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 Select 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 (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 $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 (HMO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when filling your prescriptions through a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail-order service, copays start at $2 for Tier 1 drugs and $12 for Tier 2 drugs for a one-month supply. For brand-name and specialty medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance across all pharmacy types. Additionally, Tier 5 specialty drugs are restricted to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers comprehensive medical coverage with no copay for primary care visits, annual physical exams, and home health services. For specialist consultations, members can expect a copay ranging from $0 to $50, while emergency room visits require a $115 copay that is waived upon admission. Inpatient hospital stays require a $407 daily copay for the first several days, after which there is no copay. Routine dental, vision, and hearing exams are highly accessible with no copay and no coinsurance. The plan covers prescription hearing aids up to $1,000 per ear annually, eyewear up to $325 per year, and comprehensive dental care up to a $2,000 limit with 20% to 50% coinsurance. Additionally, durable medical equipment is covered with a 20% coinsurance and no copay, and skilled nursing facility stays require no copay for the first 20 days.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization but excluding upgrades, non-Medicare-covered stays, and additional psychiatric days. For covered stays, acute care requires a $407 daily copay for days 1–6 (no copay for days 7 and beyond), and psychiatric care requires a $407 daily copay for days 1–5 (no copay for days 6–90).
Outpatient Services See details
Aetna Medicare Signature (HMO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services, and a $0 to $495 copay for outpatient hospital services. Outpatient substance abuse sessions have a $30 copay and observation services require a $407 copay per stay, both with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization services with a copay ranging from $105.00 to $110.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature (HMO) require prior authorization and include a $250 copay with no coinsurance for ground transport and a 20% coinsurance with no copay for air transport. Transportation services to health-related or plan-approved locations are not covered.
Emergency Services See details
Aetna Medicare Signature (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, urgent, and transportation services are covered up to a $250,000 lifetime maximum with no coinsurance and copays ranging from $115 to $250.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care physician services with no copay and no coinsurance, while specialist visits and other healthcare professionals require a $0 to $50 copay with no coinsurance. Therapy, mental health, psychiatric, and opioid treatment services have copays ranging from $25 to $30 and no coinsurance, but telehealth has a $0 to $50 copay and 20% coinsurance, and podiatry and chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (HMO) offers partially covered preventive services with no copay and no coinsurance for annual physical exams, health education, and select screenings, though kidney disease education requires a 20% coinsurance and no copay. Several supplemental benefits are not covered under this plan, including weight management programs, nutritional/dietary benefits, personal emergency response systems, and in-home support services.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO), offering routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. Prescription hearing aids are covered up to $1,000 per ear annually with no copay and no coinsurance, but inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services, offering eye exams with a copay of $0 to $50 and no coinsurance, including routine eye exams once per year with no copay. Covered eyewear, including contacts and eyeglasses, has no copay and no coinsurance up to a combined maximum benefit of $325 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), offering Medicare-covered dental for a $50 copay and no coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Comprehensive services such as endodontics and periodontics have no copay and 20% to 50% coinsurance up to a $2,000 annual limit, while fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment and prosthetics with no copay and 20% coinsurance. Diabetic supplies from specified manufacturers range from no coinsurance to 20% coinsurance with no copay, while diabetic shoes and inserts require a $10 copay and coinsurance, with prior authorization required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO) with prior authorization, featuring no copay for lab services, outpatient X-rays, and diagnostic radiology. Diagnostic procedures and tests require a copay of $0 to $95 with no coinsurance, while therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature (HMO) plan with no coinsurance. While some services are covered, standard cardiac rehabilitation with a $25 copay, intensive cardiac rehabilitation with a $25 copay, pulmonary rehabilitation with a $15 copay, and supervised exercise therapy for symptomatic peripheral artery disease with a $20 copay are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) covers skilled nursing facility (SNF) services with no coinsurance and does not require a prior three-day inpatient hospital stay. Prior authorization is required, and while there is no copay for days 1 through 20, you will pay a $218 daily copay for days 21 through 100, with no coverage provided for additional days.
Other Services See details
Aetna Medicare Signature (HMO) provides partial coverage for other services, featuring no copay and no coinsurance for chronic illness meal benefits, select wellness screenings, and over-the-counter items up to $15 every three months. Acupuncture is not covered under this plan.
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