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 Washoe County. This plan received an overall rating of 3 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 $4150.00 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 drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service. If you choose standard pharmacies or standard mail order, Tier 1 drugs carry a copay starting at $2, while Tier 2 drugs start at a $12 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance across both preferred and standard networks. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. Specialty drugs are limited to a one-month supply under this plan's coverage terms.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive coverage for essential medical needs, featuring no copay or coinsurance for primary care visits and routine preventive care. For specialist visits, members pay a $65 copay, while inpatient hospital stays require a $475 daily copay for the first six days with no coinsurance. Emergency room visits carry a $150 copay, which is waived if you are admitted, and ground ambulance services require a $315 copay. Members also benefit from extra dental, vision, and hearing coverage, including routine eye exams and eyewear with no copay, and routine hearing exams and hearing aids up to $1,000 per ear with no copay. Preventive dental care is available with no copay, while comprehensive dental services require no copay and a 20% to 50% coinsurance up to a $500 annual limit. Diagnostic services like lab tests and outpatient X-rays are also highly accessible, requiring no copay or a low copay up to $10.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) inpatient hospital care is covered with no coinsurance, requiring a $475 copay for days 1 to 6 of acute stays and a $370 copay for days 1 to 5 of psychiatric stays, with no copays for subsequent days. While unlimited additional acute days are covered with no copay, non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance, including outpatient hospital services which carry a $0 to $475 copay and observation services with a $475 copay per stay. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance. Outpatient substance abuse sessions are also covered with no coinsurance and a $40 copay per individual or group session.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with a copay of either $55.00 or $180.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground ambulance services with a $315 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay. Prior authorization is required for ambulance services, and transportation services are not covered.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (HMO) are covered with a $150 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum limit with copays ranging from $150 to $315 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $65 copay and no coinsurance. Physical, occupational, and speech therapies have a $25 copay and no coinsurance, whereas mental health, psychiatric, and opioid services have a $40 copay and no coinsurance. Telehealth services feature a $0 to $65 copay with 20% coinsurance, but podiatry and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (HMO) partially covers preventive services, offering most covered options like annual physicals and fitness benefits with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services 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 or dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance for routine exams, fitting evaluations, and prescription hearing aids up to $1,000 per ear annually. However, the benefit is only partially covered, as OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO) with no deductibles, copays, or coinsurance for exams and eyewear. This benefit includes one routine eye exam per year and a $100 annual maximum allowance for eyewear, including contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), with Medicare-covered dental requiring a $65 copay and no coinsurance, and preventive care like exams, cleanings, and x-rays available with no copay and no coinsurance. Covered comprehensive services have no copay and 20% to 50% coinsurance up to a $500 annual limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive 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. Covered Medicare Part B insulin has a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and miscellaneous drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance up to 20%. Prior authorization is required for these covered items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic and radiological services with prior authorization, featuring no coinsurance and a $0 to $10 copay for diagnostic tests and lab services. Outpatient X-rays and diagnostic radiology services have no copay, while therapeutic radiological services require 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 covered by Aetna Medicare Signature (HMO) with no copay and no coinsurance. While some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (HMO) with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required for admission, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, meal benefits, and dual-eligible SNP services 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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