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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 2025 to people living in MI Northern. This plan received an overall rating of 3 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 $5900.00 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, you pay no copay when using a preferred pharmacy or preferred mail-order service for any supply length. If you choose standard pharmacies or standard mail-order options, copays range from $2 to $6 for Tier 1 drugs and $12 to $36 for Tier 2 drugs depending on the supply duration. Higher-tier medications under this plan transition to coinsurance instead of flat copays. Tier 3 (Preferred Brand) drugs require a 24% coinsurance across all pharmacy options, while Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) drugs require a 25% coinsurance. Note that Tier 5 specialty prescriptions are limited to a 1-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For specialized care, members pay a $40 copay for specialists and physical therapy, while emergency room visits carry a $130 copay and urgent care costs $50. Inpatient hospital stays require daily copays for the first seven days, starting at $350 for acute stays and $325 for psychiatric stays, with no copay for additional days. This plan also includes essential dental, vision, and hearing benefits, offering routine eye exams, hearing exams, and preventive dental cleanings with no copay. Comprehensive dental services are available with no copay and 20% to 50% coinsurance, while prescription hearing aids are covered up to $500 per ear and eyewear is covered up to $150 annually. Additionally, medical equipment and supplies require no copay with coinsurance ranging from 0% to 20%.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays require a $350 daily copay for days 1 to 7 and no copay for unlimited additional days, while psychiatric stays require a $325 daily copay for days 1 to 7 and no copay for days 8 to 90, with upgrades and non-Medicare-covered stays excluded.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Patients will pay a copay ranging from $0 to $350 for outpatient hospital services, and a $40 copay for outpatient substance abuse sessions.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with a copay of either $75.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $260 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay—which is waived if admitted to the hospital within 24 hours—and urgent care with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $130 to $260, up to a $250,000 maximum benefit.
Primary Care See details
Aetna Medicare Signature (HMO-POS) provides primary care physician services with no copay and no coinsurance, while specialists, physical therapy, occupational therapy, and mental health services require a $40 copay and no coinsurance. Additional telehealth services are covered with a $0 to $50 copay and 20% coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services under Aetna Medicare Signature (HMO-POS) are mostly covered with no copay and no coinsurance, including annual physical exams, diabetes self-management, and glaucoma screenings, though kidney disease education requires a 20% coinsurance with no copay. While supplemental benefits like chemotherapy wigs are covered up to $400 with no copay or coinsurance, other services like medical nutrition therapy, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) hearing services are partially covered, offering Medicare-covered exams for a $40 copay and no coinsurance, while annual routine exams and fittings have no copay, no coinsurance, and no deductible. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, offering routine eye exams with no copay and Medicare-covered exams with a $0 to $40 copay. Covered eyewear, including contacts and eyeglasses, also features no copay and is subject to a $150 annual maximum benefit.
Dental Services See details
Aetna Medicare Signature (HMO-POS) offers partially covered dental services, featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive exams, cleanings, and x-rays. Comprehensive dental services require no copay with 20% to 50% coinsurance, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services 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 Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment with no copays, though prior authorization is required for most items. Members will pay no coinsurance to 20% coinsurance for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices require a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic procedures with a copay ranging from $0 to $100. Radiological services under this plan require prior authorization, featuring outpatient X-rays with a $10 copay, therapeutic radiological services with a minimum 20% coinsurance, and diagnostic radiology starting at no copay.
Home Health Services See details
The Aetna Medicare Signature (HMO-POS) plan covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, but only some services are covered. Standard cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $200 daily copay for days 21 through 100. Prior authorization is required, a three-day inpatient hospital stay is not required prior to admission, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO-POS), which provides an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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