A non-government entity
Aetna Medicare Signature Care (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select HVP Counties in AL. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (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 $6750.00 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 Care (HMO) plan features an enhanced alternative drug benefit with an annual prescription drug deductible of $615. After meeting this deductible, Tier 1 preferred generic drugs feature no copay at preferred pharmacies and mail-order services, or a $12 copay at standard locations. For other tiers, you will pay a 24% coinsurance for Tier 2 standard generics and a 25% coinsurance for Tier 3 preferred brand and Tier 4 non-preferred drugs. These cost-sharing rates apply during the initial coverage phase until your total drug costs reach $2,100. Once your yearly out-of-pocket drug costs exceed $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs.
Additional Benefits
The Aetna Medicare Signature Care (HMO) plan offers comprehensive medical coverage featuring no copay for primary care visits, routine preventive care, and home health services. Specialist doctor visits require a low copay between $10 and $35, while emergency room care is available for a $130 copay, which is waived upon hospital admission. For hospital stays, members pay a daily copay for the first several days of inpatient care and no copay for the remaining days, with no coinsurance required. In addition to core medical care, this plan provides valuable dental, vision, and hearing benefits, including routine exams at no copay and allowances for glasses and hearing aids. Comprehensive dental services are covered up to a $2,500 annual limit with no copay and 20% to 50% coinsurance, alongside a $30 quarterly over-the-counter item allowance. Durable medical equipment and diagnostic services are also covered, generally requiring either no copay or a standard 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Care (HMO) partially covers inpatient hospital services with no coinsurance, though upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered. Acute stays require a $388 daily copay for days 1 to 7 and no copay for days 8 to 90, while psychiatric stays require a $407 daily copay for days 1 to 5 and no copay for days 6 to 90.
Outpatient Services See details
Aetna Medicare Signature Care (HMO) covers outpatient services with no coinsurance and copays ranging from no copay for ambulatory surgical center and blood services up to $388 for outpatient hospital and observation services. Outpatient substance abuse services require a copay of $30 for group sessions or $40 for individual sessions, with prior authorization required for several of these covered benefits.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature Care (HMO) and require prior authorization. Members will pay a copay of $105.00 or $145.00, with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under Aetna Medicare Signature Care (HMO) because health-related transportation services are not covered. Ground ambulance services require a $250 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature Care (HMO) 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 care is available for a $40 copay and no coinsurance, and worldwide emergency services are covered up to $250,000 with copays ranging from $130 to $250 and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature Care (HMO), as podiatry services and routine chiropractic care are not covered. Covered services feature no copay or coinsurance for primary care visits, copays ranging from $10 to $35 with no coinsurance for specialists, and a 20% coinsurance with a $0 to $40 copay for telehealth.
Preventive Services See details
Aetna Medicare Signature Care (HMO) partially covers preventive services, offering most covered benefits—such as annual physicals and fitness programs—with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. However, several services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Care (HMO), offering routine hearing exams and fittings with no copay or coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription types are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Care (HMO) with no deductible and no coinsurance. Routine eye exams and eyewear, including contacts and glasses, feature no copay with a $275 annual maximum benefit, while other eye exams have a copay ranging from $0 to $35.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (HMO), featuring preventive care with no copay or coinsurance and comprehensive services up to a $2,500 annual maximum with no copay and 20% to 50% coinsurance. Medicare-covered dental services require a $35 copay and no coinsurance, while fluoride treatment, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under Aetna Medicare Signature Care (HMO) with prior authorization. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs feature no copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Care (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Aetna Medicare Signature Care (HMO) covers durable medical equipment, prosthetic devices, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies are covered with no copay and no coinsurance to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Care (HMO), with prior authorization required. Lab services and outpatient X-rays have no copay, diagnostic procedures range from no copay to a $95 copay, diagnostic radiology ranges from no copay to a $300 copay, and therapeutic radiology requires a 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature Care (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Care (HMO) offers cardiac rehabilitation benefits, though in practice, some services are covered while Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. Because these specific sub-services are not covered, there are no associated copays or coinsurance.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Care (HMO) covers Skilled Nursing Facility (SNF) services with no copay for days 1 to 20, a $218 daily copay for days 21 to 100, and no coinsurance. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Care (HMO), with acupuncture and dual eligible SNPs with highly integrated services not being covered. Covered benefits—including chronic illness meals, wellness exams, extra cancer screenings, and a $30 quarterly over-the-counter item reimbursement—are available with no copay and no coinsurance.
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