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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 Toledo and Cincinnati 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-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 $7500.00 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 drug deductible of $500. You will pay no copay for Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs when using preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, your costs are based on a percentage of the drug cost. Tier 3 (Preferred Brand) medications require a 22% coinsurance, while Tier 4 (Non-Preferred) drugs carry a 25% coinsurance across all pharmacy options. Specialty drugs in Tier 5 carry a 27% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits and most preventive services. Specialist office visits carry a copay of up to $40, while inpatient hospital stays require a $325 copay for the first five days and no copay for days six through ninety. Emergency care is available with a $115 copay, and urgent care visits require a $40 copay, both with no coinsurance. This plan also includes valuable supplemental benefits, such as routine vision and hearing exams with no copay, alongside annual allowances for eyewear and hearing aids. Dental coverage includes preventive care with no copay, while comprehensive dental services are covered up to $1,000 annually with coinsurance ranging from 20% to 50%. Additionally, members benefit from home health services with no copay and a quarterly $75 allowance for over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits under Aetna Medicare Signature (HMO-POS) are partially covered with no coinsurance, requiring a $325 copay for days 1 to 5 and no copay for days 6 to 90 for both acute and psychiatric stays. While unlimited additional acute hospital days are covered at no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $325, observation services require a $325 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 either $40.00 or $110.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (HMO-POS) plan are covered with a $115 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $40 copay and no coinsurance, while worldwide emergency services feature no coinsurance and copays ranging from $115 to $250 up to a $250,000 maximum limit.
Primary Care See details
Aetna Medicare Signature (HMO-POS) provides primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while telehealth services carry a $0 to $40 copay and 20% coinsurance. Some chiropractic services are covered with a $15 copay and no coinsurance, though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO-POS), with most covered benefits like annual physicals and screenings requiring no copay and no coinsurance, while kidney disease education has a 20% coinsurance and no copay. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission 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/bathroom safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) covers Medicare-covered hearing exams with a $40 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $1,250 per ear annually, but inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered under Aetna Medicare Signature (HMO-POS) with no coinsurance or deductibles, featuring no copay for annual routine eye exams and up to a $40 copay for Medicare-covered exams. Eyewear, including contacts, lenses, frames, and upgrades, has no copay up to a combined maximum plan benefit of $175 per year.
Dental Services See details
Aetna Medicare Signature (HMO-POS) partially covers dental services, offering Medicare-covered dental with a $40 copay and no coinsurance, and preventive care like exams and cleanings with no copay and no coinsurance. Comprehensive services are covered up to a $1,000 yearly limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment with no copays, featuring coinsurance ranging from no coinsurance to 20% for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices carry a 20% coinsurance and diabetic therapeutic shoes have no copay, with prior authorization required for these services.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services with prior authorization, including lab services with no copay and no coinsurance. Diagnostic tests and procedures carry a $0 to $100 copay with no coinsurance, while radiological services range from a $0 copay for diagnostic imaging to a minimum 20% coinsurance for therapeutic treatments.
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 under the Aetna Medicare Signature (HMO-POS) plan are not covered in practice. While the plan features no coinsurance, sub-services such as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered and require copayments ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and while a prior three-day hospital stay is not needed for admission, additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) partially covers other services with no copay and no coinsurance for over-the-counter items (up to $75 every three months), annual wellness exams, screening mammography, and additional gFOBT and FIT. Acupuncture, meal benefits, and dual eligible SNP services are not covered under this plan.
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