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 Parishes in LA. 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service, while standard pharmacies charge a copay starting at $2 for a one-month supply. Similarly, Tier 2 generic medications carry no copay at preferred locations and preferred mail order, with standard pharmacy copays starting at $12. Higher-tier medications under this plan require coinsurance instead of flat copayments. Tier 3 preferred brand drugs have a 24% coinsurance across all pharmacy and mail order channels, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These cost-sharing percentages remain the same whether you use preferred or standard pharmacies, or mail-order delivery.
Additional Benefits
The Aetna Medicare Signature Care (HMO) plan offers comprehensive medical coverage featuring no copay for primary care physician visits, home health services, and routine preventive care. For specialized medical needs, members pay a copay of $10 to $55 for specialist visits, while inpatient hospital stays require a daily copay for the first several days with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, such as routine dental, vision, and hearing exams with no copay. Vision coverage provides up to $175 annually for eyewear, and prescription hearing aids are covered up to $500 per ear with no copay or coinsurance. Comprehensive dental services are also covered with no copay and coinsurance ranging from 20% to 50%, up to a $2,500 annual maximum.
Inpatient Hospital See details
Aetna Medicare Signature Care (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $437 copay for days 1 to 7 of acute stays and a $458 copay for days 1 to 5 of psychiatric stays, with no copay for subsequent days. Unlimited additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Care (HMO) covers outpatient services with no coinsurance, featuring a $0 to $450 copay for outpatient hospital services and a $437 copay per stay for observation services. Ambulatory surgical center and outpatient blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $30 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Care (HMO) with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Aetna Medicare Signature Care (HMO) because transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $300 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for all ambulance services.
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 services have a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $300 depending on the service.
Primary Care See details
Aetna Medicare Signature Care (HMO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 to $55 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies are covered with a $30 copay and no coinsurance, while telehealth services carry a $0 to $55 copay and 20% coinsurance, and podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Signature Care (HMO), offering an annual physical, health education, and screenings with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. While fitness benefits and chemotherapy wigs are covered at no cost, several sub-services including in-home safety assessments, weight management, and nutritional benefits are not covered.
Hearing Services See details
Hearing services covered by Aetna Medicare Signature Care (HMO) include Medicare-covered exams for a $55 copay and no coinsurance, as well as annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance, featuring a $0 to $55 copay for eye exams and no copay for eyewear. This benefit includes one routine eye exam per year and up to $175 annually for contacts, lenses, and frames with no deductible.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (HMO), excluding fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services. Medicare-covered dental has a $55 copay and no coinsurance, while covered preventive care has no copay or coinsurance and comprehensive services have no copay and 20% to 50% coinsurance up to a $2,500 annual maximum.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Care (HMO) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
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 for these services.
Medical Equipment See details
Aetna Medicare Signature Care (HMO) covers durable medical equipment and prosthetics with no copay and 20% coinsurance, requiring prior authorization. Diabetic supplies are offered with no copay and 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay and coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Care (HMO) covers diagnostic and radiological services with prior authorization, offering lab services, outpatient X-rays, and diagnostic radiological services with no copay. Outpatient diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $95, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature Care (HMO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance. Covered services require copayments, including $25 for cardiac and intensive cardiac rehabilitation, $15 for pulmonary rehabilitation, and $20 for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond standard Medicare coverage are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Care (HMO), offering no copay and no coinsurance for chronic illness meal benefits, annual wellness exams, additional screenings, and over-the-counter items up to $15 every three months. Acupuncture is not covered under this plan.
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