A non-government entity
Aetna Medicare Signature Care (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select HVP Parishes in LA. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (HMO), 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. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced 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 $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 Care (HMO) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, there is no copay when utilizing preferred pharmacies or preferred mail-order services for up to a three-month supply. If you choose standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, costs are based on coinsurance rather than flat copayments. 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. Specialty tier medications are limited to a one-month supply under this plan.
Additional Benefits
The Aetna Medicare Signature Care (HMO) plan offers robust healthcare coverage with no copay for primary care doctor visits and annual preventive screenings. For hospital needs, inpatient stays require a $235 daily copay for the first ten days followed by no copay, while outpatient hospital services range from no copay up to $299. Emergency room visits carry a $130 copay that is waived upon admission, and urgent care visits require a $45 copay. This plan also features essential supplemental benefits, including routine dental, vision, and hearing exams with no copay. Members receive allowances for eyewear and hearing aids, up to a $2,500 annual limit for comprehensive dental care, and $30 every three months for over-the-counter items. Furthermore, home health services are provided with no copay, and skilled nursing facility stays feature no copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Signature Care (HMO) covers inpatient acute hospital stays with no coinsurance and a $235 daily copay for days 1 through 10, then no copay for additional days, although prior authorization is required and upgrades and non-Medicare-covered stays are not covered. Inpatient psychiatric care is also covered with no coinsurance and a $407 daily copay for days 1 through 5, followed by no copay for days 6 through 90, with prior authorization required and additional days not covered.
Outpatient Services See details
Aetna Medicare Signature Care (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $299, observation services have a $235 copay per stay, and outpatient substance abuse sessions carry a $30 copay.
Partial Hospitalization See details
Aetna Medicare Signature Care (HMO) covers partial hospitalization services with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature Care (HMO), requiring prior authorization for all ambulance transfers. Ground ambulance services incur a $250 copay and no coinsurance, air ambulance services require a 20% coinsurance and no copay, and transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Care (HMO) 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 $45 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays of $130 for emergency or urgent care and $250 for emergency transportation.
Primary Care See details
Aetna Medicare Signature Care (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $10 to $35 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay, mental health services carry a $30 copay (both with no coinsurance), and telehealth is available with a $0 to $45 copay and 20% coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Care (HMO) covers preventive services, including annual physicals and various screenings, with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Supplemental preventive benefits are partially covered, offering memory fitness and chemotherapy wigs with no copay and no coinsurance, while services like weight management, personal emergency response systems, and nutritional benefits are not covered.
Hearing Services See details
Aetna Medicare Signature Care (HMO) covers Medicare-covered hearing exams for a $35 copay and no coinsurance with no deductible, while routine exams and fitting evaluations have no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, 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 Care (HMO), featuring eye exams with no coinsurance and copays ranging from no copay up to $35. Eyewear is also covered with no copay and no coinsurance, providing up to a $225 annual maximum allowance for contacts, lenses, and frames.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (HMO), offering preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental services for a $35 copay and no coinsurance. Comprehensive services are covered up to a $2,500 annual limit with no copay and 20% to 50% coinsurance, though fluoride treatments, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Care (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature Care (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature Care (HMO) covers durable medical equipment (DME), prosthetics, and medical supplies with no copay and a 20% coinsurance. Covered diabetic equipment includes supplies with no coinsurance to a 20% coinsurance, and therapeutic shoes or inserts with a $10 copay.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Care (HMO) covers diagnostic and radiological services, with prior authorization required. Diagnostic services feature no coinsurance, offering no copay for lab services and a $0 to $95 copay for procedures, while radiological services feature no copay for outpatient X-rays, copays starting at $0 for diagnostic radiology, and a 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Signature Care (HMO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature Care (HMO) with no coinsurance, although in practice only some services are covered as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100; additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature Care (HMO) with no copay and no coinsurance for covered benefits, which include a meal program for chronic illness, select preventive screenings, and up to $30 every three months for over-the-counter items. Acupuncture is not covered under this plan.
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