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Aetna Medicare Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO-POS). 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-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Western New York. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO-POS) 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-POS).
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-POS), 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 $500.00 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 $6750.00 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-POS) plan features an annual drug deductible of $500. 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 higher-tier medications, costs transition from flat copays to coinsurance percentages. Tier 3 preferred brand drugs require a 22% coinsurance, and Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy options. Specialty tier drugs in Tier 5 carry a 27% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage with affordable out-of-pocket costs, featuring a ten-dollar copay for primary care visits and no copay to a forty-five-dollar copay for specialist services. Emergency care is available with a one-hundred-thirty-dollar copay, which is waived upon hospital admission, while inpatient hospital stays require daily copays for the first six days with no copay for subsequent days. Additionally, most outpatient hospital services and diagnostic lab tests require no coinsurance and low or no copays. This plan also includes valuable supplemental benefits, such as routine vision and hearing exams with no copay and a one-hundred-dollar annual allowance for eyewear. Dental care is covered with no copay for preventive and comprehensive services up to a seven-hundred-fifty-dollar annual limit. While the majority of covered services require no coinsurance, select benefits like dialysis and durable medical equipment will incur a coinsurance of up to twenty percent.
Inpatient Hospital See details
Inpatient Hospital services are partially covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring prior authorization for acute stays which cost a $399 daily copay for days 1 to 6 (no copay thereafter) and psychiatric stays which cost a $350 daily copay for days 1 to 6 (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 (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $399 copay for outpatient hospital services, a $399 copay per stay for observation services, and a $45 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are available with no copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization with no coinsurance, though a copay of $80.00 or $145.00 applies depending on the service. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground and air ambulance services with a $300 copay per service and no coinsurance, though prior authorization is required. Routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are covered up to a $250,000 maximum with a $130 copay, while worldwide emergency transportation has a $300 copay, both with no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care visits for a $10 copay and specialist services for no copay to a $45 copay, both with no coinsurance. Therapy, mental health, and psychiatric services are covered with copays ranging from $25 to $45 and no coinsurance, while telehealth benefits require no copay to a $45 copay and 20% coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance for annual physicals, screenings, and select supplemental benefits, though kidney disease education requires a 20% coinsurance and no copay. Sub-services not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), featuring Medicare-covered exams with a $45 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and copays ranging from $0 to $1,700, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance or deductibles, offering annual routine eye exams and follow-up diabetic exams with no copay, and Medicare-covered exams for a $0 to $45 copay. Covered eyewear, including contacts, lenses, frames, and upgrades, also has no copay up to a combined maximum benefit of $100 per year.
Dental Services See details
Aetna Medicare Signature (HMO-POS) provides partially covered dental services, featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other covered preventive and comprehensive services up to a $750 annual maximum. Maxillofacial prosthetics, implant services, and orthodontics are not covered under this plan.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required and step therapy applies. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs incur a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under Aetna Medicare Signature (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copay and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (HMO-POS) plan, featuring no copay and no coinsurance for lab services, and a copay of up to $45 with no coinsurance for diagnostic tests. Diagnostic radiological services require no minimum copay, outpatient X-rays require a $45 copay, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO-POS) plan 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 (HMO-POS) with no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) services are not covered. The non-covered pulmonary rehabilitation services require a $15 copay, while the remaining non-covered cardiac, intensive cardiac, and SET for PAD services require a $20 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) 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, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, providing a chronic illness meal benefit, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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