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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Eastern Massachusetts. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 $9550.00 (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 $9550.00 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 Extra (PPO) plan features an annual prescription drug deductible of $615. For generic medications, members can save significantly by utilizing preferred pharmacies or preferred mail-order services, which offer no copay for both Tier 1 preferred generics and Tier 2 generics. Standard pharmacies and standard mail-order options are also available, carrying low copays ranging from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply duration. For brand-name and specialty medications, cost-sharing transitions to coinsurance instead of 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 across all pharmacy and mail-order channels. These coinsurance rates apply consistently regardless of whether you choose a preferred or standard network provider.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan provides comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, while specialist visits require a copay ranging from $0 to $50. For hospital stays, inpatient acute care requires a $455 daily copay for the first six days and no copay thereafter, while outpatient hospital services feature copays up to $395 with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted within 24 hours, and ground ambulance services require a $290 copay. This plan also includes key supplemental benefits, offering routine dental, vision, and hearing exams with no copay and no coinsurance. Prescription hearing aids are covered with copays ranging from $0 to $1,700 for up to two devices per year, and there is no copay or coinsurance for eyewear up to a $100 annual maximum. Additionally, home health services and diagnostic labs require no copay, though certain benefits like cardiac rehabilitation and over-the-counter items are not covered.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute stays require a $455 daily copay for days 1 to 6 and no copay for days 7 and beyond, while psychiatric stays require a $390 daily copay for days 1 to 6 and no copay for days 7 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance for all services, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $395, observation services carry a $455 copay per stay, and outpatient substance abuse sessions have a $50 copay.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature Extra (PPO) plan with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature Extra (PPO), requiring prior authorization and featuring a $290 copay with no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations or any other health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature Extra (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 require a $50 copay and no coinsurance, while worldwide emergency and urgent care are covered up to a $250,000 maximum limit with no coinsurance and copays ranging from $130 to $290.
Primary Care See details
Aetna Medicare Signature Extra (PPO) covers primary care services with no copay and specialist visits with a $0 to $50 copay, both with no coinsurance. Physical, occupational, speech, mental health, psychiatric, and opioid therapies require a $50 copay and no coinsurance, while telehealth has a $0 to $50 copay and 20% coinsurance. Podiatry is not covered, and although some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) partially covers preventive services, offering annual physicals, screenings, and health education with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Not covered sub-services 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/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
Hearing services are partially covered by Aetna Medicare Signature Extra (PPO), featuring Medicare-covered exams for a $50 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are also partially covered with no coinsurance and copays ranging from $0 to $1,700 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no coinsurance, offering routine eye exams and follow-up diabetic eye exams with no copay, and Medicare-covered exams with a $0 to $50 copay. Eyewear, including contacts, lenses, and frames, is also covered with no copay or coinsurance up to a $100 annual maximum.
Dental Services See details
Aetna Medicare Signature Extra (PPO) offers partially covered dental services, including Medicare-covered dental care for a $50 copay and no coinsurance, as well as routine exams, cleanings, and x-rays with no copay and no coinsurance. Non-covered services under this plan include fluoride treatments, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance. Prior authorization is required for this benefit.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Signature Extra (PPO) with prior authorization required, offering no copay for all covered categories. Durable medical equipment and medical supplies have no coinsurance to 25% coinsurance, prosthetic devices require 25% coinsurance, and diabetic supplies range from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures have no coinsurance and a $0 to $45 copay, lab services and diagnostic radiology have no copay, outpatient X-rays have a $10 copay, and therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature Extra (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 not covered under the Aetna Medicare Signature Extra (PPO) plan, as all related sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, providing a meal benefit for chronic illness, annual wellness exams, screening mammographies, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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