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 Los Angeles and Orange 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 $599.00 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 Enhanced Alternative benefit design with a yearly drug deductible of $615. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies and preferred mail order, or a $12 copay at standard pharmacies and standard mail. For Tier 2 standard generic drugs, the plan charges a 24% coinsurance across all network pharmacies and mail-order options. For Tier 3 preferred brand drugs and Tier 4 non-preferred drugs, you will pay a 25% coinsurance regardless of the pharmacy type you choose. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase where you pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the full Low-Income Subsidy program will pay $0 for their Part D coverage.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust coverage with no copay and no coinsurance for many essential services, including primary care, specialist visits, routine vision and hearing exams, and preventive care. For inpatient hospital stays, members pay a daily copay of $190 for the first five days and no copay for days six through 90. Outpatient hospital services, diagnostic tests, and urgent care also feature no copay, while emergency room visits require a $150 copay that is waived if admitted. Supplemental benefits include dental care with no copay for preventive services and a 20% to 50% coinsurance for comprehensive services up to a $1,000 annual limit. Vision and hearing benefits provide routine exams with no copay, alongside allowances of $100 for eyewear and $1,250 per ear for prescription hearing aids. Durable medical equipment and dialysis require no copay with coinsurance up to 20%, ensuring affordable access to necessary medical supplies and treatments.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered. Covered acute and psychiatric stays require prior authorization and cost a $190 daily copay for days 1 through 5, with no copay for days 6 through 90 and no coinsurance.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance. There is no copay for outpatient hospital, ambulatory surgical center, outpatient blood, and outpatient substance abuse services, while observation services require a $190 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO) with copays ranging from no copay to $180 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Aetna Medicare Signature (HMO), as transportation services to health-related locations are not covered. Covered ground ambulance services require a $275 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature (HMO) covers emergency services with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care has no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum benefit limit with copays ranging from $150 to $275 and no coinsurance.
Primary Care See details
Primary care benefits are partially covered by Aetna Medicare Signature (HMO), as podiatry services are not covered. Most covered services, including primary care, chiropractic, and specialist visits, feature no copay and no coinsurance, while telehealth benefits require no copay and a 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO), with most covered services, including annual physicals and diabetes training, requiring no copay and no coinsurance. Kidney disease education is covered with a 20% coinsurance and no copay, but several sub-services—including in-home safety assessments, medical nutrition therapy, personal emergency response systems, and weight management programs—are not covered.
Hearing Services See details
Aetna Medicare Signature (HMO) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $1,250 per ear annually, but 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 (HMO) with no copay and no coinsurance for both eye exams and eyewear. This benefit includes one routine eye exam and unlimited follow-up diabetic eye exams per year, as well as a $100 annual maximum allowance for contact lenses, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), excluding fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics. Covered preventive services require no copay and no coinsurance, while covered comprehensive services require 20% to 50% coinsurance and no copay, up to a $1,000 annual limit.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with prior authorization required, offering Medicare Part B insulin drugs for a $35 copay and no coinsurance. Other Part B chemotherapy, radiation, and miscellaneous drugs are covered with no copay and coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis services are covered by the Aetna Medicare Signature (HMO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive this covered benefit.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment, with prior authorization required for some services. Beneficiaries will pay no copay for these benefits, with coinsurance ranging from no coinsurance up to 20% depending on the specific item.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with no coinsurance. There is no copay for diagnostic tests, lab services, diagnostic radiological services, and outpatient X-rays, while therapeutic radiological services require a $60 copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance. Prior authorization is required to access this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered under the Aetna Medicare Signature (HMO) plan, and while some services are covered, specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered in practice.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $20 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond those covered by Medicare are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO), offering acupuncture, annual wellness exams, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Over-the-counter (OTC) items, meal benefits, and Dual Eligible SNPs with highly integrated services are not covered.
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