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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 Denver Metro & Northern Colorado. 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 $4150.00 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 $615. For Tier 1 preferred generic and Tier 2 generic medications, members enjoy no copay for one-, two-, or three-month supplies when using a preferred pharmacy or preferred mail order service. If you choose a standard pharmacy or standard mail order, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, costs are structured as 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 options. This percentage-based cost sharing applies to one-, two-, and three-month supplies for Tiers 3 and 4, and one-month supplies for Tier 5.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan provides comprehensive healthcare coverage with no copay for annual preventive exams, routine hearing tests, and vision care. For doctor visits, you will pay a low $5 copay for primary care and a $45 copay for specialists. If you require hospital care, inpatient stays carry a $365 daily copay for days one through six, while emergency room visits have a $150 copay which is waived if you are admitted. Additional benefits include dental coverage, which offers preventive care with no copay and comprehensive services up to a $1,000 annual limit with 20% to 50% coinsurance. Home health services are available with no copay, and diagnostic lab services require no copay. Essential medical needs like dialysis and durable medical equipment are covered with coinsurance up to 20%.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring a copay of $365 per day for days 1 through 6 of acute stays and $370 per day for days 1 through 5 of psychiatric stays, with no copay for subsequent days. This benefit is partially covered because hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, offering no copays for ambulatory surgical center and blood services. Outpatient hospital services range from no copay to a $365 copay, observation services require a $365 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 copayment of either $55.00 or $180.00 and no coinsurance. Prior authorization is required to access this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (HMO-POS), with ground ambulance services requiring a $200 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and routine transportation services to health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $150 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance up to a $250,000 maximum benefit, requiring a $150 copay for emergency or urgent care and a $200 copay for emergency transportation.
Primary Care See details
Primary care benefits under Aetna Medicare Signature (HMO-POS) feature a $5 copay for primary care visits and a $45 copay for specialists, physical therapy, and occupational therapy, all with no coinsurance. Mental health, psychiatric, and opioid treatments require a $40 copay with no coinsurance, telehealth ranges from no copay to a $50 copay with 20% coinsurance, while podiatry is not covered and routine chiropractic services are excluded.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) provides partially covered preventive services with no copay and no coinsurance for annual exams, screenings, and fitness benefits, though kidney disease education requires a 20% coinsurance and no copay. Several supplemental services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, alternative therapies, and home-based support.
Hearing Services See details
Hearing Services are partially covered under the Aetna Medicare Signature (HMO-POS) plan, offering routine exams, fittings, and prescription hearing aids with no copay, no coinsurance, and no deductible. While prescription hearing aids are covered up to $1,250 per ear annually, over-the-counter (OTC) hearing aids as well as 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 copay, no coinsurance, and no deductibles for both eye exams and eyewear. This includes one routine eye exam per year, follow-up diabetic eye exams, and eyewear like contacts and eyeglasses up to a $125 combined annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), with preventive care requiring no copay or coinsurance, and comprehensive services up to a $1,000 annual limit requiring no copay and 20% to 50% coinsurance. Medicare-covered dental has a $45 copay and no coinsurance, while fluoride treatments, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO-POS) with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs feature no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers durable medical equipment, prosthetics, and diabetic supplies with no copay 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 procedures and tests have no coinsurance and a $0 to $20 copay, lab and diagnostic radiological services have no copay, outpatient X-rays require a $10 copay, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (HMO-POS) covers Home Health Services 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, as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered. While the plan features no coinsurance, these non-covered services carry copayments ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is partially covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, prior hospital stays of less than three days are allowed, and additional days beyond the standard Medicare-covered limit 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 with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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