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Aetna Medicare Advantra Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra 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 Advantra Signature (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Advantra Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Kent, New Castle, Sussex counties. 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) 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).
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), 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 $6500.00 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)
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Drug Coverage
The Aetna Medicare Advantra Signature (HMO) plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, there is no copay when you use a preferred pharmacy or preferred mail-order service. If you use standard pharmacies or standard mail order, copays start at $2 for Tier 1 drugs and $12 for Tier 2 drugs. For brand-name and specialty medications, your costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty drugs also carry a 25% coinsurance, which applies to a one-month supply across all pharmacy and mail-order options.
Additional Benefits
The Aetna Medicare Advantra Signature (HMO) plan offers robust medical coverage featuring no copay for primary care visits, annual physicals, routine diagnostic lab tests, and home health services. Specialist visits, urgent care, and Medicare-covered therapies are highly affordable, requiring low copays ranging from $0 to $50. For inpatient hospital stays, members pay a daily copay of $300 for the first seven days of acute care with no coinsurance. Ancillary benefits include no copay for routine vision and hearing exams, along with allowances of up to $200 for eyewear and $500 for prescription hearing aids. Preventive dental care is also covered with no copay, while comprehensive dental services require a 20% to 50% coinsurance up to a $750 annual limit. Additionally, members can take advantage of a $45 quarterly over-the-counter reimbursement allowance to help cover everyday health wellness needs.
Inpatient Hospital See details
Aetna Medicare Advantra Signature (HMO) covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 to 7 of acute stays and a $350 daily copay for days 1 to 5 of psychiatric stays, with no copay for subsequent covered days. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Advantra Signature (HMO) with no coinsurance, featuring a $0 to $300 copay for outpatient hospital services, a $300 copay per stay for observation services, and a $30 copay for outpatient substance abuse sessions. Ambulatory surgical center services and outpatient blood services are also covered with no copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Advantra Signature (HMO) covers partial hospitalization with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Advantra Signature (HMO) covers ground ambulance services with a $285 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Advantra Signature (HMO) 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 and urgent services are covered up to a $250,000 maximum with no coinsurance and a $130 copay, while worldwide emergency transportation is covered with a $285 copay and no coinsurance.
Primary Care See details
Aetna Medicare Advantra Signature (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits and other healthcare professionals require a $0 to $30 copay with no coinsurance. Physical, occupational, speech, psychiatric, and mental health therapies have a $30 copay and no coinsurance, whereas chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Advantra Signature (HMO), offering no copay and no coinsurance for annual physicals, screenings, and health education, while kidney disease education requires no copay and a 20% coinsurance. Sub-services that are not covered 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 and bathroom safety devices, and counseling services.
Hearing Services See details
Aetna Medicare Advantra Signature (HMO) covers Medicare-covered hearing exams for a $30 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $500 annual maximum, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Advantra Signature (HMO) covers vision services with no coinsurance, featuring a $0 to $30 copay for Medicare-covered eye exams and no copay for an annual routine exam. Eyewear is also covered with no copay and no coinsurance, offering up to a $200 annual maximum benefit for contacts, frames, lenses, and upgrades.
Dental Services See details
Aetna Medicare Advantra Signature (HMO) provides partially covered dental services, featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive cleanings, exams, and x-rays. Comprehensive dental services require no copay and 20% to 50% coinsurance up to a $750 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Advantra Signature (HMO) with no copay, though prior authorization is required. Under this benefit, covered Medicare Part B chemotherapy and other drugs require no copay and 0% to 20% coinsurance, while Part B insulin is available with a $35 copay and no coinsurance.
Dialysis Services See details
The Aetna Medicare Advantra Signature (HMO) 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 Advantra Signature (HMO) with no copay and coinsurance ranging from no coinsurance up to 20% depending on the item. This benefit covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment, all of which require prior authorization.
Diagnostic and Radiological Services See details
Aetna Medicare Advantra Signature (HMO) covers diagnostic procedures and lab tests with no copay and no coinsurance. Diagnostic radiological services feature a $0 minimum copay, while outpatient X-rays require a $25 copay with coinsurance, and therapeutic radiological services incur a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Advantra Signature (HMO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Advantra Signature (HMO) plan, meaning there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, or SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Advantra Signature (HMO) with no coinsurance, requiring a daily copayment of $10 for days 1 through 20 and $218 for days 21 through 100. Prior authorization is required and a prior three-day hospital stay is not needed, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Advantra Signature (HMO) partially covers other services with no copay and no coinsurance, though acupuncture is not covered. Covered benefits include a $45 quarterly over-the-counter reimbursement allowance, chronic illness meal benefits, annual wellness exams, and additional colorectal screenings.
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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.
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