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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 IL 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 $6350.00 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 generics and Tier 2 generics, members pay no copay when utilizing preferred pharmacies or preferred mail-order services. Standard pharmacy and standard mail-order services for these generic tiers require copays ranging from $2 to $6 for Tier 1, and $12 to $36 for Tier 2. For brand-name and specialty medications, costs transition from flat copays to coinsurance. Tier 3 preferred brand drugs carry 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 require a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust healthcare coverage with no copay or coinsurance for primary care doctor visits, annual physicals, and home health services. For specialized medical care, members pay a $40 copay for specialist visits, while inpatient hospital stays require a $350 daily copay for the first eight days followed by no copay. Outpatient hospital services feature copays ranging from no copay to $350, and emergency room visits carry a $130 copay that is waived upon admission. This plan also includes generous supplemental benefits, providing routine dental cleanings and routine hearing evaluations with no copay or coinsurance. Vision eyewear is covered up to $250 annually with no copay, while routine eye exams and Medicare-covered hearing exams require copays up to $40. Additionally, diagnostic lab services and home infusion therapies are available with no copay, while durable medical equipment and dialysis services require coinsurance up to 20%.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $350 daily copay for days 1 to 8 (with no copay for days 9 and beyond), and inpatient psychiatric stays with a $225 daily copay for days 1 to 7 (with no copay for days 8 to 90). Prior authorization is required for these services, and upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
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, a $0 to $350 copay for outpatient hospital and observation services, and a $40 copay for substance abuse sessions. Prior authorization is required for outpatient hospital, surgical, and substance abuse services.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copay of either $75.00 or $145.00 and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. For transportation benefits, some services are covered, but transportation to plan-approved locations or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) 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, while worldwide emergency care, urgent care, and transportation are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $250.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care physician visits with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Physical, occupational, and speech therapy services require a $45 copay and no coinsurance, while routine chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), offering an annual physical exam, health education, fitness benefits, and various screenings with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. However, several supplemental options are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management programs, and counseling services.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (HMO-POS), featuring a $40 copay and no coinsurance for Medicare-covered exams, alongside annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though inner, outer, and over-the-ear prescription aids and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductible and no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for eyewear. Routine eye exams are covered once per year, and eyewear, including lenses, frames, and contacts, is covered up to a combined maximum of $250 annually.
Dental Services See details
Aetna Medicare Signature (HMO-POS) features partially covered dental services, including preventive care (exams, cleanings, and x-rays) with no copay and no coinsurance, and Medicare-covered dental with a $40 copay and no coinsurance. Comprehensive services are covered with no copay and a 20% to 50% coinsurance, though fluoride treatments, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this plan, Medicare Part B chemotherapy and other drugs have no copay and a coinsurance of 0% to 20%, while Part B insulin drugs are covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment, including 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
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic tests with a $0 to $105 copay, while radiological services require a $20 copay for X-rays, a minimum 20% coinsurance for therapeutic radiology, and diagnostic radiology starting at no copay.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under the Aetna Medicare Signature (HMO-POS) plan feature no coinsurance, and while some services are covered, key sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered. These individual rehabilitation services carry copays ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) 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, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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