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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 Tulsa 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 $300.00 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 a $300 annual drug deductible and offers competitive copays on generic medications. For Tier 1 preferred generics, you pay no copay when using a preferred pharmacy or preferred mail-order service, while standard pharmacies charge a copay starting at $2. Tier 2 generic drugs are also affordable, with copays starting at $10 at preferred locations and $12 at standard pharmacies for a one-month supply. Higher-tier medications under this plan transition to coinsurance instead of flat copayments. Tier 3 preferred brand drugs require a 25% coinsurance, and Tier 4 non-preferred drugs carry a 26% coinsurance across all pharmacy options. For Tier 5 specialty drugs, members pay a 29% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for core medical needs, featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits range from no copay up to a $70 copay, while inpatient hospital stays require a daily copay for the first six days of a stay with no coinsurance. Emergency care is available with a $130 copay, which is waived if you are admitted within 24 hours, and urgent care carries a $50 copay. For routine care, the plan provides preventive dental, vision, and hearing benefits with no copays, alongside allowances for eyewear and prescription hearing aids. Diagnostic lab work and outpatient X-rays also have no copay, while physical therapy and outpatient substance abuse sessions require a $50 copay. Additionally, durable medical equipment, dialysis, and Medicare Part B drugs feature no copays but may require coinsurance up to 20 percent.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) inpatient hospital benefits are covered with no coinsurance, requiring a $430 copay for days 1 through 6 of acute stays and a $325 copay for days 1 through 6 of psychiatric stays, with no copay for days 7 through 90. The benefit is partially covered, as 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, including ambulatory surgical center and blood services with no copays. Outpatient hospital services have a copay of $0 to $400, observation services have a $430 copay per stay, and outpatient substance abuse sessions require a $50 copay, with prior authorization required for most services.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copayment of either $70 or $145 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $340 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay 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 limit with no coinsurance and copays of $130 for emergency or urgent care and $340 for emergency transportation.
Primary Care See details
Primary care benefits under the Aetna Medicare Signature (PPO) feature no copay and no coinsurance for primary care physician services, while specialist visits range from no copay to a $70 copay with no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, excluding routine and other chiropractic services, whereas podiatry is not covered. Physical, occupational, mental health, psychiatric, and opioid therapies require a $50 copay and no coinsurance, and telehealth services carry a range of no copay to a $70 copay with 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) preventive services are partially covered, featuring no copay and no coinsurance for annual physicals, diabetes training, and glaucoma screenings, though kidney disease education requires a 20% coinsurance with no copay. Covered supplemental benefits like health education, memory fitness, and chemotherapy wigs (up to $400) have no copay and no coinsurance, but services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, therapeutic massage, adult day care, and home safety devices are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams with a $70 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 annual limit per ear, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copay, no coinsurance, and no deductible for both exams and eyewear. This includes one routine eye exam per year up to a $50 maximum, and a combined $125 annual maximum allowance for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), offering preventive care 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 $70 copay and no coinsurance, whereas fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or 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, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Medicare Part B chemotherapy and other Part B drugs carry a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers durable medical equipment, prosthetics, and diabetic supplies with no copays, though prior authorization is required. Coinsurance ranges from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic procedures and tests have no coinsurance and a copay of up to $50, lab services and outpatient X-rays have no 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 offered by Aetna Medicare Signature (PPO) with no coinsurance, but only some services are covered. Specifically, cardiac rehabilitation (with a $20 copay), intensive cardiac (with a $20 copay), pulmonary (with a $15 copay), and SET for PAD services (with a $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 hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are partially covered under the Aetna Medicare Signature (PPO) plan, which offers no copay and no coinsurance for annual wellness exams, screening mammographies, additional gFOBT and FIT tests, and over-the-counter (OTC) items up to $30 every three months. Acupuncture and meal benefits are not covered.
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