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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 2026 to people living in Upstate NY: Otsego, Seneca, Wayne, Yates. 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 $184.00. 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 drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay for one-month, two-month, or three-month supplies when utilizing a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, Tier 1 copays range from $2 to $6 and Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, cost-sharing is based on 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 require a 25% coinsurance across all pharmacy and mail-order options. These coinsurance rates apply to all available supply lengths, though Tier 5 specialty medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive healthcare coverage with predictable out-of-pocket costs and no coinsurance for many core medical services. Members benefit from no copay for primary care physician visits, routine preventive care, and home health services. For more specialized care, inpatient hospital stays require a $399 daily copay for days one through five, while specialist office visits and Medicare-covered dental services carry a $45 copay. Routine vision, dental, and hearing benefits are highly accessible, featuring no copay for annual cleanings, routine eye exams, and hearing fittings. Additionally, prescription hearing aids are covered up to twice yearly with copays ranging from no copay to $1,700, and eyewear is covered up to a $100 annual maximum. Emergency care is also covered with a $115 copay, which is waived if the member is admitted to the hospital within 24 hours.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $399 daily copay for days 1 through 5 and no copay for days 6 through 90. Unlimited additional acute care days are covered with no copay, though 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, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $399, observation services carry a $399 copay per stay, and outpatient substance abuse sessions have a $45 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground and air ambulance services with a $300 copay and no coinsurance, with prior authorization required. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
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 no coinsurance. Urgently needed services require a $40 copay with no coinsurance, while worldwide emergency and urgent care are covered up to a $250,000 maximum with no coinsurance and copays of $115 for medical care and $300 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care physician visits with no copay and no coinsurance, while specialist visits require a $45 copay and no coinsurance. Physical and occupational therapies have no coinsurance with copays of $25 and $35, podiatry is not covered, and some chiropractic services are covered but routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Signature (HMO) preventive services are partially covered, with annual physicals, health education, and screenings requiring no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Supplemental services not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, home-based palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO) with no deductible, offering Medicare-covered exams for a $45 copay and routine exams or fittings with no copay and no coinsurance. Prescription hearing aids are covered up to twice yearly with copays ranging from $0 to $1,700 and no coinsurance, though OTC devices and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no coinsurance or deductibles, offering routine and diabetic eye exams with no copay, and Medicare-covered exams with a $0 to $45 copay. Covered eyewear, including lenses, frames, and contacts, features no copay and is subject to a $100 annual maximum benefit.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (HMO), featuring Medicare-covered dental care for a $45.00 copay and no coinsurance, and select preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. Several sub-services are not covered under this plan, including fluoride, restorative treatments, endodontics, periodontics, prosthodontics, implants, and oral surgery.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO) covers Dialysis Services with no copay and a 20% coinsurance, with prior authorization required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment with no copay, though prior authorization is required for these services. Coinsurance ranges from no coinsurance to 20% for durable medical equipment (DME), medical supplies, and diabetic supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO), with prior authorization required. Diagnostic tests and procedures have no coinsurance and a $0 to $45 copay, lab services have no copay or coinsurance, and radiological services range from no copay for diagnostic imaging to a $45 copay for x-rays and a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO) covers Cardiac Rehabilitation Services with no coinsurance and copays ranging from $15 to $20, though only some services are covered. Specifically, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services under the Aetna Medicare Signature (HMO) are partially covered, offering a meal benefit for chronic illness, annual wellness exams and screening mammographies, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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