A non-government entity
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 Cleveland and Toledo 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 $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 $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 an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail order, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply limit. Higher-tier medications under this plan are covered via 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 both carry a 25% coinsurance. These coinsurance rates apply regardless of whether you use preferred or standard pharmacies, with specialty drugs limited to a one-month supply.
Additional Benefits
Aetna Medicare Signature (PPO) offers robust medical coverage with affordable out-of-pocket costs, featuring a $5 copay for primary care visits and no copay to a $40 copay for specialists. Inpatient hospital stays require a $350 daily copay for days one through six, followed by no copay for days seven through 90. Emergency room visits carry a $130 copay, which is waived upon admission, while urgent care services require a $50 copay. For additional wellness needs, the plan provides routine hearing and preventive dental exams with no copay and no coinsurance. Vision benefits include a $225 annual allowance for eyewear with no copay, alongside eye exams ranging from no copay to a $40 copay. Comprehensive dental services are covered with no copay and a 20% to 50% coinsurance up to a $1,000 annual limit, while members also receive a $90 allowance every three months for over-the-counter items with no copay.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $350 daily copay for days 1 through 6 and no copay for days 7 through 90 for acute and psychiatric stays. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $350 for outpatient hospital services and $350 per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, though a copay of either $40 or $145 applies depending on the service. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay with no coinsurance, and worldwide emergency services are covered up to $250,000 with no coinsurance and copays of $130 for emergency or urgent care and $275 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits for a $5 copay and specialist visits for no copay to a $40 copay, both with no coinsurance. While therapies require a $40 copay and no coinsurance, some chiropractic services are covered for a $15 copay and no coinsurance, though routine and other chiropractic care are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), with most covered benefits like annual physical exams and screenings requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several options such as medical nutrition therapy, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, including Medicare-covered exams for a $40 copay and no coinsurance, alongside routine annual exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 yearly limit per ear, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no deductibles and no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for eyewear. This includes one routine eye exam every year with up to a $50 maximum benefit, as well as a $225 annual allowance for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring Medicare-covered dental with a $40 copay and no coinsurance, alongside preventive care like exams and cleanings with no copay and no coinsurance. Comprehensive services such as restorative work and endodontics are covered with no copay and 20% to 50% coinsurance up to a $1,000 annual limit, while fluoride, implants, maxillofacial prosthetics, and orthodontics 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 benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with prior authorization, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic equipment. DME, medical supplies, and diabetic shoes require no copay, with coinsurance ranging from no coinsurance to 20% for DME, medical supplies, and diabetic supplies, and a flat 20% coinsurance for prosthetics and diabetic shoes.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization, offering diagnostic lab services with no copay and diagnostic procedures with a $0 to $150 copay, both with no coinsurance. Radiological services include outpatient X-rays for a $5 copay plus coinsurance, diagnostic radiology with a minimum $0 copay, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, but some services are covered while cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation (with a $20 copay), pulmonary rehabilitation (with a $15 copay), and SET for PAD services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is partially covered by Aetna Medicare Signature (PPO) with no coinsurance, as additional days beyond the Medicare-covered limit are not covered. This benefit requires prior authorization, allows admission without a prior three-day hospital stay, and features no copay for days 1 to 20 and a $218 copay for days 21 to 100.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (PPO), offering no copay and no coinsurance for over-the-counter (OTC) items up to $90 every three months, annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture and meal benefits are not covered under this plan.
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