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 Kern 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 $2000.00 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 Enhanced Alternative drug benefit with an annual prescription drug deductible of $615.00. After meeting this deductible, Tier 1 preferred generic drugs have no copay at preferred pharmacies or through preferred mail order, but require a $12.00 copay at standard pharmacies and standard mail. For other tiers, you will pay a 24% coinsurance for Tier 2 standard generics and a 25% coinsurance for Tier 3 preferred brands 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 pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care, specialist, and routine preventive visits. For hospital stays, members pay a $300 daily copay for the first five days of inpatient care, with subsequent days through day 90 requiring no copay or coinsurance. Emergency room visits carry a $150 copay that is waived upon admission, while urgently needed services require no copay and no coinsurance. Routine vision, hearing, and preventive dental services are covered with no copay or coinsurance, including a $100 annual allowance for eyewear and up to $500 per ear annually for prescription hearing aids. Comprehensive dental care requires no copay but carries a 20% to 50% coinsurance up to a $500 annual limit. Diagnostic tests, lab services, and standard X-rays also feature no copay and no coinsurance, helping to keep out-of-pocket costs predictable.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services, which require a $300 daily copay for days 1 through 5 and no copay or coinsurance for days 6 through 90. Upgrades, non-Medicare-covered stays, and additional days for psychiatric hospitalizations are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (HMO) with no coinsurance, featuring a $150 copay for outpatient hospital services, a $300 copay per stay for observation services, and a $100 copay for ambulatory surgical center services. Additionally, outpatient substance abuse sessions and blood services are covered with no copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature (HMO) subject to prior authorization, with cost-sharing ranging from no copay to a $180.00 copay and no coinsurance.
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, with prior authorization required. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (HMO) with a $150 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require no copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 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, such as primary care physician, specialist, and therapy visits, feature no copay and no coinsurance, while additional telehealth benefits require a 20% coinsurance and no copay.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Signature (HMO) plan, offering annual physicals, fitness benefits, and health education with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. However, several services are not covered, including 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 benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), featuring routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear every year with no copay or coinsurance, but OTC hearing aids as well as inner ear, outer ear, and over the ear prescription hearing aids 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 per year. Eyewear, such as contacts and glasses, is also covered with no copay or coinsurance up to a combined maximum of $100 annually.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), offering preventive care like oral exams, cleanings, and x-rays with no copay and no coinsurance. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $500 annual limit, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO) covers home infusion bundled services with prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and miscellaneous drugs have no copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (HMO), with durable medical equipment and diabetic supplies requiring 0% to 20% coinsurance and no copays. Prosthetic devices carry a 20% coinsurance with no copay, while medical supplies and diabetic therapeutic shoes or inserts are available with no copays and no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic and radiological services with no coinsurance. There is no copay for diagnostic tests, lab services, and outpatient X-rays, while diagnostic radiological services range from a $0 to $60 copay and therapeutic radiological services require a $60 copay.
Home Health Services See details
Aetna Medicare Signature (HMO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (HMO) plan, as all sub-services—including intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Signature (HMO) with prior authorization required, though additional days beyond the Medicare-covered limit are not covered. For covered stays, there is a $20 copay and no coinsurance for days 1 through 20, and a $218 copay and no coinsurance for days 21 through 100.
Other Services See details
Aetna Medicare Signature (HMO) partially covers Other Services with no copays and no coinsurance for acupuncture, annual wellness exams, screening mammographies, and additional gFOBT and FIT tests. Over-the-counter (OTC) items, meal benefits, and Dual Eligible SNPs with Highly Integrated Services are not covered.
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