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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 IN Northeast. 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 $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:
Sign up for Aetna Medicare Signature (PPO)
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Drug Coverage
The Aetna Medicare Signature (PPO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using a preferred retail pharmacy or preferred mail-order service. If you use standard pharmacies or standard mail-order services, Tier 1 copays range from $2 to $6 and Tier 2 copays range from $12 to $36 depending on the supply fill. For higher-tier medications, cost-sharing is structured as coinsurance across all pharmacy types. You will pay a 24% coinsurance for Tier 3 preferred brand drugs, and a 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring no copay for primary care visits, home health services, and most preventive care. Specialist visits range from no copay up to $45, while inpatient hospital stays require a daily copay of $325 for acute care or $275 for psychiatric care for the first seven days, with no copay for additional days. Outpatient services and diagnostic lab tests are also highly accessible, often requiring no copay or low copay options with no coinsurance. This plan also includes valuable supplemental benefits, such as routine hearing and vision exams with no copay, alongside annual allowances for hearing aids and eyewear. Preventive dental care features no copay, while comprehensive dental services are covered with no copay and a 20% to 50% coinsurance up to a $750 annual limit. Additionally, emergency and urgent care services are covered worldwide with predictable copays and no coinsurance, ensuring peace of mind wherever you travel.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) provides partially covered inpatient hospital benefits with no coinsurance, though prior authorization is required. Acute stays require a $325 daily copay for days 1 to 7 (with no copay for additional days), while psychiatric stays require a $275 daily copay for days 1 to 7 (with no copay for days 8 to 90); upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $325 copay for outpatient hospital services and a $325 copay 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
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of either $75.00 or $145.00 and no coinsurance, depending on the service. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $280 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to plan-approved or any 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 $40 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered with a $130 copay, and worldwide emergency transportation with a $280 copay, all featuring no coinsurance up to a $250,000 maximum plan benefit.
Primary Care See details
Aetna Medicare Signature (PPO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $45 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies require copays ranging from $30 to $40 with no coinsurance, while chiropractic and podiatry services are not covered. Telehealth benefits are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under Aetna Medicare Signature (PPO), with most services like annual physicals and glaucoma screenings requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but several supplemental options—including weight management, nutritional benefits, in-home safety assessments, and personal emergency response systems—are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, offering Medicare-covered exams for a $45 copay and routine exams or fitting evaluations with no copay, all with no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, featuring eye exam copays ranging from no copay to $45 and no copay for eyewear. This coverage includes up to a $50 annual maximum for eye exams and a $150 annual maximum for eyewear, such as contacts and eyeglasses.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), offering preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental with a $45 copay and no coinsurance. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $750 annual limit, though fluoride, implants, orthodontics, and maxillofacial prosthetics 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. Under this plan, Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and 0% to 20% coinsurance, while covered Part B insulin has a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with prior authorization required. Beneficiaries will pay no copay, with coinsurance ranging from 0% to 20% depending on the specific equipment or supplies.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, with diagnostic services featuring no coinsurance, lab services at no copay, and diagnostic procedures ranging from a $0 to $100 copay. Radiological services require prior authorization and include a $20 copay for outpatient X-rays, a 20% coinsurance for therapeutic radiological services, and diagnostic radiological services starting at no copay.
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 by Aetna Medicare Signature (PPO) with no coinsurance and no copay, although in practice, sub-services like standard 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, requiring a $10 copay for days 1 to 20 and a $218 copay for days 21 to 100. Prior authorization is required, a three-day prior inpatient hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, providing covered benefits like annual wellness exams, screening mammographies, and additional gFOBT and FIT tests with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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