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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 North Carolina. 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 $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 $6900.00 (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 $6900.00 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) prescription drug plan features an annual drug deductible of $500. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order options carry a copay starting at $2 for Tier 1 and $12 for Tier 2 drugs for a one-month supply. Brand-name and specialty medications are covered under a coinsurance structure rather than flat copays. You will pay 22% coinsurance for Tier 3 preferred brand drugs and 25% coinsurance for Tier 4 non-preferred drugs at both preferred and standard pharmacies. Specialty Tier 5 drugs require a 27% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, while specialist visits range from no copay to a $30 copay. For hospital care, inpatient services require a daily copay of $382 for the first eight days of acute stays with no coinsurance and no copay for subsequent days. Emergency room visits carry a $130 copay, which is waived if you are admitted within 24 hours, while urgently needed care requires a $20 copay. Additional benefits include routine dental, vision, and hearing services, with no copays for routine exams and annual physicals. Vision eyewear is covered with no copay up to a $200 annual limit, and prescription hearing aids are covered up to $1,250 per ear with no copay. Preventive dental services have no copay, while comprehensive dental care requires no copay and 20% to 50% coinsurance up to a $1,750 annual limit.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, requiring a daily copay of $382 for days 1 to 8 of acute stays and $286 for days 1 to 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
Outpatient services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance for all services, including no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $382 (with a $382 copay per stay for observation), while individual and group outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (PPO) covers partial hospitalization services with a copay of $140.00 or $145.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Signature Extra (PPO) require prior authorization, with ground ambulance services carrying a $275 copay and air ambulance services requiring a 20% coinsurance. While transportation services are technically covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (PPO) with a $130 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed services require a $20 copay and no coinsurance. Worldwide emergency services are also covered up to a $250,000 limit with no coinsurance, carrying a $130 copay for emergency or urgent care and a $275 copay for emergency transportation.
Primary Care See details
Primary care services under Aetna Medicare Signature Extra (PPO) feature no copay and no coinsurance for primary care visits, while specialist visits require a $0 to $30 copay and no coinsurance. Therapy services have a $35 copay with no coinsurance, podiatry is not covered, and for chiropractic care, some services are covered but routine and other chiropractic services are not covered. Mental health, psychiatric, and opioid treatments have a $40 copay with no coinsurance, while telehealth services require a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (PPO), featuring no copay and no coinsurance for annual physicals, screenings, and fitness benefits, though kidney disease education requires a 20% coinsurance with no copay. Several supplemental services, including weight management programs, nutritional benefits, and in-home safety assessments, are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) offers partially covered hearing services, featuring Medicare-covered exams for a $30 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids are covered per year with no copay or coinsurance up to a $1,250 limit per ear, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a $0 to $30 copay and eyewear with no copay. This plan features a $50 annual maximum for eye exams and a $200 annual maximum allowance for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (PPO), featuring Medicare-covered dental at a $30 copay and no coinsurance, and preventive care like cleanings and exams with no copay and no coinsurance. Comprehensive services are covered with no copay and a 20% to 50% coinsurance up to a $1,750 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Extra (PPO) with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin has a $35 copay with no coinsurance, while chemotherapy and other Part B drugs range from no coinsurance 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 these services.
Medical Equipment See details
Medical equipment covered by Aetna Medicare Signature Extra (PPO) features no copays, with coinsurance ranging from 0% to 20% for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these benefits, and certain diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic tests carry a copay of $0 to $200 with no coinsurance, lab services and outpatient X-rays feature no copay, and diagnostic radiological services have a minimum $0 copay, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Signature Extra (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Extra (PPO) covers Cardiac Rehabilitation Services with no coinsurance, but some services are covered while other key rehabilitation services are not. Specifically, standard cardiac rehabilitation (requiring a $20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, requiring a $10 copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) provides partial coverage for other services with no copay and no coinsurance for covered benefits, including annual wellness exams, screening mammographies, and up to $30 every three months in over-the-counter item reimbursements. Acupuncture and meal benefits are not covered under this plan.
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