A non-government entity
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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature (HMO) is a HMO plan offered by Aetna Health Inc. (PA) available for the 2026 plan year to people living in Central Ohio Area. 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 $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
Health deductible: information not available.
This plan has a $500.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6900.00 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) prescription drug plan features an annual drug deductible of $500. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when you fill your prescription through a preferred retail pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order services charge copays starting at $2 for Tier 1 and $12 for Tier 2 drugs, depending on the supply duration. For brand-name and specialty medications, costs are determined by coinsurance percentages 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. Tier 5 specialty medications are covered at a 27% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust medical coverage with predictable out-of-pocket costs, including no coinsurance for inpatient hospital stays, outpatient services, and doctor visits. Patients pay a low $5 copay for primary care visits, while specialist visits range from no copay to a $45 copay. Emergency room care is covered with a $115 copay, and inpatient hospital stays require a $400 daily copay for the first several days before transitioning to no copay. In addition to core medical care, this plan features valuable supplemental benefits, including routine dental, vision, and hearing exams with no copay. Members benefit from a $250 annual eyewear allowance and up to $1,250 per ear for prescription hearing aids with no copay. Additionally, preventive services, home health care, and up to $75 every three months for over-the-counter items are covered with no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a $400 copay for days 1 to 6 of acute stays and days 1 to 4 of psychiatric stays. Stays are covered with no copay for days 7 to 90 (acute) and days 5 to 90 (psychiatric), but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance, featuring copays ranging from no copay to $400 for outpatient hospital and observation services. Ambulatory surgical center and blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with a copay of either $40.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services under Aetna Medicare Signature (HMO) cover ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. For transportation services, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum with no coinsurance, requiring a $115 copay for emergency or urgent services and a $250 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care visits with a $5 copay and specialist visits with no copay to a $45 copay, both with no coinsurance. Chiropractic care is partially covered with a $15 copay and no coinsurance, though routine and other chiropractic services are not covered. Physical, occupational, and speech therapies require a $35 copay, while mental health and podiatry services carry a $40 to $45 copay, all with no coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), with most services—including annual physical exams, health education, and screenings—offered with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but several sub-services, including personal emergency response systems, medical nutrition therapy, weight management, and alternative therapies, are not covered.
Hearing Services See details
Aetna Medicare Signature (HMO) partially covers hearing services with no deductible, featuring Medicare-covered exams for a $45 copay and annual routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $1,250 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no coinsurance, featuring a $0 to $45 copay for eye exams and no copay for eyewear. Routine eye exams are covered once per year, and a $250 annual maximum allowance is provided for eyeglasses and contact lenses with no deductible.
Dental Services See details
Aetna Medicare Signature (HMO) offers partially covered dental services, featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive cleanings, exams, and X-rays. Covered comprehensive services like restorative care, endodontics, periodontics, and prosthodontics have no copay and 20% to 50% coinsurance up to a $1,500 annual limit, while fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance of 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with no copay and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies may be limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic and radiological services with prior authorization, featuring no copay and no coinsurance for lab services, and no coinsurance with a copay ranging from no copay to $60 for diagnostic procedures. Radiological services require a $5 copay plus coinsurance for X-rays, a minimum 20% coinsurance for therapeutic services, and a minimum of no copay for diagnostic radiology.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under Aetna Medicare Signature (HMO) because none of the associated sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered by the plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance for covered benefits, which include annual wellness exams, screening mammographies, additional gFOBT and FIT screenings, and up to $75 every three months for over-the-counter items. Acupuncture and meal benefits are not covered under this plan.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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