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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 IN Southern, IN Southwest. 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 $5200.00 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 has an annual drug deductible of $615. You can save on costs with no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12. For higher-tier medications, you will pay a percentage of the drug cost rather than a flat copay. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance across all pharmacy and mail-order channels.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers affordable access to core medical services, featuring a low $5 copay for primary care visits and copays ranging from no copay to $45 for specialists. Inpatient hospital stays require a $325 daily copay for the first seven days, followed by no copay for the remaining covered days. Emergency room visits carry a $130 copay, which is waived if you are admitted, while urgent care visits require a $35 copay. For routine wellness, the plan provides dental cleanings, eye exams, and prescription hearing aids with no copays or coinsurance, alongside a $100 annual eyewear allowance and a $1,250 comprehensive dental benefit limit. Skilled nursing facility care is also highly accessible, offering no copay for the first 20 days of your stay. Additionally, members can access home health services with no copay and receive a $15 quarterly allowance for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring prior authorization and a $325 daily copay for days 1 through 7, followed by no copay for days 8 through 90. Unlimited additional acute days are covered at no copay, while additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a $0 to $325 copay, observation services have a $325 copay per stay, and outpatient substance abuse sessions carry a $40 copay, all with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copayment of either $60.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization, requiring a $260 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport. Transportation services to plan-approved or other 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—waived if admitted to the hospital within 24 hours—and urgently needed services with a $35 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance up to a $250,000 maximum limit, carrying copays of $130 for emergency or urgent care and $260 for emergency transportation.
Primary Care See details
Primary Care benefits under Aetna Medicare Signature (HMO-POS) feature a $5 copay and no coinsurance for primary care visits, and range from no copay to a $45 copay with no coinsurance for specialists. Physical, occupational, mental health, psychiatric, and speech therapies require a $40 copay with no coinsurance, while telehealth services carry a 20% coinsurance and copays up to $45. Podiatry and routine chiropractic care are not covered under these benefits.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO-POS), with no copay and no coinsurance for annual physicals, health education, and glaucoma screenings, though kidney disease education requires a 20% coinsurance with no copay. Several supplemental benefits are not covered under this plan, including medical nutrition therapy, weight management programs, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), with Medicare-covered exams requiring a $45 copay and no coinsurance, while routine exams, fittings, and prescription hearing aids have no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually, but OTC hearing aids, inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, including annual routine eye exams and follow-up diabetic exams with no copay, and Medicare-covered exams with a $0 to $45 copay. Covered eyewear, such as contacts, lenses, and frames, also features no copay and no coinsurance up to a combined maximum benefit of $100 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), offering cleanings, exams, and x-rays with no copay and no coinsurance, and Medicare-covered dental for a $45 copay and no coinsurance. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $1,250 annual maximum, while fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental 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 may apply. Under this benefit, Medicare Part B insulin requires a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment with no copay and coinsurance ranging from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices require a 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts are covered with no copay, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance for diagnostic services and no copay for lab services. Diagnostic procedures and tests carry a copay of $0 to $100, outpatient X-rays require a $10 copay, and therapeutic radiological services have a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO-POS) plan. While there is no coinsurance, all specific sub-services are not covered, including standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($25 copay).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO-POS), featuring no copay and no coinsurance for over-the-counter (OTC) items up to $15 every three months via reimbursement, annual wellness exams, screening mammography, and additional gFOBT and FIT. Acupuncture and meal benefits are not covered under this plan.
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