A non-government entity
Aetna Medicare Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for 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 Aetna Medicare Signature (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in South Non Metro Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that 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 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 Aetna Medicare Signature (PPO), 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 combined Maximum Out-Of-Pocket cost of $10100.00 (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 $10100.00 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:
Sign up for Aetna Medicare Signature (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when filling prescriptions through preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order services carry low copays, ranging from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply duration. For brand-name and specialty medications, costs are based on coinsurance rather than set copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance. These coinsurance rates apply uniformly across all preferred and standard pharmacy and mail-order options, with Tier 5 specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage with predictable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, routine physicals, and home health services. For specialized medical care, members can expect copays ranging from $0 to $35 for specialist visits, while acute inpatient hospital stays require a $445 copay for the first six days and no copay thereafter. Outpatient hospital services and diagnostic lab tests are also highly affordable, featuring low copays and no coinsurance. This plan also includes essential supplemental benefits, providing routine dental, vision, and hearing exams with no copay and no coinsurance. Members receive a $125 annual allowance for eyewear, up to $500 per ear annually for prescription hearing aids, and an over-the-counter item allowance of $15 every three months. Additionally, there is no copay for home infusion services, though durable medical equipment and select Part B drugs may require coinsurance up to 20%.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature (PPO) with no coinsurance, although upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. For acute inpatient stays, there is a $445 copay for days 1 to 6 and no copay for days 7 and beyond. Psychiatric inpatient stays require a $325 copay for days 1 to 6 and no copay for days 7 to 90.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $275 copay for outpatient hospital services and no copay for ambulatory surgical center services. Observation services require a $445 copay per stay, outpatient substance abuse sessions carry a $30 copay, and outpatient blood services have no copay or deductible.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $350 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance (waived if admitted within 24 hours), and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent services are covered up to a $250,000 maximum benefit with no coinsurance, requiring a $130 copay for emergency or urgent care and a $350 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits range from a $0 to $35 copay with no coinsurance. Therapy, mental health, and psychiatric services require a $30 copay with no coinsurance, telehealth carries a $0 to $50 copay and 20% coinsurance, while podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive Services under Aetna Medicare Signature (PPO) are partially covered, offering an annual physical exam, health education, memory fitness, remote access technologies, and routine screenings with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, and wigs for chemotherapy hair loss are covered up to $400 annually with no copay and no coinsurance. Excluded services that are not covered include in-home safety assessments, medical nutrition therapy, weight management programs, and personal emergency response systems.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, offering Medicare-covered exams for a $30 copay and no coinsurance, while annual routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 maximum benefit per ear annually, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. This benefit includes one routine eye exam per year up to a $50 limit, and a combined $125 annual maximum for contacts, lenses, and frames.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring no copay and no coinsurance for preventive care like cleanings and exams, and a $30 copay with no coinsurance for Medicare-covered dental. Other covered services like endodontics and periodontics have no copay and 20% to 50% coinsurance up to a $1,000 annual limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, while associated Medicare Part B chemotherapy, radiation, and other drugs require a 0% to 20% coinsurance. Medicare Part B insulin is covered under this benefit with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment covered under Aetna Medicare Signature (PPO) features no copays, with prior authorization required for most services. Durable medical equipment has no copay and no coinsurance to 17% coinsurance, while prosthetics, medical supplies, and diabetic equipment require no copay and carry coinsurance ranging from no coinsurance up to 20%.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization, offering lab services and outpatient X-rays with no copays. Diagnostic procedures and tests have a $0 to $50 copay with no coinsurance, while diagnostic radiological services have copays starting at $0 and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided with no coinsurance under the Aetna Medicare Signature (PPO) plan. While some services are covered, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily 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 the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services with no copay and no coinsurance for annual wellness exams, screening mammographies, additional gFOBT and FIT screenings, and over-the-counter (OTC) items up to $15 every three months. Acupuncture and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved