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Allina Health Aetna Medicare Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Allina Health Aetna Medicare Signature (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Allina Health Aetna Medicare Signature (PPO) in 2025, please refer to our full plan details page.
Allina Health Aetna Medicare Signature (PPO) is a PPO plan offered by Allina Health and Aetna Insurance Holding Company available for enrollment in 2025 to people living in Brown and Nicollet Counties. This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that Allina Health Aetna Medicare Signature (PPO) 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 Allina Health Aetna Medicare Signature (PPO).
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 Allina Health Aetna Medicare Signature (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $106.00. 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 $250.00 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 combined Maximum Out-Of-Pocket cost of $5150.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $5150.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 Allina Health Aetna Medicare Signature (PPO) plan has a $250 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, for preferred generic drugs, you'll pay a $10 copay at a preferred pharmacy or $12 at a standard pharmacy. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for Part D covered drugs.
Additional Benefits
The Allina Health Aetna Medicare Signature (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a $325 copay per admission, while outpatient services can have copays ranging from $0 to $250. Emergency services have a $140 copay, and primary care visits have no copay. The plan also covers hearing, vision, and dental services. Hearing exams have a $30 copay, and vision services have no copay for eyewear. Dental services have a $30 copay for Medicare-covered services, with a maximum benefit of $1250 per year.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, with a $325 copay per admission or stay for Medicare-covered stays. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, along with Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient Services include coverage for outpatient hospital services with a copay of $0-$250, observation services with a $250 copay, ambulatory surgical center (ASC) services with no copay, outpatient substance abuse services with a $30 copay for both individual and group sessions, and outpatient blood services with no copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Allina Health Aetna Medicare Signature (PPO) plan, with a $95 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Allina Health Aetna Medicare Signature (PPO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $350 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Allina Health Aetna Medicare Signature (PPO) plan. Emergency Services has a $140 copay, Urgently Needed Services has a $35 copay, Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $140 copay, and Worldwide Emergency Transportation has a $350 copay.
Primary Care See details
Primary Care Physician Services are covered with no copay. Chiropractic Services are covered with a $20 copay for routine care. Occupational Therapy Services have a $35 copay. Physician Specialist Services have a $30 copay. Mental Health Specialty Services, including individual and group sessions, have a $30 copay. Podiatry Services, including routine foot care, have a $30 copay. Other Health Care Professional services have a copay between $0 and $30. Psychiatric Services, including individual and group sessions, have a $30 copay. Physical Therapy and Speech-Language Pathology Services have a $35 copay. Additional Telehealth Benefits are covered with a 20% coinsurance and a copay between $0 and $35. Opioid Treatment Program Services have a $30 copay.
Preventive Services See details
Preventive Services, including annual physical exams, are covered with no copay. Other services such as wigs for hair loss related to chemotherapy, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit are covered with no copay. Kidney disease education services have a 20% coinsurance. In-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers of enrollees, and enhanced disease management are not covered.
Hearing Services See details
Hearing Services include hearing exams, routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Hearing exams have a $30 copay. Routine hearing exams and fitting/evaluation for hearing aids have no copay, with a limit of 1 visit per year. Prescription hearing aids are covered up to $1,000 per ear, per year, and have no copay for all types with a limit of 2 visits per year, though inner ear, outer ear, and over the ear prescription hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
The Allina Health Aetna Medicare Signature (PPO) plan covers vision services, including eye exams with a copay of $0-$30, and eyewear with no copay. Eyewear has a combined maximum benefit of $200 per year, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades.
Dental Services See details
Dental Services are covered, including Medicare Dental Services with a $30 copay, and other services like oral exams, dental x-rays, and more with no copay. This plan has a maximum benefit coverage of $1250 per year for both in-network and out-of-network services. Some services, such as Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and prior authorization is required. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Allina Health Aetna Medicare Signature (PPO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment, including Durable Medical Equipment, Prosthetics/Medical Supplies, and Diabetic Equipment, is covered. Durable Medical Equipment has a coinsurance between 0% and 20%, and Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies have a coinsurance between 0% and 20%. Diabetic Supplies have a coinsurance between 0% and 20%, and Diabetic Therapeutic Shoes/Inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Allina Health Aetna Medicare Signature (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $25, Lab Services have no copay, Diagnostic Radiological Services have a copay up to $100, Therapeutic Radiological Services have 20% coinsurance, and Outpatient X-Ray Services have a $15 copay.
Home Health Services See details
Home Health Services are covered by the Allina Health Aetna Medicare Signature (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Allina Health Aetna Medicare Signature (PPO) plan, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. The plan mentions copays for certain Cardiac and Pulmonary Rehabilitation Services, but the specifics of the copays are not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, the copay is $10, for days 21-38 the copay is $214, and for days 39-100, there is no copay.
Other Services See details
Other Services include acupuncture with a $20 copay, and over-the-counter items with no copay, up to $60 every three months. Meal benefits and other services such as annual wellness exams and screening mammography, and gFOBT/FIT tests are covered with no copay. Several services are not covered, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and more.
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