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Aetna Medicare Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in North, Central, West, NW, SW, TC, South FL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (PPO) 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 (PPO).
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 (PPO), 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 has a $770.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 combined Maximum Out-Of-Pocket cost of $10100.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using preferred retail pharmacies or preferred mail-order services. If you choose standard retail or standard mail-order pharmacies, copays start at $2 for Tier 1 and $12 for Tier 2 drugs for a one-month supply. For brand-name and specialty prescriptions, costs are calculated as 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 carry a 25% coinsurance across all pharmacy and mail-order options.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage with no copay and no coinsurance for primary care visits, annual physical exams, routine eye exams, and preventive dental care. Specialist visits feature a low cost-sharing structure with copays ranging from no copay to $60, while home health services and laboratory tests also require no copay. For emergency and urgent needs, emergency room visits carry a $130 copay, and inpatient hospital stays require a daily copay of $420 for the first seven days with no coinsurance. This plan provides valuable vision, hearing, and dental benefits to help reduce out-of-pocket costs. Vision services feature no copays or coinsurance alongside a $180 annual eyewear allowance, while hearing benefits include routine exams with no copay and coverage for up to two hearing aids. Additionally, preventive dental services are fully covered with no copay, and comprehensive dental care is available with 20% to 50% coinsurance up to a $750 annual limit.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a daily copay of $420 for days 1 to 7 of acute stays and $390 for days 1 to 6 of psychiatric stays, with no copay for subsequent days. Upgrades, non-Medicare-covered stays, and psychiatric additional days are not covered under this plan, and prior authorization is required.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services which both feature no copay. Outpatient hospital services require a copay ranging from no copay to $395, observation services carry a $420 copay per stay, and outpatient substance abuse individual and group sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization services are covered under Aetna Medicare Signature (PPO) with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required to access these benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $260 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency room visits with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency services are also covered up to a $250,000 maximum limit with no coinsurance, requiring a $130 copay for emergency or urgent care and a $260 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) features primary care physician visits with no copay and no coinsurance, while specialist services range from a $0 to $60 copay with no coinsurance. Most other covered services, including physical, occupational, mental health, and psychiatric therapies, carry a $40 copay and no coinsurance, though podiatry is not covered and chiropractic services are only partially covered.
Preventive Services See details
Aetna Medicare Signature (PPO) covers preventive services, such as annual physical exams and health education, with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. The benefit is partially covered, excluding services like in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Aetna Medicare Signature (PPO) provides partially covered hearing services with no deductible and no coinsurance, featuring a $60 copay for Medicare-covered exams and no copay for annual routine exams and fitting evaluations. Up to two prescription hearing aids are covered per year with no coinsurance and copays ranging from $0 to $1,700, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copays, no coinsurance, and no deductibles for both eye exams and eyewear. Covered benefits include one routine eye exam per year up to a $50 maximum and a combined annual eyewear allowance of $180 for contacts, eyeglasses, lenses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) dental services are partially covered, offering preventive care like cleanings and oral exams with no copay and no coinsurance, and Medicare-covered dental services for a $60 copay and no coinsurance. Comprehensive services like restorative and endodontic care have no copay and 20% to 50% coinsurance up to a $750 annual limit, while fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to select manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with no coinsurance for diagnostic services, no copay for lab services, and no copay for outpatient X-rays. Diagnostic procedures and tests have a copay ranging from $0 to $100, while diagnostic radiological services start at a $0 copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
The Aetna Medicare Signature (PPO) plan covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Signature (PPO) with no copay and no coinsurance; however, in practice, specific sub-services including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day inpatient hospital stay is not needed, but additional days beyond the 100-day Medicare benefit period are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering covered benefits like annual wellness exams, screening mammographies, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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