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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 Central 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 $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 drugs, you will pay no copay when using a preferred pharmacy or preferred mail-order service for any supply length. If you choose a standard pharmacy or standard mail-order service, Tier 1 drugs have a copay starting at $2 and Tier 2 drugs start at $12 for a one-month supply. For higher-tier medications, the plan transitions to coinsurance costs across all pharmacy and mail-order options. You will pay 24% coinsurance for Tier 3 preferred brand drugs, and 25% coinsurance for both Tier 4 non-preferred drugs and Tier 5 specialty drugs. Specialty drugs are limited to a one-month supply, while Tier 3 and Tier 4 drugs maintain the same coinsurance rates for up to a three-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring low out-of-pocket costs, including a $5 copay for primary care visits and specialist visits ranging from no copay to a $70 copay. Inpatient hospital stays require no coinsurance, with daily copays for the first six days and no copay thereafter, while emergency room visits carry a $130 copay that is waived upon admission. Outpatient services and diagnostic lab tests are also highly affordable, often requiring no copay or coinsurance. For routine wellness, the plan provides preventive care, annual physicals, and home health services with no copay or coinsurance. Routine dental cleanings, annual hearing exams, and routine eye exams are covered with no copay, and the plan features a $150 annual eyewear allowance and up to $500 per ear annually for prescription hearing aids. Durable medical equipment is available with no copay, though some medical supplies and devices may require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization for both acute and psychiatric stays. Acute stays have a $450 daily copay for days 1-6 and no copay for days 7 and beyond, while psychiatric stays require a $300 daily copay for days 1-6 and no copay for days 7-90. Upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services covered by the Aetna Medicare Signature (PPO) feature no coinsurance, with copays ranging from no copay for ambulatory surgical center and blood services up to $400 for outpatient hospital services and $450 per stay for observation services. Outpatient substance abuse sessions carry a $50 copay, and prior authorization is required for most of these outpatient benefits.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $350 copay and air ambulance services with a 20% coinsurance, with prior authorization required for all ambulance services. While some transportation services are covered, transportation to plan-approved locations and any other health-related locations is not covered.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (PPO) are covered 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 maximum with no coinsurance and copays ranging from $130 to $350.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits with a $5 copay and specialist services with no copay to a $70 copay, both with no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies require a $50 copay and no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) offers partially covered preventive services, featuring no copay and no coinsurance for annual physical exams, health education, and glaucoma screenings, while kidney disease education requires a 20% coinsurance and 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
Aetna Medicare Signature (PPO) partially covers hearing services, offering annual routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $70 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay and no coinsurance, but OTC hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Signature (PPO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. The plan provides up to a $50 annual maximum for routine eye exams (limited to one per year) and a $150 annual combined allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), which offers Medicare-covered dental services for a $70 copay and no coinsurance, and routine exams, cleanings, and x-rays for no copay and no coinsurance. However, fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, orthodontics, and oral surgery are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Aetna Medicare Signature (PPO) plan with no copay, although prior authorization is required. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copay for durable medical equipment (DME), prosthetics, and diabetic shoes. Coinsurance ranges from no coinsurance to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices require a 20% coinsurance and prior authorization is required for most items.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with prior authorization required. Diagnostic tests require a $0 to $50 copay with no coinsurance, lab services have no copay or coinsurance, and radiological services require a $5 copay for X-rays and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers Cardiac Rehabilitation Services with no copay and no coinsurance, meaning some services are covered, while 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 prior three-day hospital stay is not required, and additional days beyond the standard Medicare benefit 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.
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