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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 Nashville TN 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 $25.00. 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 $9500.00 (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 $9500.00 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) prescription drug plan features an annual deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you will pay no copay when using preferred retail pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order services, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy networks and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Giveback (PPO) offers comprehensive medical coverage with no copay for primary care doctor visits and low copays ranging from no copay to $45 for specialist visits. For hospital needs, inpatient stays require a daily copay of $388 for the first seven days, while outpatient services feature no coinsurance and copays ranging from no copay up to $388. Emergency care is covered with a $115 copay, which is waived if you are admitted, and urgent care visits require a $40 copay. This plan also includes valuable preventive and wellness benefits, featuring no copay and no coinsurance for routine physicals, fitness programs, and annual eye exams. Dental care is partially covered, offering no copay for preventive services and a 20% to 50% coinsurance for comprehensive care up to a $1,500 annual limit. Additionally, members benefit from hearing aid coverage up to $1,250 per ear yearly, a $100 annual eyewear allowance, and a $30 quarterly over-the-counter medication reimbursement.
Inpatient Hospital See details
Inpatient hospital benefits under the Aetna Medicare Signature Giveback (PPO) are covered with no coinsurance, requiring a $388 daily copay for days 1-7 of acute stays and a $260 daily copay for days 1-8 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and specific services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Giveback (PPO) with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $388 for outpatient hospital services, $388 per stay for observation services, and $40 per session for outpatient substance abuse services, with prior authorization required for most care.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature Giveback (PPO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Aetna Medicare Signature Giveback (PPO), which features a $275 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services, subject to prior authorization. Transportation services are not covered in practice because trips to plan-approved or other health-related locations are excluded.
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 are covered with a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $275.
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 therapy services require a $35 copay with no coinsurance, while mental health, psychiatric, and opioid treatment services carry a $40 copay with no coinsurance. Telehealth benefits are available with a $0 to $40 copay and 20% coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by the Aetna Medicare Signature Giveback (PPO), with most covered benefits—including annual physicals, fitness benefits, and health education—offering no copay and no coinsurance, while kidney disease education requires no copay and a 20% coinsurance. Sub-services that are not covered include 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 or dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Giveback (PPO) covers hearing services, including Medicare-covered exams for a $45 copay and no coinsurance, alongside routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 yearly limit per ear, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Giveback (PPO) covers vision services with no deductibles and no coinsurance, featuring routine eye exams with no copay and Medicare-covered exams with a copay ranging from $0 to $45. Eyewear, including contacts and eyeglasses, is covered with no copay and no coinsurance up to a combined annual limit of $100.
Dental Services See details
Aetna Medicare Signature Giveback (PPO) offers partially covered dental services, including Medicare-covered dental for a $45 copay and no coinsurance, and preventive services with no copay and no coinsurance. Comprehensive dental care is covered with no copay and 20% to 50% coinsurance up to a $1,500 yearly maximum, though fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services 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 associated Medicare Part B chemotherapy, radiation, and other drugs require 0% to 20% coinsurance. Part B insulin is covered with a $35 copay and no coinsurance, and prior authorization or step therapy may be required.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Giveback (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Signature Giveback (PPO) with no copays for durable medical equipment, prosthetics, and diabetic therapeutic shoes. Coinsurance for these covered benefits ranges from no coinsurance up to 20%, depending on the specific items and supplies needed.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Giveback (PPO) covers diagnostic and radiological services, with prior authorization required for these benefits. Lab services and outpatient X-rays have no copay, diagnostic tests carry a $0 to $200 copay with no coinsurance, and therapeutic radiological services require 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature Giveback (PPO) with no coinsurance, though only some services are covered in practice. Standard cardiac, intensive cardiac, and SET for PAD services are not covered and carry a $20 copay, while pulmonary rehabilitation is also not covered and carries a $15 copay.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Giveback (PPO) partially covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Additional days beyond the standard Medicare-covered limit are not covered, and prior authorization is required.
Other Services See details
Other Services are partially covered by the Aetna Medicare Signature Giveback (PPO), featuring no copay and no coinsurance for covered benefits like annual wellness exams, screening mammographies, and select over-the-counter (OTC) items. While acupuncture and meal benefits are not covered, eligible OTC items are covered up to $30 every three months through reimbursement.
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