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 2026 to people living in El Paso 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) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail order, copays start at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Brand-name and specialty medications on this plan require coinsurance instead of flat copayments. Tier 3 preferred brand drugs have a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. Additionally, Tier 5 specialty drugs are limited to a one-month supply regardless of whether you use a preferred or standard pharmacy.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers affordable access to essential medical care, featuring no copays for primary care doctor visits, annual physical exams, and home health services. Specialist visits range from a $0 to $50 copay, while emergency room visits require a $115 copay that is waived if you are admitted. For hospital stays, inpatient care requires a $395 daily copay for the first six days followed by no copay for additional days, while outpatient services range from no copay up to a $350 copay. This plan also includes valuable supplemental benefits, such as preventive dental care, routine eye exams, and routine hearing tests with no copays or coinsurance. Prescription hearing aids are covered up to $500 per ear annually, and you receive up to $100 per year for eyewear and $30 every three months for over-the-counter items with no copay. Comprehensive dental services are covered up to a $1,000 annual limit with no copay and 20% to 50% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring a $395 daily copay for days 1 to 6 of acute stays (followed by no copay for unlimited additional days) and a $300 daily copay for days 1 to 6 of psychiatric stays. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $350 copay and observation services with a $395 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $35 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copay of either $80.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services under Aetna Medicare Signature (HMO) require prior authorization, featuring a $250 copay and no coinsurance for ground ambulance, and a 20% coinsurance and no copay for air ambulance. For transportation, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services are covered with a $40 copay and no coinsurance, and worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $115 to $250.
Primary Care See details
Aetna Medicare Signature (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Chiropractic benefits are partially covered, as routine chiropractic and all podiatry services are not covered, while covered physical, occupational, and mental health therapies require a $35 copay and no coinsurance. Additional telehealth benefits are also available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO), featuring an annual physical exam, fitness benefits, and health education with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Several supplemental options are not covered under this plan, including medical nutrition therapy, weight management programs, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Aetna Medicare Signature (HMO) provides partially covered hearing services, featuring Medicare-covered exams with a $50 copay and no coinsurance, plus annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear yearly 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 Signature (HMO) covers vision services with no copay, no coinsurance, and no deductible, including one routine eye exam and follow-up diabetic eye exams annually. Eyewear, including contact lenses, eyeglasses, frames, and upgrades, is also covered with no copay or coinsurance up to a combined maximum limit of $100 per year.
Dental Services See details
Aetna Medicare Signature (HMO) partially covers dental services, offering preventive care like exams, cleanings, and X-rays with no copay and no coinsurance, alongside Medicare-covered dental for a $50 copay and no coinsurance. Comprehensive services are covered up to a $1,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, other diagnostic, other preventive, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Signature (HMO) with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
The Aetna Medicare Signature (HMO) plan covers Dialysis Services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment benefits under Aetna Medicare Signature (HMO) are covered with no copay and coinsurance ranging from no coinsurance to 20% for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices require a 20% coinsurance with no copay, and diabetic therapeutic shoes or inserts are covered with no copay.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic services with no coinsurance, offering lab services with no copay and diagnostic tests with a copay of $0 to $50. Radiological services are also covered, featuring outpatient X-rays with no copay, diagnostic radiology with a minimum $0 copay, and therapeutic radiology with a minimum 20% coinsurance. Prior authorization is required for these services, and diagnostic services also require a referral.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered by Aetna Medicare Signature (HMO) with no coinsurance and a required referral, though only some services are covered. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered, carrying copayments of $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and coverage does not extend to additional days beyond the standard Medicare-covered 100 days.
Other Services See details
Other services covered by Aetna Medicare Signature (HMO) include over-the-counter (OTC) items up to $30 every three months, annual wellness exams and screening mammographies, and additional gFOBT and FIT screenings, all with no copay and no coinsurance. Acupuncture and meal benefits are not covered.
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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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