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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 Panhandle 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 $9550.00 (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 $9550.00 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) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, Tier 1 drugs have copays ranging from $2 to $6, while Tier 2 drugs carry copays ranging from $12 to $36 depending on the supply length. Higher-tier medications on this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options. For Tier 4 non-preferred drugs and Tier 5 specialty drugs, you will pay a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring no copay or coinsurance for primary care physician visits, preventive care, and home health services. Specialist visits require a low copay ranging from no copay up to $55, while inpatient hospital stays require a $415 daily copay for the first six days of acute care. Emergency room visits carry a $130 copay, which is waived upon hospital admission, and urgent care services require a $50 copay. For supplemental benefits, the plan provides routine vision exams, eyewear, routine dental cleanings, and hearing evaluations with no copay or coinsurance. Prescription hearing aids are covered up to a $500 annual limit per ear, while durable medical equipment features no copay and up to 20% coinsurance. Skilled nursing facility stays are covered with no coinsurance, requiring a $10 daily copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $415 daily copay for days 1 through 6 of acute stays and a $375 daily copay for days 1 through 6 of psychiatric stays, with no copay for subsequent days. 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 $350 copay for outpatient hospital services and a $415 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copays or coinsurance, while outpatient substance abuse services require a $45 copay per session and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, requiring a copay of either $85.00 or $145.00. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (PPO), requiring prior authorization and featuring a $290 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Additional transportation services to plan-approved or 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 have a $50 copay and no coinsurance, while worldwide emergency services are covered up to $250,000 with no coinsurance and copays ranging from $130 for urgent and emergency care to $290 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 require a $0 to $55 copay with no coinsurance. Most other covered services, such as physical therapy, occupational therapy, and mental health sessions, carry a $45 copay and no coinsurance, whereas chiropractic services are only partially covered and podiatry is not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (PPO), with covered benefits like annual physicals, health education, and screenings requiring no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Uncovered services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, featuring Medicare-covered exams for a $55 copay and no coinsurance, alongside routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual limit per ear, 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 (PPO) with no copays, no coinsurance, and no deductibles for exams and eyewear. The plan provides one routine eye exam per year up to a $50 maximum, alongside a $125 annual allowance for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring a $55 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for routine exams, cleanings, and x-rays. However, fluoride treatments, restorative services, 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, while chemotherapy and other Medicare Part B drugs require a 0% to 20% coinsurance. Covered Medicare Part B insulin is available with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with no copay for all covered items. Coinsurance for these benefits ranges from no coinsurance up to 20%, depending on the specific item, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with prior authorization required for all services. There is no copay for lab services, diagnostic radiology, and outpatient X-rays, while diagnostic procedures and tests have a $0 to $50 copay with no coinsurance, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance; however, while some services are covered, specific sub-services including Cardiac Rehabilitation ($20 copay), Intensive Cardiac Rehabilitation ($20 copay), Pulmonary Rehabilitation ($15 copay), and Supervised Exercise Therapy for PAD ($25 copay) 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 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, providing 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 under this plan.
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