A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (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 (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Spokane County Inland Empire Washington. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (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 (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 (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 $6750.00 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) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when filling your prescription at a preferred pharmacy or through preferred mail order. If you choose a standard pharmacy or standard mail order, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the fill supply. Brand-name and specialty medications are covered under a coinsurance structure instead of flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy types. Tier 5 specialty tier drugs also carry a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers affordable healthcare coverage highlighted by no copays for primary care physician visits, annual physicals, routine eye and hearing exams, and preventive dental care. Specialist visits range from no copay to a $60 copay, while inpatient hospital stays require a daily copay of $485 for the first five days. Emergency care is also highly accessible with a $130 copay that is waived if you are admitted to the hospital within 24 hours. For supplemental care, the plan provides a $1,000 annual hearing aid allowance per ear and a $100 annual eyewear allowance, both with no copays for the associated routine exams. Home health services are covered with no copay, while dialysis and durable medical equipment require a 20% coinsurance. Skilled nursing facility stays are also covered, requiring a $10 daily copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, there is a $485 daily copay for days 1 to 5 and no copay for additional days, excluding upgrades and non-Medicare-covered stays; psychiatric care requires a $465 daily copay for days 1 to 5 and no copay for days 6 to 90, with additional days not covered.
Outpatient Services See details
Outpatient Services covered by Aetna Medicare Signature (HMO) feature no coinsurance, with no copays for ambulatory surgical center and blood services. Outpatient hospital services require a $0 to $450 copay, observation services have a $485 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copay ranging from $140 to $145 and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ambulance services with a $300 copay for ground transport and 20% coinsurance for air transport, both of which require prior authorization. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $130 copay and no coinsurance, which is 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 are covered up to a $250,000 maximum with no coinsurance and copays of $130 for emergency or urgent care and $300 for emergency transportation.
Primary Care See details
Primary Care benefits under the Aetna Medicare Signature (HMO) feature primary care physician visits with no copay and no coinsurance, and specialist visits with no copay to a $60 copay and no coinsurance. Physical, occupational, mental health, and psychiatric therapies require a $40 copay and no coinsurance, telehealth services have no copay to a $60 copay and 20% coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), featuring no copay and no coinsurance for annual physicals, fitness benefits, and wellness screenings, though kidney disease education requires a 20% coinsurance and no copay. Sub-services not covered include in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), offering no copay and no coinsurance for annual routine hearing exams, fitting evaluations, and prescription hearing aids with a $1,000 maximum coverage per ear each year. Over-the-counter (OTC) hearing aids as well as 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) with no copay and no coinsurance for both eye exams and eyewear. The plan includes one routine eye exam per year and provides a $100 annual maximum benefit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (HMO) partially covers dental services, providing Medicare-covered dental for a $60 copay and no coinsurance, and preventive exams, cleanings, and x-rays with no copay and no coinsurance. Specific services such as fluoride, restorative care, endodontics, periodontics, prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with no copay and no coinsurance, although prior authorization is required. Within this benefit, Medicare Part B insulin drugs are covered with 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
Dialysis Services are covered under Aetna Medicare Signature (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and medical supplies, with no copay and a 20% coinsurance. Diabetic supplies are covered with a 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts require no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with prior authorization required. Diagnostic procedures range from no copay to a $30 copay with no coinsurance, lab and outpatient X-ray services have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO) plan, as none of the sub-services, including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered in practice. Consequently, there is no plan coverage, copay, or coinsurance for these services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, though a prior three-day inpatient hospital stay is not, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO) 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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