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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 2026 to people living in Mid 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 $74.00. 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 $6350.00 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 has an annual drug deductible of $615. You can benefit from no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs when filling prescriptions through a preferred pharmacy or preferred mail-order service. For standard pharmacies and standard mail order, copays start at $2 for Tier 1 drugs and $12 for Tier 2 drugs for a one-month supply. For higher-tier medications, costs are structured as coinsurance rather than flat copays. Tier 3 (Preferred Brand) drugs require a 24% coinsurance, while Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) drugs carry a 25% coinsurance. This coinsurance rate remains the same whether you use preferred or standard pharmacies, or mail-order delivery.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage with no copay or coinsurance for primary care physician visits and annual wellness exams. Specialist visits feature a copay ranging from $0 to $50, while emergency services require a $130 copay that is waived upon hospital admission. For hospital care, inpatient acute stays require a daily copay of $375 for days one through seven, and outpatient hospital services carry a copay up to $375, both with no coinsurance. Members also benefit from routine dental, vision, and hearing services, featuring no copay for annual eye exams, hearing evaluations, and select preventive dental cleanings. The plan provides a $175 annual allowance for eyewear, prescription hearing aid coverage with copays up to $1,700, and a $50 copay for Medicare-covered dental exams. Furthermore, home health care and diagnostic lab services are covered with no copay, while skilled nursing facility stays require a $10 daily copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring a daily copay of $375 for days 1-7 of acute stays and $295 for days 1-7 of psychiatric stays, with no copay for days 8-90. Unlimited additional acute days are covered at no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Patients will pay a $50 copay for outpatient substance abuse sessions and a copay ranging from $0 to $375 for outpatient hospital and observation services, with prior authorization required for most care.
Partial Hospitalization See details
The Aetna Medicare Signature (HMO-POS) plan covers partial hospitalization services with a copayment of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ambulance services with prior authorization, requiring a $295 copay for ground ambulance services and a 20% coinsurance for air ambulance services. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (HMO-POS) 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 with no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $295.
Primary Care See details
Primary care benefits under Aetna Medicare Signature (HMO-POS) feature no copay and no coinsurance for primary care physician visits, and a $0 to $50 copay with no coinsurance for specialists. Physical, occupational, and mental health therapies require copays up to $50 with no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) covers annual physical exams and most preventive screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered, excluding services such as in-home safety assessments, medical nutrition therapy, weight management, and personal emergency response systems.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), offering Medicare-covered exams for a $50 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are covered with no coinsurance and copays ranging from $0 to $1,700 for up to two aids per year, though inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no coinsurance, offering eye exams with a $0 to $50 copay and eyewear with no copay. Covered benefits include one routine eye exam per year at no copay and a $175 annual allowance for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), featuring Medicare-covered dental services for a $50 copay and no coinsurance, and select preventive care with no copay and no coinsurance. Covered preventive care includes four oral exams, two cleanings, and one x-ray annually, while fluoride, restorative, endodontic, periodontic, prosthodontic, implant, and oral surgery services 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 chemotherapy and other Part B drugs carry a 0% to 20% coinsurance with no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO-POS) with no copays for durable medical equipment, prosthetics, and diabetic shoes, though prior authorization is required. Coinsurance for these covered benefits ranges from no coinsurance up to 25% depending on the specific device or supply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization required. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $40 copay for procedures, while radiological services require a $10 copay for X-rays, no minimum copay for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Signature (HMO-POS) covers home health services with no copay and no coinsurance, though prior authorization is required.
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. Specifically, cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $210 daily copay for days 21 through 100. Prior authorization is required, a prior 3-day inpatient hospital stay is not required for admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the Aetna Medicare Signature (HMO-POS) are partially covered, featuring no copay and no coinsurance for covered benefits such as chronic illness meal benefits, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings. Acupuncture and over-the-counter (OTC) items are not covered under this plan.
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