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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in IL Chicago. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 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 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 Extra (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members pay no copay when filling prescriptions through a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options charge copays ranging from $2 to $6 for Tier 1 drugs and $12 to $36 for Tier 2 drugs, depending on the supply duration. For brand-name and specialty medications, cost-sharing transitions to coinsurance across all pharmacy and mail-order channels. Tier 3 preferred brands require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. Specialty drugs are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust medical coverage featuring no copay for primary care visits, annual physicals, and home health services. For specialized care, members pay a $40 copay for specialist visits, while inpatient hospital stays require a daily copay for the first seven days and no copay thereafter. Emergency care is accessible with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. Routine hearing and vision exams are covered with no copay, alongside allowances for glasses and prescription hearing aids. Preventive dental care also features no copay, while comprehensive dental services are covered with a 20% to 50% coinsurance up to a $2,000 annual limit. Additionally, skilled nursing facility stays require no copay for the first 20 days, helping keep your out-of-pocket recovery costs predictable.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, there is a $360 daily copay for days 1-7 and no copay for days 8 and beyond, while psychiatric stays require a $300 daily copay for days 1-7 and no copay for days 8-90. The benefit is partially covered as hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $360, observation services have a $360 copay per stay, and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (PPO) covers partial hospitalization services with a copay of either $65.00 or $145.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services under the Aetna Medicare Signature Extra (PPO) are partially covered, requiring a $275 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. Prior authorization is required for all ambulance services, and transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (PPO) with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, and worldwide emergency care is covered up to $250,000 with no coinsurance and copays between $130 and $275; none of these costs apply to a deductible.
Primary Care See details
Aetna Medicare Signature Extra (PPO) provides primary care physician services with no copay and no coinsurance, while specialist visits, physical, occupational, mental health, psychiatric, and opioid treatment therapies require a $40 copay and no coinsurance. Additional telehealth benefits are available with a $0 to $50 copay and 20% coinsurance, whereas chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Extra (PPO), offering annual physicals, health education, and screenings with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. The plan does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety devices, or counseling.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers hearing services, including Medicare-covered exams for a $40 copay and no coinsurance, alongside routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to a $500 annual maximum per ear, 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 Extra (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a copay ranging from no copay to $40 and eyewear with no copay. Routine eye exams and eyewear, including contacts and glasses, feature no copay, subject to an annual maximum benefit of $50 for exams and a combined $100 for eyewear.
Dental Services See details
Aetna Medicare Signature Extra (PPO) provides partially covered dental services, including Medicare-covered dental for a $40 copay and no coinsurance, and preventive care with no copay and no coinsurance. Comprehensive dental services are covered with no copay and 20% to 50% coinsurance up to a $2,000 yearly maximum, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy may apply. Under this benefit, Part B chemotherapy and other drugs require a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature Extra (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature Extra (PPO) covers medical equipment with no copays and coinsurance ranging from no coinsurance to 20% for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for certain items, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic services with no coinsurance, featuring no copay for lab services and copays ranging from no copay to $100 for diagnostic procedures. Covered radiological services require prior authorization, with diagnostic radiology starting at no copay, outpatient X-rays requiring a $15 copay, and therapeutic radiology requiring a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Extra (PPO) 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 Extra (PPO) plan with no coinsurance. Patients will pay a copay of $20 for cardiac and intensive cardiac rehabilitation, $15 for pulmonary rehabilitation, and $25 for supervised exercise therapy (SET) for peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, but a prior three-day inpatient hospital stay is not necessary for admission.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, providing an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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