A non-government entity
Aetna Medicare Signature Extra (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Washoe County. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 $4200.00 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 Extra (HMO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, Tier 1 drugs carry a copay starting at $2.00, while Tier 2 drugs start at a $12.00 copay for a one-month supply. Higher-tier medications transition to coinsurance across all pharmacy and mail-order types. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance. This structure allows beneficiaries to minimize out-of-pocket costs by utilizing preferred network pharmacies for generic prescriptions.
Additional Benefits
The Aetna Medicare Signature Extra (HMO) plan features robust medical coverage with no copays and no coinsurance for primary care visits, preventive screenings, annual physicals, and home health services. For specialist visits and Medicare-covered dental services, members pay a flat $45 copay with no coinsurance. Inpatient hospital stays require a daily copay of $385 for the first seven days, while emergency room visits carry a $150 copay that is waived if you are admitted. This plan also offers valuable everyday wellness benefits, including routine dental, vision, and hearing exams with no copays, no deductibles, and no coinsurance. Vision coverage includes a $100 annual allowance for eyewear, and prescription hearing aids are covered up to $1,000 per ear yearly. Diagnostic lab tests, outpatient X-rays, and durable medical equipment also feature no copays, though some equipment may require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Extra (HMO) covers inpatient hospital services with no coinsurance, requiring a $385 daily copay for days 1 through 7 of an acute stay and a $370 daily copay for days 1 through 5 of a psychiatric stay, followed by no copay for subsequent days. Prior authorization is required, and the benefit is only partially covered as upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Extra (HMO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $385, while outpatient substance abuse individual and group sessions have a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (HMO) covers partial hospitalization services with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services under the Aetna Medicare Signature Extra (HMO) require prior authorization, featuring a $325 copay and coinsurance for ground ambulance services and a 20% coinsurance and copay for air ambulance services. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Extra (HMO) covers emergency services with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $30 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $150 to $325.
Primary Care See details
Aetna Medicare Signature Extra (HMO) covers primary care physician visits with no copay and no coinsurance, and specialist visits with a $45 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies require a $40 copay and no coinsurance, while podiatry is not covered, and although some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Signature Extra (HMO) covers preventive services with no copay and no coinsurance for annual physicals, health education, and screenings, while kidney disease education requires no copay and a 20% coinsurance. This benefit is partially covered because in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Extra (HMO), featuring no copay, coinsurance, or deductible for annual routine hearing exams and fitting evaluations. Prescription hearing aids are covered up to $1,000 per ear yearly with no copay or coinsurance, but OTC hearing aids, inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Extra (HMO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. This includes one routine eye exam annually and a $100 yearly maximum allowance for eyewear, such as contacts, eyeglasses, lenses, and frames.
Dental Services See details
Aetna Medicare Signature Extra (HMO) provides partial dental coverage, offering Medicare-covered dental services for a $45 copay and no coinsurance, and routine oral exams, cleanings, and X-rays for no copay and no coinsurance. Non-covered services include fluoride, orthodontics, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and other diagnostic or preventive services.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature Extra (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature Extra (HMO) covers medical equipment with no copays for durable medical equipment (DME), prosthetics, and diabetic shoes, though prior authorization is required. Coinsurance ranges from no coinsurance to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices require a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (HMO) with no copays and no coinsurance for lab services, diagnostic procedures, outpatient X-rays, and diagnostic radiological services. Therapeutic radiological services require a 20% coinsurance, and prior authorization is required for these diagnostic and radiological services.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Extra (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature Extra (HMO) with no copay and no coinsurance, though only some services are covered in practice. Standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for PAD services are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Aetna Medicare Signature Extra (HMO) partially covers other services, providing an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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