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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 North 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)
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Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose standard pharmacies or standard mail-order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications under this plan, cost-sharing transitions to 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 carry a 25% coinsurance across all pharmacy and mail-order options. These percentage-based costs apply to all available supply durations, helping you estimate your out-of-pocket prescription expenses.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for everyday health needs, featuring no copay and no coinsurance for primary care visits, annual physicals, routine vision exams, and preventive dental care. For specialized care, members pay no coinsurance and low copays, including $0 to $50 for specialist visits and $35 for standard therapy sessions. Additionally, diagnostic labs, X-rays, and home health services are available with no copay and no coinsurance. For more intensive medical needs, inpatient hospital stays require daily copays for the first six days with no coinsurance, while skilled nursing facility stays feature daily copays and no coinsurance. Emergency room visits have a $130 copay, and outpatient hospital services range from no copay up to a $300 copay. Other essential benefits, such as dialysis and certain durable medical equipment, are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $445 daily copay for days 1 through 6 of acute stays and a $325 daily copay for days 1 through 6 of psychiatric stays, with no copay for subsequent days. This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services, a $445 copay per stay for observation services, and a $35 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) 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
Ambulance and transportation services are partially covered by the Aetna Medicare Signature (PPO) plan, which requires a $330 copay for ground ambulance services and a 20% coinsurance for air ambulance services. Prior authorization is required for ambulance services, but transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) 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 require a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 lifetime maximum with no coinsurance and copays ranging from $130 to $330.
Primary Care See details
Aetna Medicare Signature (PPO) provides primary care doctor visits with no copay and no coinsurance, and specialist visits for a $0 to $50 copay and no coinsurance. Most other services, such as physical therapy, occupational therapy, and mental health care, require a $35 copay and no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (PPO), with most covered options like annual physicals, fitness benefits, and glaucoma screenings requiring no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered 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 and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services under the Aetna Medicare Signature (PPO) include annual routine exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. Some prescription hearing aid services are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copay and no coinsurance for both eye exams and eyewear. The plan includes one routine eye exam per year up to a $50 maximum benefit and a $150 annual combined allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) provides partially covered dental services, featuring preventive care like exams and cleanings with no copay and no coinsurance, and comprehensive services with no copay and 20% to 50% coinsurance up to a $1,000 annual limit. Medicare-covered dental services require a $50 copay and no coinsurance, whereas fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, although 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, and diabetic therapeutic shoes. Depending on the specific item, coinsurance ranges from no coinsurance to 20% for medical supplies, diabetic supplies, and durable medical equipment, while prosthetic devices require a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with prior authorization required. Lab services, outpatient X-rays, and diagnostic radiological services have no copay, while diagnostic procedures have a $0 to $50 copay 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) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no coinsurance under Aetna Medicare Signature (PPO), but while some services are covered, cardiac, intensive cardiac, pulmonary, and SET for 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 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required for admission, additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (PPO), offering over-the-counter items (up to $15 every three months), annual wellness exams, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, meal benefits, and dual-eligible SNP services are not covered.
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