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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 Select Central and Southwest Virginia counties. 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.
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 $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 $8900.00 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 $615. Beneficiaries enjoy no copay for Tier 1 preferred generic and Tier 2 generic medications when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options require a copay starting at $2.00 for Tier 1 and $12.00 for Tier 2 drugs. For higher-tier medications, costs are 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 carry a 25% coinsurance across all pharmacy and mail-order networks. These coinsurance rates remain consistent whether you utilize preferred or standard prescription drug services.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust coverage with no copay or coinsurance for primary care physician visits, routine annual physicals, and laboratory services. For specialist consultations, members will pay anywhere from no copay to a $40 copay, while inpatient hospital stays require a $388 daily copay for the first seven days. Outpatient hospital services range from no copay to a $340 copay, and outpatient X-rays are covered with no copay or coinsurance. Additionally, the plan features built-in dental, vision, and hearing benefits, including no copay for routine exams and preventive dental care. Prescription hearing aids are covered up to $500 per ear with no copay, and covered eyewear has a $100 annual maximum limit with no copay. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $388 daily copay for days 1 to 7, and psychiatric stays with no coinsurance and a $260 daily copay for days 1 to 8. Prior authorization is required, and some services such as 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 no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $340, observation services have a $340 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO-POS) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization, requiring a $275 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (HMO-POS) plan are covered with a $115 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services require a $40 copay and no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum limit with no coinsurance, requiring a $115 copay for emergency or urgent services and a $275 copay for emergency transportation.
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 $40 copay with no coinsurance for specialists. Covered occupational, physical, and speech therapies require a $30 to $50 copay and no coinsurance, while mental health services carry a $40 copay and no coinsurance. Chiropractic and podiatry services are not covered under this plan.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) preventive services are partially covered, offering no copay and no coinsurance for annual physical exams, fitness benefits, and screenings, while kidney disease education has no copay but a 20% coinsurance. Sub-services that are not covered 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, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing Services are partially covered by Aetna Medicare Signature (HMO-POS), featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (HMO-POS) covers vision services with no coinsurance and no deductible, featuring eye exams with a $0 to $40 copay, which includes one routine exam per year at no copay. Covered eyewear, such as glasses and contact lenses, has no copay and is subject to a $100 combined maximum benefit limit annually.
Dental Services See details
Aetna Medicare Signature (HMO-POS) provides partially covered dental services, featuring Medicare-covered dental care with a $40 copay and no coinsurance, alongside preventive services with no copay and no coinsurance. Comprehensive dental benefits have a $500 annual maximum with no copay and 20% to 50% coinsurance, though orthodontics, implants, fluoride, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs incur no coinsurance to 20% 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
Aetna Medicare Signature (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copays and coinsurance ranging from no coinsurance 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 by Aetna Medicare Signature (HMO-POS) with prior authorization required. Diagnostic tests have no coinsurance and a copay of $0 to $100, while lab services and outpatient X-rays have no copay or coinsurance. Diagnostic radiological services feature a $0 minimum copay, and therapeutic radiological services require 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, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO-POS) plan. While the plan technically features no coinsurance, key services—including cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation—are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) 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 Medicare-covered limits are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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