A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (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 (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties Across MS. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (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 (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 (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 (HMO) drug plan features an annual drug deductible of $615, with excellent savings available on lower-tier medications. You will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when filling prescriptions at a preferred pharmacy or through preferred mail order. If you choose a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, the plan utilizes percentage-based coinsurance rather than flat copays. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy options. This structure makes the plan highly cost-effective for members utilizing generic prescriptions while offering clear, predictable cost-sharing for specialty care.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust healthcare coverage with no copay and no coinsurance for primary care visits, routine annual physicals, and home health services. Specialist visits, urgent care, and emergency room services are covered with flat copayments, while inpatient hospital stays require a daily copay for the first several days with no copay thereafter. Additionally, outpatient diagnostic tests, lab services, and x-rays are available with no copay and no coinsurance. Beneficiaries also enjoy valuable routine care, including dental, vision, and hearing exams with no copay, alongside allowances for prescription hearing aids and eyewear. While medical equipment, dialysis, and Part B chemotherapy drugs require a twenty percent coinsurance, preventive dental care and home infusion services are covered with no copay. This plan offers a balanced cost structure designed to minimize out-of-pocket expenses for preventive wellness and routine healthcare needs.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, there is a $388 daily copay for days 1 through 7 and no copay thereafter, while psychiatric stays require a $407 daily copay for days 1 through 5 and no copay for days 6 through 90; upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, featuring outpatient hospital copays of $0 to $475 and observation services at a $388 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copayment of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (HMO), with ground ambulance services requiring a $250 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, while plan-approved and health-related transportation services are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with copays ranging from $115 to $250 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits, mental health, and physical therapies feature copays ranging from $0 to $50 with no coinsurance. Podiatry and routine chiropractic services are not covered, and telehealth benefits carry a 20% coinsurance alongside a $0 to $50 copay.
Preventive Services See details
Aetna Medicare Signature (HMO) offers partially covered preventive services with no copay and no coinsurance for annual physicals, fitness benefits, and screenings, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, telemonitoring, and counseling.
Hearing Services See details
Hearing services covered by Aetna Medicare Signature (HMO) include annual routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. For prescription hearing aids, there is no copay and no coinsurance up to a $500 annual limit per ear, though some services are covered but inner ear, outer ear, and over the ear models, as well as OTC hearing aids, are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no deductibles and no coinsurance, offering routine annual eye exams with no copay and Medicare-covered exams with a copay of up to $50. Eyewear, including lenses, frames, and contacts, also features no copay and is covered up to a combined maximum of $100 per year.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Signature (HMO) plan, featuring no copay and no coinsurance for preventive care like cleanings and exams, and a $50 copay with no coinsurance for Medicare-covered dental. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $2,000 yearly limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment covered by Aetna Medicare Signature (HMO) includes durable medical equipment, prosthetics, and medical supplies, all of which require no copay and 20% coinsurance. Diabetic supplies are covered with no copay and up to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic services with no coinsurance, offering no copay for lab services and a $0 to $95 copay for diagnostic procedures. Covered radiological services feature no copay for outpatient X-rays and diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, although prior authorization is required for these services.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare Signature (HMO) with no coinsurance and no copay for covered services, although only some services are covered as standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day inpatient hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, but additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO) provides partial coverage for other services with no copays and no coinsurance, offering benefits such as a $15 quarterly over-the-counter item reimbursement, chronic illness meals, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings. Acupuncture is not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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