A non-government entity
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 Southeastern 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:
Sign up for Aetna Medicare Advantra Signature (HMO-POS)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Advantra Signature (HMO-POS) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when filling your prescription through a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order service, copays for Tier 1 drugs start at $2.00 and Tier 2 drugs start at $12.00 for a one-month supply. Brand-name and specialty medications under this plan require coinsurance rather than flat copays. Tier 3 preferred brand drugs have a 24% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs require 25% coinsurance, with specialty tier coverage limited to a one-month supply.
Additional Benefits
The Aetna Medicare Advantra Signature (HMO-POS) plan offers affordable healthcare coverage with no copay for primary care visits, annual physicals, or home health services. Specialist visits require a copay ranging from no copay to $50, while emergency room visits incur a $115 copay that is waived upon hospital admission. For hospital care, inpatient stays require a daily copay of $375 for the first seven days of acute stays, and outpatient services carry a copay up to $375 with no coinsurance. This plan also includes valuable supplemental benefits, featuring no copay for routine eye exams, routine hearing exams, and preventive dental cleanings. Hearing aids are covered with no copay up to $500 per ear annually, and eyewear is covered up to a $100 annual maximum. Additionally, comprehensive dental care is available with 20% to 50% coinsurance up to a $500 yearly limit, alongside a $15 quarterly over-the-counter allowance.
Inpatient Hospital See details
Aetna Medicare Advantra Signature (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and daily copays of $375 for days 1 to 7 of acute stays and $350 for days 1 to 5 of psychiatric stays. There is no copay for subsequent days, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers outpatient hospital services with a $0 to $375 copay and no coinsurance, and observation services with a $375 copay per stay and no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $50 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Advantra Signature (HMO-POS) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the service, you will pay either no copay or a $110 copay.
Ambulance and Transportation Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers ground ambulance services with a $300 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Advantra Signature (HMO-POS) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 lifetime maximum with no coinsurance and copays ranging from $115 to $300.
Primary Care See details
Aetna Medicare Advantra Signature (HMO-POS) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while chiropractic services are not covered under this plan.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Advantra Signature (HMO-POS) with no copay and no coinsurance for annual physicals, health education, fitness benefits, and select screenings, while kidney disease education requires no copay and a 20% coinsurance. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems (PERS), 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 services.
Hearing Services See details
Hearing services under Aetna Medicare Advantra Signature (HMO-POS) are partially covered with no deductible and no coinsurance. Medicare-covered exams require a $50 copay and no coinsurance, while routine exams, fitting evaluations, and prescription hearing aids (up to $500 per ear annually) have no copay and no coinsurance. OTC hearing aids, along with inner ear, outer ear, and over-the-ear prescription hearing aids, are not covered.
Vision Services See details
Aetna Medicare Advantra Signature (HMO-POS) covers vision services with no deductibles and no coinsurance, offering annual routine eye exams and follow-up diabetic exams with no copay, and Medicare-covered exams with a copay ranging from no copay to $50. Covered eyewear, including contacts, eyeglasses, lenses, frames, and upgrades, has no copay and is subject to a combined annual maximum benefit of $100.
Dental Services See details
Aetna Medicare Advantra Signature (HMO-POS) provides partially covered dental services, with Medicare-covered dental requiring a $50 copay and no coinsurance. Preventive services like exams and cleanings feature no copay and no coinsurance, while covered comprehensive services have no copay and 20% to 50% coinsurance up to a $500 annual limit. Fluoride treatment, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Advantra Signature (HMO-POS) 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 of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under Aetna Medicare Advantra Signature (HMO-POS) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Advantra Signature (HMO-POS) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copayments and coinsurance ranging from 0% 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 Advantra Signature (HMO-POS) with no copay or coinsurance for lab services and diagnostic tests. Outpatient X-rays require a $25 copay, therapeutic radiological services incur a 20% coinsurance, and prior authorization is required.
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 under Aetna Medicare Advantra Signature (HMO-POS) with no copay and no coinsurance. However, only some services are covered in practice, as standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Advantra Signature (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $213 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Advantra Signature (HMO-POS) partially covers other services with no copay and no coinsurance, including meal benefits for chronic illness, annual wellness exams, and a $15 quarterly over-the-counter reimbursement. Acupuncture is not covered under this benefit.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved