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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 Southern & Western 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 $5900.00 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 pay no copay when using a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order service, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For brand-name and specialty drugs, cost-sharing transitions to 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 require a 25% coinsurance across all pharmacy and mail-order options. Note that Tier 5 specialty medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with predictable costs, featuring a $5 copay for primary care visits and no copay for annual physicals, routine vision exams, and preventive dental care. For inpatient hospital stays, members pay a daily copay of $395 for the first six days of acute care and no copay for subsequent days, with no coinsurance required. Emergency room visits carry a $130 copay, which is waived upon hospital admission, and urgent care services require a $50 copay. Specialist visits and physical therapy require a $50 copay, whereas home health services, routine hearing exams, and outpatient surgical services are available with no copay. The plan also includes supplemental benefits, such as a $1,250 annual allowance per ear for prescription hearing aids and up to $100 annually for eyewear, both with no copay or coinsurance. While many services require prior authorization, most covered diagnostic lab tests and preventive screenings also feature no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient hospital stays with no coinsurance, requiring a $395 daily copay for days 1-6 of acute care (no copay for days 7 and beyond) and a $370 daily copay for days 1-5 of psychiatric care (no copay for days 6-90). Prior authorization is required, and certain services such as non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $395 copay for outpatient hospital services, a $395 copay per stay for observation services, and a $40 copay for outpatient substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for most outpatient care.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, though prior authorization is required. Depending on the treatment facility or service, you will pay a copay of either $55.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ambulance services with prior authorization, requiring a $260 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO-POS) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, 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, carrying a $130 copay for emergency or urgent care and a $260 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO-POS) primary care benefits include primary care physician visits for a $5 copay and no coinsurance, and specialist, occupational, and physical therapy visits for a $50 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services require a $40 copay and no coinsurance, telehealth is covered with a $0 to $50 copay and 20% coinsurance, and podiatry and routine chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) partially covers preventive services, offering annual physicals, health education, and screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Several supplemental benefits are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) covers hearing exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 maximum benefit per ear annually, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance for both eye exams and eyewear. This includes one routine eye exam every year and a combined maximum benefit of $100 per year for covered contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (HMO-POS) covers Medicare-covered dental services with a $50 copay and no coinsurance, and partially covers preventive dental services with no copay and no coinsurance. Covered preventive services include oral exams, cleanings, and dental X-rays, while fluoride treatments, restorative services, endodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though 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 have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (HMO-POS) covers dialysis services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO-POS) with no copays, although coinsurance ranging from no coinsurance to 20% may apply depending on the item. Prior authorization is required for durable medical equipment, prosthetics, and diabetic supplies, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO-POS) covers diagnostic and radiological services, with diagnostic services requiring no coinsurance, no copay for lab services, and a $0 to $20 copay for diagnostic procedures. Radiological services require prior authorization and range from no minimum copay for diagnostic radiology to a $20 copay for outpatient X-rays and a 20% minimum coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (HMO-POS) provides Cardiac Rehabilitation Services with no coinsurance, but only some services are covered in practice. Standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for PAD are not covered and require copayments ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, requiring no 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 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO-POS) 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 under this plan.
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