A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare 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 Signature (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Galveston County. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that Aetna Medicare 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 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 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 $9250.00 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 (HMO) prescription drug plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order service, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36. Brand-name and specialty medications are subject to coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy and mail-order options. Note that Tier 5 specialty medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan provides robust medical coverage featuring a five-dollar copay for primary care visits and specialist visits starting with no copay. Emergency care requires a one-hundred-fifteen-dollar copay, which is waived upon admission, while inpatient hospital stays carry a three-hundred-ninety-five-dollar copay for the first six days before transitioning to no copay. Outpatient services, diagnostic lab tests, and home health care are also highly affordable, with many of these services requiring no copay. For dental, vision, and hearing needs, the plan offers routine exams and preventive dental cleanings with no copay or coinsurance. Members benefit from a one-hundred-twenty-five-dollar annual eyewear allowance, a five-hundred-dollar annual hearing aid allowance, and a fifteen-dollar quarterly over-the-counter allowance. Comprehensive dental services are also available with coinsurance ranging from twenty to fifty percent up to a one-thousand-dollar annual limit.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (HMO) with no coinsurance, though prior authorization is required. For acute stays, there is a $395 copay for days 1 through 6 and no copay for days 7 and beyond, while psychiatric stays carry a $300 copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered under the Aetna Medicare Signature (HMO) plan feature no coinsurance, with ambulatory surgical center and outpatient blood services also requiring no copay. Outpatient hospital visits require a copay of $0 to $400, observation services carry a $395 copay per stay, and outpatient substance abuse sessions cost a $50 copay, with prior authorization required for several services.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copayment of either $80.00 or $110.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services under Aetna Medicare Signature (HMO) cover ground ambulance services with a $320 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay (waived if admitted within 24 hours) and urgent care with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum with no coinsurance, requiring a $115 copay for emergency or urgent care and a $320 copay for emergency transportation.
Primary Care See details
Primary care benefits under Aetna Medicare Signature (HMO) are partially covered, offering primary care visits for a $5 copay and specialist visits for a $0 to $55 copay, both with no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Other covered services like therapy and mental health require a $35 to $55 copay and no coinsurance, though podiatry, routine chiropractic, and other chiropractic services are not covered.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (HMO) are partially covered, featuring no copay and no coinsurance for an annual physical exam, select screenings, and supplemental benefits like memory fitness and health education. Kidney disease education is covered with no copay and a 20% coinsurance, while several other services, such as in-home support and nutritional benefits, are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), with Medicare-covered exams requiring a $55 copay and no coinsurance, while routine annual exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are covered up to $500 annually with no copay and no coinsurance, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no copay, no coinsurance, and no deductible. This benefit includes one routine eye exam per year, unlimited follow-up diabetic eye exams, and eyewear—including contacts, eyeglasses, and upgrades—up to a combined maximum benefit of $125 annually.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Signature (HMO) plan, offering preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental with a $55 copay and no coinsurance. Comprehensive services require no copay and 20% to 50% coinsurance up to a $1,000 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO) with no copays, though coinsurance ranging from 0% to 20% applies to durable medical equipment, prosthetics, medical supplies, and diabetic equipment. Prior authorization is required for these services, and diabetic supplies may be limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with no coinsurance and no copay for lab services, and a $0 to $50 copay for diagnostic procedures. Outpatient X-rays require a $5 copay, while therapeutic radiological services carry a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare 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 offered by Aetna Medicare Signature (HMO) with no coinsurance and a required referral, but only some services are covered. Specifically, standard cardiac rehabilitation, intensive cardiac rehabilitation, and SET for PAD services (each requiring a $20 copay), as well as pulmonary rehabilitation services (requiring a $15 copay), are not covered under this plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, and a $218 daily copay for days 21 through 100, though additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services with no copay and no coinsurance, offering a fifteen-dollar quarterly over-the-counter allowance alongside annual wellness exams and select cancer screenings. Acupuncture and meal benefits are not covered under this plan.
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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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