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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 Northern Kentucky Area. 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 $650.00 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 prescription drugs, this plan offers no copay for Tier 1 preferred generics and Tier 2 generics when filled through a preferred pharmacy or preferred mail order. If you use standard pharmacies or standard mail order services, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs transition to coinsurance across all pharmacy and mail-order options. 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. These coinsurance rates remain the same whether you utilize preferred or standard pharmacies and mail-order services.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust core medical coverage with no copay and no coinsurance for primary care physician visits. Specialist visits range from no copay to a $40 copay, while inpatient hospital stays require a $310 daily copay for the first five days and no copay for days six through 90. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care services require a $50 copay. This plan also features valuable everyday health benefits, including no copay for preventive dental, routine vision, and routine hearing exams. Prescription hearing aids are covered up to $1,000 per ear with no copay, and there is an allowance of up to $150 for eyewear and $70 every three months for over-the-counter items. Additionally, skilled nursing facility stays have no copay for the first 20 days, followed by a $218 daily copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) inpatient hospital care is partially covered with no coinsurance, requiring a $310 daily copay for days 1 through 5 and no copay for days 6 through 90 for both acute and psychiatric stays. Unlimited additional days for acute stays are covered with no copay, but additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring a $0 to $310 copay for outpatient hospital services and a $310 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a copay of either $40.00 or $145.00 depending on the service. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $250 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. For transportation services, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance up to a $250,000 maximum, with copays of $130 for emergency or urgent care and $250 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits, physical and occupational therapies, podiatry, and mental health services range from no copay to a $40 copay with no coinsurance. Some chiropractic services are covered, but routine and other chiropractic services are not covered, and telehealth benefits are available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) preventive services are partially covered, offering no copay and no coinsurance for annual physical exams, glaucoma screenings, and diabetes self-management training, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission 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 and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) provides partially covered hearing services, which include Medicare-covered exams for a $40 copay and no coinsurance, as well as routine exams and fittings with no copay or coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $1,000 annual maximum per ear, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no coinsurance, offering eye exams with a $0 to $40 copay and eyewear with no copay. Routine eye exams are covered with no copay up to a $50 annual limit, while contacts, eyeglasses, lenses, frames, and upgrades have no copay up to a combined annual limit of $150.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental with a $40 copay and no coinsurance. Comprehensive dental options are available with no copay and 20% to 50% coinsurance up to a $2,000 annual limit, but other diagnostic services, fluoride, other preventive services, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, although prior authorization is required. Covered Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays and coinsurance ranging from no coinsurance up to 20% for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for most equipment, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with no coinsurance and no copay for lab services, while diagnostic procedures and tests require a copay of $0 to $50. Outpatient x-rays incur a $10 copay plus coinsurance, and therapeutic radiological services require a copay and a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (PPO) plan, as all individual 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 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (PPO), featuring no copay and no coinsurance for over-the-counter (OTC) items up to $70 every three months, annual wellness exams, screening mammography, and additional gFOBT and FIT screenings. Acupuncture and meal benefits are not covered under this plan.
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