A non-government entity
Aetna Medicare Signature Care (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (HMO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select HVP Counties Across GA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (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 Care (HMO) plan has a $615 prescription drug deductible. For Tier 1 preferred generic and Tier 2 generic drugs, there is no copay when using preferred retail pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2, depending on the supply duration. Brand-name and specialty medications require coinsurance instead of flat copays. You will pay 24% coinsurance for Tier 3 preferred brand drugs, and 25% coinsurance for Tier 4 non-preferred drugs and Tier 5 specialty medications. These coinsurance percentages remain the same whether you use preferred or standard pharmacies and mail-order services.
Additional Benefits
The Aetna Medicare Signature Care (HMO) plan offers affordable healthcare coverage with no copay for primary care physician visits, annual physicals, and home health services. Specialist visits require a low copay ranging from $10 to $55, while inpatient hospital stays require daily copays with no coinsurance. Emergency room visits carry a $115 copay, which is waived if you are admitted to the hospital. For supplemental care, this plan provides strong coverage with no copay for routine dental, vision, and hearing exams. You will also benefit from generous allowances, including up to $250 annually for eyewear and $500 per ear for prescription hearing aids. Additional benefits like home infusion services feature no copay, and you receive a $30 quarterly over-the-counter allowance.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Signature Care (HMO) with no coinsurance, requiring a $388 copay per day for days 1 to 7 of acute stays and a $407 copay per day for days 1 to 5 of psychiatric stays. While unlimited additional acute days are covered at no copay, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered under Aetna Medicare Signature Care (HMO) feature no coinsurance across all categories, with no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $495, observation services require a $388 copay per stay, and outpatient substance abuse sessions carry a $35 copay.
Partial Hospitalization See details
Aetna Medicare Signature Care (HMO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature Care (HMO), with ground ambulance services requiring a $275 copay (no coinsurance) and air ambulance services requiring a 20% coinsurance (no copay), both subject to prior authorization. Some transportation services are covered, but trips to plan-approved or any health-related locations are not covered in practice.
Emergency Services See details
Aetna Medicare Signature Care (HMO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $115 to $275.
Primary Care See details
Aetna Medicare Signature Care (HMO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 to $55 copay and no coinsurance. While some chiropractic services are covered, routine and other chiropractic care are not covered, and other benefits like physical therapy and mental health services require copays of $35 to $50 with no coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Care (HMO) with no copay and no coinsurance for annual physicals, health education, and various screenings, though kidney disease education requires no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Care (HMO) partially covers hearing services, offering routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $55 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Care (HMO) covers vision services with no coinsurance, offering routine annual eye exams and follow-up diabetic eye exams with no copay, while Medicare-covered exams have a copay ranging from $0 to $55. Eyewear, including contacts and eyeglasses, is also covered with no copay or coinsurance up to a $250 combined maximum limit per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Care (HMO), featuring no copay and no coinsurance for preventive care like exams, cleanings, and x-rays, while Medicare-covered dental services require a $55 copay and no coinsurance. Comprehensive dental services are covered with no copay and 20% to 50% coinsurance up to a $2,500 annual maximum, though fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Care (HMO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature Care (HMO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for this covered benefit.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Care (HMO) with no copay and 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no coinsurance to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Care (HMO) covers diagnostic and radiological services, though prior authorization is required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $95 copay for procedures, while radiological services range from no copay for outpatient X-rays to a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature Care (HMO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no coinsurance under Aetna Medicare Signature Care (HMO), although some services are not covered. Specifically, standard cardiac rehabilitation (with a $30 copay), intensive cardiac rehabilitation (with a $40 copay), pulmonary rehabilitation (with a $25 copay), and supervised exercise therapy for peripheral artery disease (with a $20 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Care (HMO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Care (HMO) partially covers other services with no copay and no coinsurance, providing benefits such as a $30 quarterly over-the-counter allowance, chronic illness meals, and select wellness exams, while acupuncture is not covered.
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