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Aetna Medicare Signature Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Plus (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 Plus (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Plus (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Southern Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Plus (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 Plus (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 Plus (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. Additionally, this plan comes with a Part B Premium reduction of $2.00. You must continue to pay paying your reduced 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 $13900.00 (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 $13900.00 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 Plus (PPO) plan features an Enhanced Alternative prescription drug benefit with an annual drug deductible of $615.00. After meeting this deductible, you will enjoy no copay for Tier 1 preferred generic drugs at preferred retail pharmacies or through preferred mail order, though standard pharmacies charge a $12.00 copay. For Tier 2 standard generic drugs, the plan requires a 24% coinsurance across all pharmacy options. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both carry a 25% coinsurance during the initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Medicare Part D drugs. Additionally, members who qualify for the full Low-Income Subsidy will benefit from a reduced Part D premium of $0.00.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan offers comprehensive coverage with predictable cost-sharing, featuring no deductibles for key services like vision and hearing. For hospital care, inpatient acute stays require a $388 copay for days 1 through 7 and no copay thereafter, while outpatient hospital services range from no copay up to a $450 copay. Emergency care is covered with a $115 copay, and primary care visits range from no copay up to $40. Routine preventive services, including dental cleanings, annual physicals, and vision exams, are available with no copay and no coinsurance. Additionally, the plan provides a $275 annual eyewear allowance and covers prescription hearing aids up to $500 per ear with no copay. Other essential benefits like home health services feature no copay and no coinsurance, though certain specialized care like dialysis and durable medical equipment require a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Plus (PPO) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Acute stays carry a $388 copay for days 1 through 7 and no copay for days 8 through 90, while psychiatric stays require a $407 copay for days 1 through 5 and no copay for days 6 through 90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Plus (PPO) with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $450, observation services cost a $388 copay per stay, and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Aetna Medicare Signature Plus (PPO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by Aetna Medicare Signature Plus (PPO), as transportation services to plan-approved or any health-related locations are not covered. Ground ambulance services require a $295 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay, with prior authorization required for both.
Emergency Services See details
Aetna Medicare Signature Plus (PPO) covers emergency services with a $115 copay and urgently needed services with a $40 copay, with no coinsurance for either service. Worldwide emergency and urgent care, as well as emergency transportation, are also covered with copays ranging from $115 to $295 and no coinsurance, up to a $250,000 maximum benefit limit.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature Plus (PPO), with podiatry services and routine chiropractic care not covered. Covered services feature copays ranging from no copay up to $40, and no coinsurance for most benefits except for a 20% coinsurance on telehealth services.
Preventive Services See details
Preventive Services are partially covered under the Aetna Medicare Signature Plus (PPO) plan, with no copay and no coinsurance for annual physicals, health education, fitness benefits, and routine screenings, while kidney disease education requires a 20% coinsurance and no copay. However, several services are not covered, including 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/bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Plus (PPO) with no deductible and no coinsurance, offering annual routine exams and fitting evaluations with no copay, and other exams for a $35 copay. Prescription hearing aids are covered up to a $500 annual limit per ear with no copay, but inner ear, outer ear, over-the-ear, and over-the-counter hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Plus (PPO) with no deductible or coinsurance, featuring a $0 to $35 copay for eye exams and no copay for eyewear. The coverage includes a $50 annual maximum for exams and a $275 yearly combined allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature Plus (PPO) partially covers dental services, excluding fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics. Covered preventive services like oral exams, cleanings, and x-rays have no copay and no coinsurance, while Medicare-covered dental services require a $35 copay and no coinsurance. Other covered comprehensive services have no copay and a 20% to 50% coinsurance up to a $2,000 annual maximum.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Signature Plus (PPO) with prior authorization required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while other covered Part B chemotherapy, radiation, and miscellaneous drugs require no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature Plus (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature Plus (PPO) covers medical equipment, including durable medical equipment, prosthetics, and medical supplies for a 20% coinsurance and no copay. Diabetic supplies are covered with no coinsurance to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts have no copay and no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Plus (PPO) with prior authorization required. Lab services and outpatient X-rays have no copay or coinsurance, diagnostic tests require a $0 to $95 copay and no coinsurance, diagnostic radiology requires a copay of up to $300 and no coinsurance, and therapeutic radiology has a 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature Plus (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature Plus (PPO) plan, as cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are all not covered. Since these services are not covered by the plan, there are no copayments or coinsurance benefits available.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered under Aetna Medicare Signature Plus (PPO), which excludes coverage for additional days beyond the Medicare-covered limit. There is no coinsurance for this benefit, with no copay required for days 1 through 20 and a $218 daily copay for days 21 through 100.
Other Services See details
Other Services are partially covered under Aetna Medicare Signature Plus (PPO), as acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered. Covered benefits, including chronic illness meals, select wellness exams, and a $45 quarterly over-the-counter allowance, are offered with no copay and no coinsurance.
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