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Aetna Medicare Signature Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Giveback (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 Giveback (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Giveback (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Greenville/Spartanburg SC and Surrounding 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 Giveback (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 Giveback (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 Giveback (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 $30.00. 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 $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 $9200.00 (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 $9200.00 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 Giveback (PPO) plan features a $500 drug deductible. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options require a low copay, starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. For higher-tier medications, the plan utilizes coinsurance rather than set copays across all pharmacy types. You will pay 22% coinsurance for Tier 3 preferred brand drugs and 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs require a 27% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Giveback (PPO) offers comprehensive medical coverage featuring no copay for primary care physician visits and a $0 to $45 copay for specialists. Inpatient hospital stays require a $388 daily copay for the first seven days with no coinsurance, while emergency room visits have a $115 copay. Outpatient services and diagnostic lab work are also highly accessible, often requiring no copay and no coinsurance. Supplemental care under this plan includes no copay for routine dental, vision, and hearing exams. Comprehensive dental services are covered up to a $1,000 annual limit with 20% to 50% coinsurance, alongside a $100 annual allowance for eyewear and a $1,250 annual allowance per ear for prescription hearing aids. Members also benefit from a $30 quarterly over-the-counter item allowance with no copay.
Inpatient Hospital See details
Aetna Medicare Signature Giveback (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $388 daily copay for days 1 through 7 of acute stays and a $260 daily copay for days 1 through 8 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Giveback (PPO) covers outpatient services with no coinsurance, featuring a $0 to $388 copay for hospital services and a $388 copay per stay for observation services. Ambulatory surgical center and blood services require no copay and no coinsurance, while outpatient substance abuse sessions have a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature Giveback (PPO) covers partial hospitalization services with a copay of $105 or $110 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature Giveback (PPO) require prior authorization and cost a $275 copay with no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services are not covered.
Emergency Services See details
Aetna Medicare Signature Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency and urgent services are covered up to a $250,000 maximum limit with no coinsurance and copays of $115 (or $275 for worldwide emergency transportation).
Primary Care See details
Aetna Medicare Signature Giveback (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $45 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while podiatry is not covered, and for chiropractic services, some services are covered but routine chiropractic care and other chiropractic services are not covered. Mental health, psychiatric, and opioid treatment services have a $40 copay and no coinsurance, while telehealth options carry a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Giveback (PPO), featuring no copay and no coinsurance for annual physicals, health education, fitness benefits, remote access, chemotherapy wigs, and select screenings, while kidney disease education has no copay and 20% coinsurance. Sub-services that are not covered under this plan include In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefits, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Hearing services under the Aetna Medicare Signature Giveback (PPO) include Medicare-covered exams for a $45 copay and no coinsurance, plus annual routine 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 maximum per ear annually, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by the Aetna Medicare Signature Giveback (PPO) with no coinsurance and no deductibles, featuring eye exam copays ranging from $0 to $45 and no copay for eyewear. This plan includes one routine eye exam per year up to a $50 limit, alongside a $100 annual combined maximum allowance for contacts, frames, and lenses.
Dental Services See details
Aetna Medicare Signature Giveback (PPO) covers Medicare dental services for a $45 copay and no coinsurance, alongside preventive care like exams, cleanings, and x-rays with no copay and no coinsurance. Comprehensive dental benefits are partially covered up to a $1,000 annual maximum with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Giveback (PPO) with no copay, while Medicare Part B chemotherapy, radiation, and other drugs require a 0% to 20% coinsurance. Additionally, Medicare Part B insulin is covered under this benefit with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature Giveback (PPO) covers Dialysis Services with no copay and a 20% coinsurance, though prior authorization is required for these services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Signature Giveback (PPO) with no copays, though coinsurance ranging from no coinsurance to 20% applies to durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices carry a 20% coinsurance with no copay, while diabetic therapeutic shoes and inserts are covered with no copay, and prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Giveback (PPO), requiring prior authorization for all services. Diagnostic services feature no coinsurance, with no copay for lab work and a $0 to $200 copay for diagnostic tests, while radiological services feature no copay for diagnostic imaging and x-rays, though x-rays require coinsurance and therapeutic services carry a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature Giveback (PPO) 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 Giveback (PPO) with no coinsurance; however, only some services are covered in practice, as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copays ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Giveback (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Giveback (PPO) provides partial coverage for other services, excluding acupuncture and meal benefits. Covered benefits such as annual wellness exams, screening mammographies, additional colorectal screenings, and up to $30 of over-the-counter items every three months are offered with no copay and no coinsurance.
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