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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 Cincinnati 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 does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $500.00 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 $8950.00 (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 $8950.00 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:
Sign up for Aetna Medicare Signature (PPO)
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Drug Coverage
The Aetna Medicare Signature (PPO) plan features a $500 annual drug deductible. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail order, Tier 1 drugs carry a copay starting at $2, while Tier 2 drugs start at a $12 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance across both preferred and standard networks. Tier 3 preferred brand drugs require a 22% coinsurance, Tier 4 non-preferred drugs require a 25% coinsurance, and Tier 5 specialty drugs carry a 27% coinsurance for a one-month supply. This structure helps you easily estimate your out-of-pocket prescription expenses under this plan.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with no copay for primary care doctor visits and key preventive services. Inpatient hospital stays require a $350 daily copay for the first six days and no copay for days seven through 90, while outpatient services feature no coinsurance and copays ranging from no copay to $350. Emergency care is available with a $130 copay, which is waived if you are admitted, alongside worldwide emergency coverage up to a $250,000 limit. Supplemental benefits include routine vision and hearing exams with no copay, alongside annual allowances of up to $1,000 per ear for prescription hearing aids and $100 for eyewear. Dental care is partially covered, offering preventive services with no copay and comprehensive care up to $1,000 annually with 20% to 50% coinsurance and no copay. Members also benefit from a $60 quarterly over-the-counter allowance and home health services with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $350 daily copay for days 1 through 6 and no copay for days 7 through 90. Unlimited additional acute care days are covered, but non-Medicare-covered stays, room upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient hospital services with no coinsurance and a copay of $0 to $350, while outpatient observation services require a $350 copay per stay. Ambulatory surgical center and outpatient blood services are offered with no copay and no coinsurance, and outpatient substance abuse sessions require a $40 copay with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization with a copay of either $40.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $275 copay (no coinsurance) for ground transport and a 20% coinsurance (no copay) for air transport. Transportation services to plan-approved or any other 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 $50 copay, with no coinsurance or deductible for either service. Worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum limit with no coinsurance, requiring a $130 copay for emergency and urgent care and a $275 copay for transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Other services, including physical, occupational, speech, mental health, psychiatric, podiatry, and opioid treatment therapies, carry a $40 copay and no coinsurance, while telehealth services require a $0 to $50 copay and 20% coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, though routine and other chiropractic care are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) covers key preventive services, including annual physicals, glaucoma screenings, and health education, with no copay and no coinsurance, while kidney disease education has a 20% coinsurance and no copay. This benefit is partially covered, as sub-services such as in-home safety assessments, personal emergency response systems, weight management programs, and medical nutrition therapy are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered with no copay or coinsurance up to a $1,000 maximum benefit per ear every year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductible, no coinsurance, and a copay ranging from no copay to $40 for eye exams, which includes one routine exam yearly. Eyewear is also covered with no deductible, no copay, and no coinsurance up to a combined $100 annual limit for contacts, lenses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring preventive cleanings and exams with no copay and no coinsurance, and Medicare-covered dental for a $40 copay and no coinsurance. Comprehensive benefits like restorative care and endodontics have no copay and 20% to 50% coinsurance up to a $1,000 annual limit, though 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, Part B chemotherapy, radiation, and other drugs have no copay and 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 by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers durable medical equipment, prosthetics, and diabetic supplies with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (PPO) with prior authorization required, offering diagnostic services with no coinsurance, no copay for lab tests, and a $0 to $200 copay for diagnostic procedures. Radiological services feature a $5 copay plus coinsurance for outpatient X-rays, a minimum 20% coinsurance for therapeutic radiology, and diagnostic radiology starting at no copay.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Aetna Medicare Signature (PPO) plan.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services under the Aetna Medicare Signature (PPO) are partially covered with no copay and no coinsurance, including up to $60 every three months for over-the-counter (OTC) items, annual wellness exams, screening mammography, and additional FIT or gFOBT tests. Acupuncture and meal benefits are not covered under this plan.
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