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Aetna Medicare Signature Advantage (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Advantage (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 Advantage (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Advantage (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Pima County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Advantage (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 Advantage (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 Advantage (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
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 $3300.00 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 Advantage (HMO) plan features an enhanced alternative drug benefit with a $615 annual prescription drug deductible. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred retail pharmacies or through preferred mail order, while standard pharmacies and standard mail order require a $12 copay. For Tier 2 standard generic drugs, you will pay a 24% coinsurance regardless of the pharmacy or mail service you choose. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both require a 25% coinsurance during the initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and will pay nothing for covered Part D prescription drugs. If you qualify for the low-income subsidy, your Part D cost is reduced to $0.
Additional Benefits
The Aetna Medicare Signature Advantage (HMO) plan offers comprehensive medical coverage, featuring no copays or coinsurance for primary care physician visits, routine home health services, and annual wellness exams. For specialist visits, emergency care, and outpatient services, members will generally pay predictable copayments with no coinsurance. Inpatient hospital stays and skilled nursing facility care require daily copayments for the initial days of a stay, after which you will pay no copay. Supplemental benefits include routine dental, vision, and hearing services, with no copays or coinsurance for preventive care, annual eye exams, and hearing evaluations. Comprehensive dental services are covered up to a $2,000 annual limit with no copay and a 20% to 50% coinsurance, while prescription hearing aids and eyewear are covered up to generous annual benefit limits. Note that certain services, such as routine transportation, cardiac rehabilitation, and over-the-counter items, are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Aetna Medicare Signature Advantage (HMO) with no coinsurance, though prior authorization is required. Acute stays require a $275 copay per day for days 1 to 7 (no copay for days 8 to 90), and psychiatric stays require a $370 copay per day for days 1 to 5 (no copay for days 6 to 90). Upgrades, non-Medicare-covered stays, and additional days for psychiatric care are not covered.
Outpatient Services See details
Aetna Medicare Signature Advantage (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $225, while observation services carry a $275 copay per stay and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered under the Aetna Medicare Signature Advantage (HMO) plan, subject to prior authorization. Depending on the service, you will pay a copay of either $55.00 or $180.00, with no coinsurance.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Aetna Medicare Signature Advantage (HMO) plan, as transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $290 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
Emergency services are covered by the Aetna Medicare Signature Advantage (HMO) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 lifetime maximum with copays ranging from $150 to $290 and no coinsurance.
Primary Care See details
Aetna Medicare Signature Advantage (HMO) covers primary care physician visits with no copay and no coinsurance, while specialist, therapy, and mental health services require a $30 copay and no coinsurance. Telehealth benefits are covered with a $0 to $50 copay and 20% coinsurance, though podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Advantage (HMO), offering annual physical exams, health education, and fitness benefits with no copay and no coinsurance. Kidney disease education is covered with a 20% coinsurance and no copay, but several supplemental services—including in-home safety assessments, nutritional benefits, and weight management programs—are not covered.
Hearing Services See details
Hearing services covered under Aetna Medicare Signature Advantage (HMO) include annual routine hearing exams and fitting evaluations with no copays, coinsurance, or deductibles. Prescription hearing aids are partially covered with no copay up to a $1,000 annual maximum per ear, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Advantage (HMO) with no copay and no coinsurance, which includes one routine eye exam annually and unlimited diabetic eye exams. Eyewear is also covered with no copay, no coinsurance, and no deductible, providing up to a $200 combined maximum benefit limit every year for contacts, glasses, and upgrades.
Dental Services See details
Aetna Medicare Signature Advantage (HMO) partially covers dental services, offering preventive care like exams, cleanings, and x-rays with no copay or coinsurance, while Medicare-covered dental has a $30 copay and no coinsurance. Comprehensive dental services are covered up to a $2,000 annual limit with 20% to 50% coinsurance and no copay, though fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Advantage (HMO) covers home infusion bundled services, which require prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Advantage (HMO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Signature Advantage (HMO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, subject to prior authorization. These covered benefits require no copay, with coinsurance ranging from no coinsurance to 20% for most equipment and supplies, and a flat 20% coinsurance for prosthetic devices.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Advantage (HMO), with prior authorization required for all services. Diagnostic tests, lab services, and outpatient X-rays are available with no copay and no coinsurance, while diagnostic radiological services require a $0 to $175 copay (no coinsurance) and therapeutic radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Advantage (HMO) plan with no copay and no coinsurance. Prior authorization is required to receive these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature Advantage (HMO) plan, as all related sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Advantage (HMO) with prior authorization, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100, with no coinsurance. This benefit is partially covered because additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Advantage (HMO), providing coverage for annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, meal benefits, and Dual Eligible SNPs are not covered under this benefit.
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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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