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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 2025, 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 Select Counties in Augusta, Macon and South GA. This plan received an overall rating of 4.5 out of 5 stars in 2025.
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 $590.00 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 $6900.00 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 has a $590 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance for your medications. For preferred generic drugs, you will pay no copay at preferred pharmacies and mail order, and a $12 copay at standard pharmacies. For standard generic drugs, preferred brand drugs, and non-preferred drugs, you will pay 22% or 25% coinsurance depending on the drug and pharmacy. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers a wide range of benefits, including coverage for inpatient and outpatient hospital services, with varying copays depending on the service. You can expect no copay for primary care physician services, routine eye exams, and many dental services, while other services like specialist visits and hearing exams have copays. This plan also covers emergency services, ambulance services, and various therapies like physical and occupational therapy. Additional benefits include preventive services like annual physical exams and some hearing and vision services. You can also get coverage for medical equipment, home health services, and skilled nursing facility care.
Inpatient Hospital See details
The Aetna Medicare Signature (HMO) plan covers Inpatient Hospital services, including acute and psychiatric care. For Inpatient Hospital-Acute, you have a $380 copay for days 1-7, and no copay for days 8-90; for Inpatient Hospital Psychiatric, you have a $407 copay for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay of $0-$380, and observation services with a $380 copay. Ambulatory Surgical Center (ASC) Services have no copay, Outpatient Substance Abuse Services have a $30 copay for individual and group sessions, and Outpatient Blood Services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Aetna Medicare Signature (HMO) plan, but requires prior authorization. You will have an $80 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Aetna Medicare Signature (HMO) plan, with prior authorization required for all ambulance services. Ground ambulance services have a $250 copay, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Aetna Medicare Signature (HMO) plan. Emergency Services has a $110 copay, Urgently Needed Services has a $40 copay, and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, while Worldwide Emergency Transportation has a $250 copay.
Primary Care See details
Primary Care benefits include coverage for Primary Care Physician Services with no copay, Chiropractic Services with a $15 copay, Occupational Therapy Services with a $25 copay, Physician Specialist Services with a copay between $10 and $35, and Mental Health Specialty Services with a $30 copay for individual and group sessions. Podiatry Services have a $35 copay, Other Health Care Professional services have a copay between $0 and $35, Psychiatric Services have a $30 copay for individual and group sessions, Physical Therapy and Speech-Language Pathology Services have a $25 copay, Additional Telehealth Benefits have a 20% coinsurance and a copay between $0 and $40, and Opioid Treatment Program Services have a $30 copay. Routine Chiropractic Care is not covered.
Preventive Services See details
Preventive Services include an annual physical exam with no copay, and additional preventive services, including health education, wigs for hair loss related to chemotherapy, additional sessions of smoking and tobacco cessation counseling, fitness benefit, remote access technologies, and kidney disease education services. Kidney disease education services have a 20% coinsurance. Other preventive services, including glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit, have no copay.
Hearing Services See details
The Aetna Medicare Signature (HMO) plan covers hearing exams with a $35 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered up to $500 per ear every year, and prescription hearing aids (all types) are covered with no copay. OTC Hearing Aids are not covered, nor are Prescription Hearing Aids - Inner Ear, Prescription Hearing Aids - Outer Ear, or Prescription Hearing Aids - Over the Ear.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services, including eye exams with a copay of $0-$35, and eyewear such as contact lenses, eyeglasses, eyeglass lenses, eyeglass frames, and upgrades with no copay, with a combined maximum benefit of $170 per year. Routine eye exams are covered with no copay, with one visit allowed per year.
Dental Services See details
Dental services include a $35 copay for Medicare Dental Services, and no copay for Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), and Oral and Maxillofacial Surgery. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Aetna Medicare Signature (HMO) plan, but require prior authorization. You will pay 20% coinsurance for dialysis services.
Medical Equipment See details
Medical equipment is covered under the Aetna Medicare Signature (HMO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, while Prosthetic Devices and Medical Supplies have a 20% coinsurance and no copay. Diabetic Supplies have a 0-20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a copay ranging from $0 to $95. Lab services have no copay, while diagnostic radiological services have a copay of at most $300. Therapeutic radiological services have a coinsurance of at least 20%, and outpatient X-ray services have no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Signature (HMO) plan, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for some Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Signature (HMO) plan, with a $0 copay for days 1-20 and a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items and Meal Benefits, with no copay. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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