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Aetna Medicare Signature Extra (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Houston and Surrounding Counties. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 Extra (HMO) plan features an annual drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, there is no copay when filled at preferred pharmacies or through preferred mail-order services. Standard pharmacy and standard mail-order options for these generic tiers require a copay, ranging from $2 to $12 for a one-month supply. For higher-tier medications, Tier 3 (Preferred Brand) drugs require a 24% coinsurance across all pharmacy and mail-order channels. Tier 4 (Non-Preferred Drug) and Tier 5 (Specialty Tier) prescriptions both have a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (HMO) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. Specialist visits require a low copay of up to $40, while emergency room visits carry a $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay a daily copay of $350 for the first five days of acute care with no coinsurance. This plan also includes valuable extra benefits to support your overall wellness, including routine vision and dental care with no copayments. You will receive up to $175 annually for eyewear and up to $2,500 yearly for comprehensive dental services with no copay and 20% to 50% coinsurance. Additionally, the plan provides a quarterly allowance of $60 with no copay for over-the-counter health products and covers routine hearing exams at no cost.
Inpatient Hospital See details
Aetna Medicare Signature Extra (HMO) partially covers inpatient hospital services with no coinsurance, requiring a $350 daily copay for days 1 to 5 of acute stays and a $300 daily copay for days 1 to 6 of psychiatric stays, followed by no copay for remaining days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient Services covered by Aetna Medicare Signature Extra (HMO) feature no coinsurance across all services, though prior authorization is required for many. Patients pay a $0 to $250 copay for outpatient hospital services, a $350 copay per stay for observation services, and a $35 copay for substance abuse sessions, while ambulatory surgical center and blood services have no copay and no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered by Aetna Medicare Signature Extra (HMO) with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature Extra (HMO) require prior authorization, featuring a $310 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Routine transportation services to plan-approved or health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature Extra (HMO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgent care with a $50 copay, with no coinsurance for either service. Worldwide emergency and urgent services are also covered up to a $250,000 limit with no coinsurance and copays of $130 for care or $310 for emergency transportation.
Primary Care See details
Aetna Medicare Signature Extra (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies, alongside mental health and psychiatric sessions, have a $35 copay and no coinsurance. Podiatry is not covered, chiropractic services are partially covered since routine and other chiropractic services are not covered, and telehealth is available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (HMO), with no copay and no coinsurance for annual physicals, health education, and routine screenings, though kidney disease education requires a 20% coinsurance and no copay. Supplemental options like in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and nutritional/dietary benefits are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (HMO) covers hearing services with no deductible, offering Medicare-covered exams for a $40 copay and no coinsurance, alongside annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $750 annual limit per ear, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Extra (HMO) with no deductible, no copay, and no coinsurance for eye exams and eyewear. Covered benefits include one routine eye exam annually and a combined maximum benefit of $175 per year for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature Extra (HMO) partially covers dental services, offering Medicare-covered dental for a $40 copay and no coinsurance, alongside preventive care like exams and cleanings with no copay or coinsurance. Comprehensive dental services are covered up to a $2,500 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, and certain other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Extra (HMO) with no copay and no coinsurance, although prior authorization is required. Part B insulin drugs require a $35 copay and no coinsurance, while other Part B drugs, including chemotherapy, carry a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature Extra (HMO) with no copay and a 20% coinsurance, and prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature Extra (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for most equipment, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (HMO), featuring no copay for lab services and outpatient X-rays, and a $0 to $50 copay with no coinsurance for diagnostic procedures and tests. Diagnostic radiological services have no copay, while therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature Extra (HMO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Extra (HMO) covers some cardiac rehabilitation services with no copay, no coinsurance, and a required referral. However, cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for peripheral artery disease (PAD) rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Extra (HMO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. You will pay a daily copayment of $10 for days 1 through 20 and $218 for days 21 through 100, though additional days beyond the standard Medicare benefit are not covered.
Other Services See details
Aetna Medicare Signature Extra (HMO) partially covers other services with no copay and no coinsurance, including an annual wellness exam, screening mammography, and additional colorectal cancer screenings. Eligible over-the-counter (OTC) items are also covered with no copay and no coinsurance up to $60 every three months, while acupuncture and meal benefits are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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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