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Aetna Medicare Advantra Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra 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 Advantra Signature (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Advantra Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Northeastern 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 (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 (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 (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 $7500.00 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 (HMO-POS) plan features an annual prescription 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 choose a standard pharmacy or standard mail order, Tier 1 drug copays start at $2 and Tier 2 drug copays start at $12. Higher-tier medications on this plan require coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options. Non-preferred drugs in Tier 4 and specialty drugs in Tier 5 both require a 25% coinsurance for your prescription needs.
Additional Benefits
The Aetna Medicare Advantra Signature (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care doctor visits, routine preventive screenings, and home health care. Specialist visits, outpatient therapy, and Medicare-covered dental and hearing exams require a $35 copay with no coinsurance. For more intensive care, inpatient hospital stays require a $475 copay per stay, while emergency room visits carry a $115 copay that is waived if you are admitted. This plan also includes valuable supplemental benefits, featuring no copay and no coinsurance for routine dental cleanings, annual eye exams, and routine hearing tests. Prescription hearing aids are covered up to $500 per ear annually, and eyewear is covered up to a combined maximum of $125 per year. Additionally, members receive a $30 quarterly over-the-counter allowance, though certain specialized services like dialysis and durable medical equipment will require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Advantra Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, there is a $475 copay per stay, whereas psychiatric care requires a $350 daily copay for days 1 through 5 and no copay for days 6 through 90. Upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Advantra Signature (HMO-POS) with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital and observation services require a copay of $0 to $325, while individual and group outpatient substance abuse sessions carry a $35 copay.
Partial Hospitalization See details
Aetna Medicare Advantra Signature (HMO-POS) covers partial hospitalization services with no coinsurance and either no copay or a $110 copay, depending on the service. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Advantra Signature (HMO-POS) require prior authorization, costing a $300 copay with no coinsurance for ground transport and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Advantra Signature (HMO-POS) with a $115 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services have a $40 copay and no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 limit with no coinsurance, requiring a $115 copay for medical care and a $300 copay for emergency transportation.
Primary Care See details
Aetna Medicare Advantra Signature (HMO-POS) covers primary care physician services with no copay and no coinsurance, while specialist visits, therapy services, and mental health care require a $35 copay and no coinsurance. Chiropractic care is partially covered with a $15 copay and no coinsurance for routine care (up to 12 visits per year), though other chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered under Aetna Medicare Advantra Signature (HMO-POS) with no copay and no coinsurance for annual physicals, screenings, and select supplemental benefits, though kidney disease education requires a 20% coinsurance and no copay. Excluded services include 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/bathroom safety devices, and counseling.
Hearing Services See details
Hearing Services are partially covered by Aetna Medicare Advantra Signature (HMO-POS), featuring a $35 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for routine annual exams and fittings. Up to $500 per ear is covered annually for prescription hearing aids with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, including annual routine eye exams and follow-up diabetic eye exams with no copay. Eyewear is also covered with no copay and no coinsurance up to a combined maximum of $125 per year, though Medicare-covered eye exams may require a copay of up to $35.
Dental Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers Medicare-covered dental services for a $35 copay and no coinsurance, while preventive services like exams and cleanings are fully covered with no copay and no coinsurance. Comprehensive dental services are partially covered with no copay and 20% to 50% coinsurance up to a $500 annual maximum, though other diagnostic services, fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Aetna Medicare Advantra Signature (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and prior authorization required. Coinsurance ranges from no coinsurance up to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Advantra Signature (HMO-POS) plan, with prior authorization required for these services. Diagnostic procedures, lab services, and diagnostic radiological services are provided with no copay and no coinsurance, while outpatient X-rays require a $15 copay and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Advantra Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Advantra Signature (HMO-POS) with no copay and no coinsurance; however, only some services are covered, while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Advantra Signature (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Advantra Signature (HMO-POS), offering no copay and no coinsurance for a $30 quarterly over-the-counter allowance, chronic illness meal benefits, annual wellness exams, screening mammographies, and additional colorectal screenings. Acupuncture and dual eligible SNP highly integrated services are not covered under this benefit.
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