A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Metro: Bronx & Brooklyn. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO) 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 (HMO).
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 (HMO), 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 Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail order, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. Brand-name and specialty medications under this plan are subject to coinsurance rather than flat 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 options. Note that Tier 5 specialty drugs are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust healthcare coverage designed to keep your out-of-pocket expenses low and predictable. You will benefit from no coinsurance on most primary services, including a low $5 copay for primary care visits and no copay for routine preventive services, annual physicals, and home health care. Specialist visits range from no copay to a $50 copay, while emergency room services require a $115 copay that is waived if you are admitted. This plan also features excellent everyday benefits, including no copays for routine dental cleanings, routine vision exams, and routine hearing exams, as well as a $100 annual allowance for eyewear. If you require hospital care, inpatient acute stays have a $399 daily copay for the first six days, while skilled nursing facility stays offer no copay for the first 20 days. These structured copays and lack of coinsurance on key benefits make managing your healthcare costs straightforward and affordable.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring a $399 daily copay for days 1 to 6 of acute stays and a $346 daily copay for days 1 to 6 of psychiatric stays, with no copay for remaining covered days. Prior authorization is required, and non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, though prior authorization is required for most services. There is no copay for ambulatory surgical center or blood services, while outpatient hospital copays range from $0 to $395, observation services cost $399 per stay, and outpatient substance abuse sessions require a $45 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with a copay of $80.00 or $110.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground and air ambulance services with a $265 copay and no coinsurance, subject to prior authorization. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered with no coinsurance and copays ranging from $115 to $265, up to a $250,000 maximum benefit limit.
Primary Care See details
Primary care benefits through the Aetna Medicare Signature (HMO) feature a $5 copay for primary care visits and a range from no copay to a $50 copay for specialists, both with no coinsurance. Physical, occupational, and speech therapies require a $35 copay, mental health services require a $45 copay, and telehealth services range from no copay to a $50 copay with 20% coinsurance. Chiropractic and podiatry services are not covered under this plan, and all covered services besides telehealth feature no coinsurance.
Preventive Services See details
Aetna Medicare Signature (HMO) covers preventive services with no copay and no coinsurance for annual physicals, fitness benefits, and wellness screenings, while kidney disease education requires no copay and a 20% coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefits, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Hearing services are partially covered with no deductible by Aetna Medicare Signature (HMO), featuring a $50 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine exams and fitting evaluations. Prescription hearing aids are covered with no coinsurance and copays ranging from $0 to $1,700, 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
Aetna Medicare Signature (HMO) covers vision services with no coinsurance, offering routine and diabetic eye exams with no copay, while other covered eye exams have a copay of up to $50. Eyewear, including contact lenses and eyeglasses, is also covered with no copay up to a combined maximum plan benefit of $100 annually.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (HMO), featuring a $50 copay and no coinsurance for Medicare-covered dental services. Preventive services including oral exams, cleanings, and dental X-rays are available with no copay and no coinsurance, but fluoride, restorative, endodontic, periodontic, prosthodontic, implant, orthodontic, and oral surgery services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, though prior authorization is required. Under this benefit, Part B insulin drugs have a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (HMO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO) with no copay and coinsurance ranging from 0% to 20%, depending on the item. Prior authorization is required for durable medical equipment, prosthetics, and diabetic equipment, with diabetic supplies limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (HMO) with prior authorization, featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $50 copay for diagnostic procedures. Radiological services include a $0 minimum copay for diagnostic radiology, a $50 copay for outpatient X-rays, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO) covers cardiac and pulmonary rehabilitation services with no coinsurance, although copayments apply to individual services. Members will pay a $20 copay for standard cardiac rehabilitation, intensive cardiac rehabilitation, and supervised exercise therapy (SET), while pulmonary rehabilitation services require a $15 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services, excluding over-the-counter (OTC) items. Covered benefits include acupuncture for a $50 copay and no coinsurance up to 12 treatments yearly, as well as chronic illness meals, annual wellness exams, and additional cancer screenings with no copay and no coinsurance.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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