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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 Clark and Nye Counties. 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 $500.00 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 $10000.00 (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 $10000.00 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 prescription savings, this plan offers no copay on Tier 1 preferred generic and Tier 2 generic drugs when filled through preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, copays start at $2 for Tier 1 and $12 for Tier 2 prescriptions. For higher-tier medications, costs are based on coinsurance rather than flat copays across all pharmacy types. You will pay a 24% coinsurance for Tier 3 preferred brand drugs, while Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty drugs also incur a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides affordable healthcare coverage, featuring no copay and no coinsurance for primary care doctor visits, routine preventive care, and home health services. Specialist visits, mental health sessions, and urgent care require predictable copays ranging from forty to forty-five dollars, while inpatient hospital stays incur a daily copay for the first five days. Emergency care is covered with a flat one hundred thirty dollar copay, which is completely waived if you are admitted to the hospital. For extra benefits, the plan features no copay and no coinsurance for routine vision and hearing exams, alongside annual allowances for eyewear and prescription hearing aids. Preventive dental services also have no copay, while comprehensive dental, dialysis, and durable medical equipment require no copay but carry coinsurance up to fifty percent. Diagnostic laboratory tests and outpatient X-rays are covered with no copay and no coinsurance, helping you manage your diagnostic health needs with minimal out-of-pocket costs.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $275 daily copay for days 1 to 5 of acute stays and a $370 daily copay for days 1 to 5 of psychiatric stays, followed by no copay for days 6 to 90. Unlimited additional acute days are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay ranging from no copay to $325, while observation services incur a $275 copay per stay and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization benefits with no coinsurance, though prior authorization is required. Depending on the specific service, you will pay a copay of either $55.00 or $145.00.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Signature (PPO) require prior authorization, featuring a $310 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $45 copay, with no coinsurance or deductible for either service. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum limit with no coinsurance and copays ranging from $130 to $310.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician visits with no copay and no coinsurance, while specialist and mental health services require a $40 copay and no coinsurance. Physical and occupational therapies cost a $20 copay with no coinsurance, podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), with most services like annual physicals, glaucoma screenings, and fitness benefits requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but sub-services such as alternative therapies, weight management, counseling, and personal emergency response systems are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) provides hearing services with no copay and no coinsurance for routine exams, fitting evaluations, and prescription hearing aids, featuring a $1,000 maximum annual benefit per ear. However, hearing benefits are only partially covered because OTC hearing aids, along with 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 copay, no coinsurance, and no deductible for eye exams and eyewear. The plan provides up to a $50 annual maximum for eye exams, including one routine exam yearly, and a $250 yearly combined maximum for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), offering Medicare-covered dental for a $40 copay and no coinsurance, and preventive care like exams and cleanings with no copay or coinsurance. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $2,000 annual limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this plan, Medicare Part B chemotherapy and other drugs require a 0% to 20% coinsurance with no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by the Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical Equipment benefits under Aetna Medicare Signature (PPO) are covered with no copays, though prior authorization is required for most services. Durable medical equipment, medical supplies, and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices carry a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), though prior authorization is required. There is no copay and no coinsurance for diagnostic procedures, lab services, and diagnostic radiological services, while outpatient X-rays feature no copay and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) 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 under Aetna Medicare Signature (PPO) with no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered and carry copays of $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a three-day prior inpatient hospital stay is not needed, though additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services are partially covered by the Aetna Medicare Signature (PPO) plan, which offers an annual wellness exam, screening mammography, 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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