admitted to the hospital within 24 hours—and no coinsurance. Urgently needed services have a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $285.
Primary Care See details
Aetna Medicare Signature Extra (HMO) covers primary care physician visits for a $10 copay and no coinsurance, and specialist visits for no copay to a $40 copay and no coinsurance. Physical, occupational, speech, mental health, psychiatric, and opioid treatment services are covered with copays ranging from $35 to $40 and no coinsurance, while chiropractic and podiatry services are not covered. Telehealth benefits are also available with no copay to a $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (HMO), featuring no copay and no coinsurance for annual physicals, fitness benefits, health education, and various screenings. Kidney disease education is covered with no copay and a 20% coinsurance, while several services—including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and therapeutic massage—are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (HMO) covers hearing services with no deductible, offering Medicare-covered exams for a $40 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from no copay to $1,700 for up to two devices per year, 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 Extra (HMO) with no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for annual routine exams. Eyewear, including contacts and eyeglasses, is covered with no copay up to a $100 annual maximum limit.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (HMO), offering routine oral exams, cleanings, and dental X-rays with no copay and no coinsurance. Medicare-covered dental services require a $40 copay and no coinsurance, while restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, orthodontics, and fluoride treatments are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (HMO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Extra (HMO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (HMO) with no copay, though prior authorization is required. Depending on the item, you will pay no coinsurance up to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices and diabetic shoes or inserts require 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature Extra (HMO) plan, with prior authorization required for all services. Diagnostic services feature no coinsurance, no copay for lab services, and a $0 to $40 copay for diagnostic procedures, while radiological services require a $40 copay plus coinsurance for X-rays, a $0 minimum copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered by the Aetna Medicare Signature Extra (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Extra (HMO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, although some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature Extra (HMO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit is partially covered because additional days beyond those covered by Medicare are not covered, and prior authorization is required.
Other Services See details
Aetna Medicare Signature Extra (HMO) partially covers other services, offering a meal benefit for chronic illness, annual wellness exams, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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