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.

This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.

Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by Aetna Health Inc. (NY) available for the 2026 plan year 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.

Overview IconKey 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

Health deductible: information not available.

This plan has a $500.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.

Out-of-Pocket Maximums

This plan has a Maximum Out-Of-Pocket cost of $6750.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6750.00 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:

Regular visits to your primary care doctor are covered and will have a coinsurance of 0% (no coinsurance).

Specialist Visits:

Visits to specialists are covered and will have a coinsurance of 0% (no coinsurance). Specialist visits may require a referral from your primary care doctor or prior authorization.

Emergency Room:

Trips to the Emergency Room are covered, and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Urgent Care:

Trips to Urgent Care are covered and will have a coinsurance of 0% (no coinsurance). Coverage may vary for in-network and out-of-network hospitals.

Sign up for Aetna Medicare Signature (HMO-POS)

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.

Drug Coverage IconDrug 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 IconAdditional 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.

Plan Providers IconPlan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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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.

* 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.

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