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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 COC, MAR, MOH, PIM and YAV Counties. 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 $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 (HMO) plan offers enhanced alternative prescription drug coverage with an annual drug deductible of $615.00. Once this deductible is met, the initial coverage phase begins and lasts until total drug costs reach $2,100.00. During this initial phase, Tier 1 preferred generic drugs have no copay when filled at preferred pharmacies or through preferred mail order, and a $12.00 copay at standard pharmacies or standard mail. For other drug tiers, you will pay a 24% coinsurance for Tier 2 standard generic drugs and a 25% coinsurance for both Tier 3 preferred brand and Tier 4 non-preferred drugs. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D drugs.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers affordable coverage for core healthcare needs, featuring no copay for primary care visits and a $75 copay for specialist visits. For hospital services, inpatient stays require a daily copay for the first few days with no coinsurance, while emergency room visits carry a $130 copay. Outpatient services and home health care are also covered, with many services featuring no copay and no coinsurance. In addition to medical care, this plan includes valuable preventive, dental, vision, and hearing benefits. Members pay no copay and no coinsurance for routine dental cleanings, annual eye exams, and hearing evaluations, with allowances for prescription hearing aids and eyewear. The plan also supports overall wellness by offering fitness benefits and an over-the-counter item allowance with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services, requiring a $430 daily copay for days 1 through 7 of an acute stay and a $370 daily copay for days 1 through 5 of a psychiatric stay, with no copay thereafter and no coinsurance. Prior authorization is required, and specific sub-services like upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services are covered by Aetna Medicare Signature (HMO) with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Other covered benefits include outpatient substance abuse sessions with a $40 copay, observation services with a $430 copay per stay, and outpatient hospital services with a copay ranging from $0 to $435.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization benefits with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required to access these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. While some transportation services are covered, trips to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed care is available for a $50 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 maximum with copays between $130 and $275 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care visits with no copay and no coinsurance, while specialist visits require a $75 copay and no coinsurance. Telehealth services are available with a $0 to $75 copay and a 20% coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (HMO), offering zero-dollar preventive care, annual physicals, and fitness benefits with no copay and no coinsurance. Kidney disease education services are covered with a 20% coinsurance and no copay. Uncovered services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (HMO) partially covers hearing services, providing routine hearing exams, fitting evaluations, and prescription hearing aids with no copay or coinsurance, up to a $1,000 annual maximum per ear. OTC hearing aids, as well as 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 copay and no coinsurance, including one routine eye exam per year and follow-up diabetic eye exams. Eyewear, including contact lenses and eyeglasses, is also covered with no copay or coinsurance up to a combined annual maximum benefit of $100.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), with no coverage for fluoride treatments, maxillofacial prosthetics, implant services, and orthodontics. Preventive services like exams, cleanings, and x-rays are available with no copay and no coinsurance, while covered comprehensive services require 20% to 50% coinsurance (with no copay) up to a $500 yearly limit, and Medicare-covered dental services require a $75 copay and no coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with prior authorization, offering Medicare Part B insulin drugs for a $35 copay and no coinsurance. Other covered Part B chemotherapy, radiation, and miscellaneous drugs require no copay and a coinsurance ranging from no coinsurance up to 20%.
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 covered services.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, prosthetics, and diabetic supplies, with prior authorization required. These benefits feature coinsurance ranging from no coinsurance to 20%, and no copay for diabetic therapeutic shoes and inserts.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (HMO) plan, with prior authorization required. Lab services feature no copay or coinsurance, outpatient X-rays require a $20 copay with no coinsurance, and diagnostic tests carry a $0 to $20 copay with no coinsurance. Diagnostic radiology requires a $0 to $250 copay with no coinsurance, while therapeutic radiology has a 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO) 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 Signature (HMO) plan, as specific services including Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization and excluding coverage for additional days beyond the Medicare-covered limit. Covered stays require no coinsurance, charging a daily copay of $10 for days 1 through 20 and $218 for days 21 through 100.
Other Services See details
Aetna Medicare Signature (HMO) partially covers other services with no copay and no coinsurance for covered options, including over-the-counter (OTC) items up to $15 every three months, annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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