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 Central Upstate NY 1. 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:
Sign up for Aetna Medicare Signature (HMO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature (HMO) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, Tier 1 drugs carry a copay starting at $2, while Tier 2 drugs start at a $12 copay for a one-month supply. For higher-tier medications, cost-sharing transitions to coinsurance across all pharmacy and mail-order options. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Specialty drugs are limited to a one-month supply, whereas Tier 3 and Tier 4 medications are available in one, two, or three-month supplies.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no coinsurance for inpatient hospital stays which require a daily copay of $399 for the first six days. Doctor visits are highly affordable, with a $10 copay for primary care and specialist visits ranging from no copay to $50. Emergency care is available with a $115 copay, while home health services and routine preventive care are covered with no copay and no coinsurance. For specialty benefits, the plan features routine dental cleanings, annual eye exams, and routine hearing tests with no copay or coinsurance, plus up to $100 annually for eyewear. Skilled nursing facility stays are covered with no copay for the first 20 days, followed by a $218 daily copay. Prescription hearing aids are covered with copays up to $1,700, while durable medical equipment and dialysis services require no copay and up to 20 percent coinsurance.
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 through 6 of acute stays and a $346 daily copay for days 1 through 6 of psychiatric stays, with no copay for subsequent days. Additional acute days are covered with no copay, but upgrades, non-Medicare-covered stays, 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 several services. Outpatient hospital services have a copay of $0 to $399, observation services require a $399 copay per stay, and outpatient substance abuse sessions have a $45 copay, while ambulatory surgical center and outpatient blood services have no copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature (HMO) plan with a copayment of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Aetna Medicare Signature (HMO). Ground and air ambulance services require a $300 copay and no coinsurance, while transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and urgent care with a $40 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum limit with a $115 copay, while worldwide emergency transportation has a $300 copay, with no coinsurance required.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care visits for a $10 copay and specialist services for no copay to a $50 copay, both with no coinsurance. Therapy services require a $30 copay and no coinsurance, while some chiropractic services are covered for a $15 copay and no coinsurance, but routine and other chiropractic services, as well as podiatry, are not covered. Mental health, psychiatric, and opioid treatment services have a $45 copay and no coinsurance, whereas telehealth features no copay to a $50 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), with no copay and no coinsurance for annual physical exams, health education, remote access technologies, and select screenings. Kidney disease education is covered with no copay and a 20% coinsurance, but several supplemental services like weight management, nutritional benefits, and personal emergency response systems are not covered.
Hearing Services See details
Aetna Medicare Signature (HMO) covers hearing services with no deductible, including annual routine exams and fitting evaluations with no copay and no coinsurance, and Medicare-covered exams for a $50 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from no copay up to $1,700, though OTC, inner ear, outer ear, and over the ear devices are not covered.
Vision Services See details
Vision Services under Aetna Medicare Signature (HMO) feature no deductibles or coinsurance, offering routine and diabetic eye exams with no copay and Medicare-covered exams with a copay of up to $50. Eyewear, including contacts and eyeglasses, is covered with no copay, coinsurance, or deductible up to a $100 annual maximum.
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, and no copay and no coinsurance for routine oral exams, cleanings, and x-rays. Other services, including fluoride, orthodontics, restorative care, endodontics, periodontics, prosthodontics, implants, and oral surgery, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay, though prior authorization and step therapy are required. Covered Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment with no copays, though prior authorization is required for these services. Coinsurance ranges from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a copay ranging from $0 to $50. Radiological services include diagnostic radiology with a copay starting at $0, outpatient X-rays with a $50 copay and coinsurance, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided under the Aetna Medicare Signature (HMO) with no coinsurance, but only some services are covered. Standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day hospital stay is not needed, additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services, providing a meal benefit for chronic illness, an annual wellness exam and screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved