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Aetna Medicare Advantra Signature Plus (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra Signature Plus (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 Advantra Signature Plus (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Advantra Signature Plus (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Northwestern Pennsylvania. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Advantra Signature Plus (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 Advantra Signature Plus (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 Advantra Signature Plus (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 Advantra Signature Plus (HMO-POS) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using preferred pharmacies or preferred mail order for one, two, or three-month supplies. If you choose standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the supply duration. Higher-tier medications require coinsurance rather than flat copays across all pharmacy types. You will pay a 24% coinsurance for Tier 3 preferred brand drugs and a 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs also carry a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Advantra Signature Plus (HMO-POS) plan offers comprehensive medical coverage with no copay or coinsurance for primary care visits and routine preventive services. For specialized medical needs, members pay a copay of up to $35 for specialist visits and a $425 copay per stay for acute inpatient hospital care. Emergency room visits require a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes robust dental, vision, and hearing benefits, featuring no copays for routine exams alongside allowance benefits for eyewear and hearing aids. Preventive dental care has no copay, and comprehensive dental services are covered up to a $1,000 annual limit with 20% to 50% coinsurance. Additionally, home health services are available with no copay, and members receive coverage for over-the-counter products.
Inpatient Hospital See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $425 copay per stay for acute care and a $350 copay for days 1 through 5 (no copay for days 6 through 90) for psychiatric care. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers outpatient services with no coinsurance, featuring a $0 to $250 copay for outpatient hospital services and a $250 copay per stay for observation services. Ambulatory surgical center and blood services are covered with no copays or coinsurance, while outpatient substance abuse sessions require a $35 copay with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers partial hospitalization services with no coinsurance and either no copay or a $145 copay. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services under Aetna Medicare Advantra Signature Plus (HMO-POS) include ground ambulance with a $240 copay and no coinsurance, and air ambulance with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) 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 require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to $250,000 with no coinsurance and copays ranging from $130 to $240.
Primary Care See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, and mental health services require copays up to $35 and no coinsurance. Chiropractic services are partially covered, offering routine care for a $15 copay and no coinsurance, but other chiropractic services are not covered. Additional telehealth benefits are also available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers preventive services with no copay and no coinsurance for most benefits like annual physical exams, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered, excluding in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers hearing services, featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine annual exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear yearly, though inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services covered by Aetna Medicare Advantra Signature Plus (HMO-POS) include routine and diabetic eye exams with no copay and no coinsurance, while Medicare-covered exams have a copay of $0 to $35 and no coinsurance. Eyewear, including contacts and eyeglasses, is also covered with no copay and no coinsurance up to a combined maximum allowance of $225 per year.
Dental Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers preventive dental services with no copay and no coinsurance, while Medicare-covered dental services require a $35 copay and no coinsurance. Comprehensive services are partially covered up to a $1,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Advantra Signature Plus (HMO-POS) with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy and other drugs have a 0% to 20% coinsurance with no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Advantra Signature Plus (HMO-POS) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Advantra Signature Plus (HMO-POS) with no copay, though prior authorization is required for services. Durable medical equipment, medical supplies, and diabetic supplies carry coinsurance ranging from no coinsurance to 20%, while prosthetic devices and diabetic therapeutic shoes or inserts require 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Advantra Signature Plus (HMO-POS) with no copay or coinsurance for lab services, diagnostic tests, and diagnostic radiology. Outpatient X-rays require a $20 copay, therapeutic radiological services have a 20% coinsurance, and prior authorization is required.
Home Health Services See details
Home health services are covered by Aetna Medicare Advantra Signature Plus (HMO-POS) with no copay and no coinsurance. Prior authorization is required to receive these services.
Cardiac Rehabilitation Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) does not cover Cardiac Rehabilitation Services. This non-coverage applies to all related sub-services, including intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Advantra Signature Plus (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required for admission, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Aetna Medicare Advantra Signature Plus (HMO-POS) provides partially covered Other Services with no copay and no coinsurance for covered items such as Over-the-Counter (OTC) products, chronic illness meal benefits, annual wellness exams, and additional gFOBT and FIT. Acupuncture is not covered under this plan.
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