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Aetna Medicare Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (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 (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in WI Southeast and Northeast. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (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 (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 (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 $10100.00 (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 $10100.00 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 (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose a standard pharmacy or standard mail order, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier prescriptions, cost-sharing transitions to coinsurance across all pharmacy and mail-order options. 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. Note that Tier 5 specialty medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, while specialist visits range from no copay up to a $40 copay. Emergency room visits require a $130 copay, and urgently needed care has a $45 copay, with no coinsurance for either service. For hospital stays, inpatient acute care carries a $365 daily copay for the first seven days, while outpatient hospital services range from no copay up to $365, both with no coinsurance. This plan also includes supplemental benefits, offering no copay and no coinsurance for routine dental cleanings, routine vision exams, and annual hearing tests. Prescription eyewear is covered with no copay up to a $100 annual limit, and hearing aids are covered with no copay up to a $500 annual limit per ear. Additionally, skilled nursing facility stays require no copay for the first 20 days, and home health services are fully covered with no copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $365 daily copay for days 1 to 7 of acute stays and a $295 daily copay for days 1 to 6 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 (PPO) covers outpatient services with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services have a copay ranging from $0 to $365, observation services require a $365 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $75 or $145 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Aetna Medicare Signature (PPO) plan, as transportation services to health-related locations are not covered. Prior authorized ground ambulance services require a $280 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $45 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum with no coinsurance, carrying a $130 copay for emergency or urgent care and a $280 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Physical, occupational, mental health, psychiatric, and opioid treatment services are covered with copays ranging from $40 to $45 and no coinsurance, whereas chiropractic and podiatry services are not covered. Additional telehealth benefits are available with a $0 to $45 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) provides partially covered preventive services with no copay and no coinsurance for annual physical exams, health education, and glaucoma screenings, while kidney disease education has no copay but a 20% coinsurance. Multiple supplemental services are not covered under this plan, including weight management programs, in-home safety assessments, medical nutrition therapy, and personal emergency response systems.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams for a $40 copay and no coinsurance, while annual routine hearing exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $500 annual maximum per ear, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, offering routine eye exams with no copay up to a $50 annual limit and Medicare-covered exams with a $0 to $40 copay. Prescription eyewear, including contacts, lenses, and frames, is covered with no copay up to a combined annual limit of $100.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring a $40 copay and no coinsurance for Medicare-covered dental, alongside preventive care like exams and cleanings with no copay and no coinsurance. Covered comprehensive services require no copay with 20% to 50% coinsurance up to a $1,250 annual maximum, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic services, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Covered Medicare Part B chemotherapy and other drugs carry a coinsurance ranging from no coinsurance to 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copay for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Coinsurance ranges from no coinsurance to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under Aetna Medicare Signature (PPO), with lab services provided at no copay and no coinsurance. Outpatient diagnostic tests have no coinsurance and a copay ranging from $0 to $75, while outpatient X-rays require a $20 copay plus coinsurance, and therapeutic radiological services require a copay and at least 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers Cardiac Rehabilitation Services with no coinsurance; however, while some services are covered, specific options like cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, though a prior three-day inpatient hospital stay is not required before admission.
Other Services See details
Aetna Medicare Signature (PPO) offers partial coverage for other services, including an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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