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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 Southern & Western Colorado. 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 $10000.00 (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 $10000.00 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:
Sign up for Aetna Medicare Signature (PPO)
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Drug Coverage
The Aetna Medicare Signature (PPO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order services, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For brand-name and specialty medications under this plan, you will pay a percentage of the drug cost rather than a flat copay. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy types. Tier 5 specialty drugs also have a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with no copay for primary care visits, home health services, and annual wellness exams. For hospital care, there is no coinsurance, though inpatient acute stays require a $295 daily copay for the first six days, and outpatient hospital services carry a copay ranging from no copay up to $295. Emergency room visits require a $130 copay, which is waived upon admission, while specialist visits and physical therapy carry a $45 copay. Routine dental cleanings, annual eye exams, and hearing evaluations are available with no copay, and the plan provides a $150 annual allowance for eyewear alongside $1,250 per ear for prescription hearing aids. Skilled nursing facility stays feature no copay for the first 20 days, while medical equipment and dialysis services require up to a 20% coinsurance. Please note that comprehensive dental care, acupuncture, and routine transportation are not covered under this plan.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, though prior authorization is required. Acute stays require a $295 daily copay for days 1 to 6 (with no copay for additional days), while psychiatric stays require a $370 daily copay for days 1 to 5 (with no copay for days 6 to 90); however, 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 copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services carry a copay of $0 to $295, observation services require a $295 copay per stay, and outpatient substance abuse sessions have a $40 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature (PPO) plan with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature (PPO) are covered with prior authorization, requiring a $275 copay and no coinsurance for ground transport, and a 20% coinsurance and no copay for air transport. These ambulance costs are not waived if you are admitted to the hospital, and transportation services are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay—waived if admitted to the hospital within 24 hours—and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered with a $130 copay, and worldwide emergency transportation has a $275 copay, up to a maximum benefit of $250,000 with no coinsurance.
Primary Care See details
Primary care benefits under the Aetna Medicare Signature (PPO) offer primary care physician visits with no copay and no coinsurance, while specialist visits, occupational therapy, and physical therapy require a $45 copay with no coinsurance. Mental health, psychiatric, and opioid treatment services carry a $40 copay with no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, fitness benefits, and health screenings, though kidney disease education requires a 20% coinsurance and no copay. Excluded from coverage are several sub-services, including personal emergency response systems, weight management programs, nutritional benefits, and therapeutic massages.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, which includes one routine hearing exam and one fitting evaluation per year. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,250 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 copay, no coinsurance, and no deductible for both eye exams and eyewear. The plan includes one routine eye exam per year up to a $50 maximum, alongside a combined $150 annual allowance for contact lenses, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), with Medicare-covered dental requiring a $45 copay and no coinsurance, and select preventive services like cleanings, exams, and x-rays available with no copay and no coinsurance. Comprehensive benefits, including restorative services, endodontics, periodontics, prosthodontics, implants, and orthodontics, are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance with no copay.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services 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, with coinsurance ranging from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic supplies. Prosthetic devices and diabetic therapeutic shoes or inserts are also covered with no copay and a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, with prior authorization required. Diagnostic procedures have no coinsurance and a copay of $0 to $20, while lab services have no copay. Radiological services feature a $15 copay for outpatient X-rays, a minimum $0 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature (PPO) with no coinsurance, though in practice only some services are covered. Specifically, cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation (with a $20 copay), pulmonary rehabilitation (with a $15 copay), and Supervised Exercise Therapy for Symptomatic Peripheral Artery Disease services (with a $25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the 100-day Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) provides partial coverage for other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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