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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 Southeast 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:
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Drug Coverage
The Aetna Medicare Signature (PPO) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, there is no copay when using a preferred pharmacy or preferred mail order service for up to a three-month supply. Standard pharmacies and standard mail order services require copays starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy options and supply durations. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with Tier 5 medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive medical coverage with no copay and no coinsurance for primary care visits, home health services, and preventive care like annual physicals. For hospital services, inpatient stays require a daily copay for the first six days before transitioning to no copay, while outpatient hospital services carry copays ranging from no copay up to $400. Emergency and urgent care are also covered worldwide with set copayments and no coinsurance or deductibles. Routine vision, dental, and hearing services are covered with no copays or coinsurance, though annual allowances apply to hardware like hearing aids and eyewear. While diagnostic lab tests and routine screenings require no copay, specialty services like specialist visits, dialysis, and medical equipment may incur copays or coinsurance up to 20 percent. Skilled nursing facility care and physical therapies are also covered, though certain services require prior authorization.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, though prior authorization is required. For acute care, you pay a $450 daily copay for days 1 to 6 and no copay for days 7 and beyond, while psychiatric stays require a $300 daily copay for days 1 to 6 and no copay for days 7 to 90, with upgrades, non-Medicare-covered stays, and additional psychiatric days not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copays. Outpatient hospital services require a copay of $0 to $400, observation services carry a $450 copay per stay, and outpatient substance abuse sessions have a $40 copay, with prior authorization required for most services.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the specific service, you will pay a copay of either $70.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $350 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. While transportation services are technically covered, trips to plan-approved or health-related locations are not covered in practice.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance and no deductible. Worldwide emergency and urgent care are covered with a $130 copay, and worldwide emergency transportation has a $350 copay, all with no coinsurance up to a $250,000 maximum benefit.
Primary Care See details
Primary care benefits through Aetna Medicare Signature (PPO) feature no copay and no coinsurance for primary care provider visits, while specialist, therapy, and mental health services have copays ranging from $0 to $60 with no coinsurance. Telehealth services are covered with a $0 to $60 copay and 20% coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) offers partially covered preventive services with no copay and no coinsurance for annual physicals, health education, 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, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), offering annual routine exams and fitting evaluations with no copay or coinsurance, and Medicare-covered exams for a $60 copay and no coinsurance. Prescription hearing aids are also covered with no copay or coinsurance up to a $500 annual limit per ear, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) provides vision services with no copay and no coinsurance for both eye exams and eyewear. This benefit includes up to a $50 annual maximum for eye exams, which covers one routine exam per year, and a $125 annual combined allowance for contact lenses, eyeglasses, lenses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering Medicare-covered dental services for a $60 copay and no coinsurance, and select preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. However, fluoride, restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy may be required. Under this benefit, Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while Part B chemotherapy and other drugs incur a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Coinsurance for these services ranges from no coinsurance up to 20%, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (PPO) with prior authorization required. Lab services and outpatient X-rays have no copay, diagnostic procedures and tests carry no coinsurance with a $0 to $50 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are partially covered under the Aetna Medicare Signature (PPO) plan with no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered. While covered services have no coinsurance, copayments may apply depending on the specific therapy received.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required for admission, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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