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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 Dallas and Surrounding 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) plan features an annual drug deductible of $615. For prescription drugs, this plan offers no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when filled through preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail order, Tier 1 drugs require a copay starting at $2.00, while Tier 2 drugs start at a $12.00 copay for a one-month supply. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 (Preferred Brand) drugs require a 24% coinsurance across all pharmacy and mail-order options. Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) medications both carry a 25% coinsurance, with Tier 5 coverage limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, home health services, and routine vision and hearing exams. For specialized care, members can expect predictable copays, including $0 to $70 for specialist visits, $130 for emergency care, and daily copays for inpatient hospital and skilled nursing stays. Routine dental, vision, and hearing benefits are also included, featuring no copays for select preventive dental care and routine eye exams, alongside allowances for eyewear and hearing aids. Other medical needs, such as dialysis, durable medical equipment, and therapeutic radiological services, require a coinsurance of up to 20% with no copay. Diagnostic lab tests and outpatient X-rays are covered with no copay, helping to keep routine diagnostic testing affordable. This plan balances out-of-pocket expenses by offering no copays on essential preventive care while utilizing structured copays and coinsurance for more advanced treatments.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $450 copay for days 1 to 6 of acute stays and a $375 copay for days 1 to 6 of psychiatric stays, with no copay for days 7 to 90. 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 no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $450, observation services require a $450 copay per stay, and outpatient substance abuse sessions have a $50 copay, with prior authorization required for most services.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, although 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
Ambulance and transportation services are partially covered by Aetna Medicare Signature (PPO), with ground ambulance services requiring a $300 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered under the Aetna Medicare Signature (PPO) 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, urgent, and transportation services are covered up to a $250,000 limit with copays ranging from $130 to $300 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $70 copay and no coinsurance. While physical, occupational, mental health, and psychiatric therapies are covered with copays ranging from $50 to $70 and no coinsurance, chiropractic and podiatry services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) partially covers preventive services, offering key benefits like annual exams, glaucoma screenings, and fitness benefits with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance with no copay. Several supplemental services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (PPO) with no deductible, offering routine exams and fitting evaluations annually with no copay and no coinsurance, and Medicare-covered exams for a $70 copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $500 annual limit per ear, but inner ear, outer ear, over the ear, and over-the-counter (OTC) 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. The plan provides up to a $50 annual maximum for eye exams, which includes one routine exam per year, and a combined $100 annual allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), which offers Medicare-covered dental care for a $70 copay and no coinsurance, and select preventive services with no copay and no coinsurance. Covered preventive care includes up to four oral exams, one dental X-ray, and two cleanings per year, while fluoride, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay and require prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have a 0% to 20% coinsurance with no copay, while Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these covered benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with prior authorization required. Lab and outpatient X-ray services have no copay, diagnostic procedures have a $0 to $50 copay with no coinsurance, 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) 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 three-day prior hospital stay is not needed, and additional days beyond the 100-day Medicare 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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