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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 Southern Maine. This plan received an overall rating of 4 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 prescription drug deductible of $500. For generic medications, members can benefit from no copay on both Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs when utilizing a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options require a copay, ranging from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply duration. Higher-tier medications under this plan are subject to coinsurance rather than flat copays. Tier 3 (Preferred Brand) drugs require a 22% coinsurance, while Tier 4 (Non-Preferred) drugs carry a 25% coinsurance across all pharmacy and mail-order options. Specialty drugs in Tier 5 require a 27% coinsurance for a one-month supply at both preferred and standard pharmacy locations.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage featuring no copays for primary care visits, annual physicals, and home health services. For specialized care, members can expect predictable costs, including specialist office visits ranging from no copay up to $50 and inpatient hospital stays requiring daily copays with no coinsurance. Emergency care is available with a $130 copay, which is waived upon hospital admission, while urgent care visits require a $50 copay. This plan also includes valuable wellness benefits, providing routine dental, vision, and hearing exams with no copays, alongside coverage for eyewear and hearing aids. Additionally, diagnostic lab tests, home infusions, and durable medical equipment are covered with no copays, though some equipment and specialized therapies may require coinsurance up to 25%. Overall, the plan minimizes out-of-pocket costs by pairing predictable copays with no coinsurance for many essential services.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a $435 daily copay for days 1 to 7 for acute stays (with no copay for additional days) and a $334 daily copay for days 1 to 7 for psychiatric stays (with no copay for days 8 to 90). Prior authorization is required, and 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, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services require a copay of $0 to $435, observation services have a $360 copay per stay, and outpatient substance abuse sessions carry a $50 copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $290 copay and air ambulance services with a 20% coinsurance, with prior authorization required for both. Transportation services to health-related locations are not covered under this plan.
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. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency care and transportation are covered up to a $250,000 maximum with copays ranging from $130 to $290 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Physical, occupational, speech, mental health, psychiatric, and opioid treatment therapies have copays ranging from $40 to $50 with no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Podiatry and chiropractic services are not covered under this plan.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, screenings, and fitness benefits, while kidney disease education requires a 20% coinsurance and no copay. Sub-services not covered by this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) covers hearing services with no deductibles, offering Medicare-covered exams for a $50 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to two per year with no coinsurance and a copay up to $1,700, though OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no deductibles and no coinsurance, including routine and follow-up diabetic eye exams with no copay. Medicare-covered eye exams have a $0 to $50 copay, while eyewear like contacts and eyeglasses is covered with no copay up to a $100 annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), with Medicare-covered dental services requiring a $50 copay and no coinsurance. Covered preventive services, including select oral exams, cleanings, and x-rays, feature no copay and no coinsurance, while other services—including fluoride, restorative, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics—are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay with no coinsurance, while chemotherapy, radiation, and other Part B drugs have 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, and prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO-POS) with no copay for durable medical equipment (DME), prosthetics, medical supplies, and diabetic therapeutic shoes or inserts. Depending on the item, coinsurance ranges from no coinsurance to 25% for DME and medical supplies, is 25% for prosthetic devices, and ranges from no coinsurance to 20% for diabetic supplies, with prior authorization required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS), with prior authorization required for all services. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $35 copay. Radiological services include a $20 copay and coinsurance for X-rays, a $0 minimum copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance. Prior authorization is required before receiving these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature (HMO-POS) plan with no coinsurance, though only some services are covered. Standard cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) covers skilled nursing facility 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 while a prior three-day inpatient hospital stay is not needed, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO-POS), offering 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.
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