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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 MI Southeast. 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 prescription drug 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, copays start at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Higher-tier medications require coinsurance rather than flat copays. Tier 3 preferred brand drugs incur a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance across all pharmacy options. These coinsurance rates apply regardless of whether you choose a preferred or standard pharmacy or mail-order service.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive coverage for essential medical services, often featuring no coinsurance and low cost-sharing. Primary care doctor visits, preventive screenings, and home health services require no copay, while specialist visits carry a copay of up to $40. For inpatient hospital stays, members pay a daily copay of $295 for the first 7 days, followed by no copay for days 8 through 90. This plan also includes supplemental benefits like dental, vision, and hearing care to help minimize out-of-pocket expenses. Preventive dental care, routine hearing exams, and routine eye exams are available with no copay, and members receive a $225 annual allowance for eyewear and a $1,000 yearly allowance per ear for prescription hearing aids. Additionally, members can access up to $60 in over-the-counter items every three months with no copay.
Inpatient Hospital See details
Inpatient Hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $295 daily copay for days 1 to 7 and no copay for days 8 to 90. Additional acute hospital days are covered with no copay, but additional psychiatric days, non-Medicare-covered stays, and hospital upgrades are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of no copay to $295, with observation services at a $295 copay per stay, while outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of either $75.00 or $145.00 and no coinsurance. Prior authorization is required to access these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $255 copay (and no coinsurance) for ground transport and a 20% coinsurance (and no copay) for air transport. Transportation services are not covered, including trips to plan-approved or any other health-related locations.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $30 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with copays ranging from $130 to $255 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Other covered services like therapy, mental health, and psychiatric care carry a $30 to $40 copay and no coinsurance, though telehealth services have a $0 to $40 copay and 20% coinsurance. Podiatry is not covered, and chiropractic care is only partially covered, as routine and other chiropractic services are excluded.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (PPO) are partially covered, offering annual physical exams, health education, and select screenings with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. Several supplemental options are not covered under this plan, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services covered by Aetna Medicare Signature (PPO) include Medicare-covered exams for a $40 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum per ear every year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a $0 to $40 copay and eyewear with no copay. Routine eye exams are limited to one per year with a $50 annual maximum benefit, and eyewear includes a combined annual allowance of $225 for contacts, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), excluding other diagnostic dental services, fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics. Covered preventive services have no copay and no coinsurance, Medicare-covered services require a $40 copay and no coinsurance, and covered comprehensive services feature no copay and 20% to 50% coinsurance up to a $1,750 annual limit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Covered Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with prior authorization required for most services. Covered items feature no copay, with coinsurance ranging from no coinsurance up to 20% depending on the specific equipment or supply.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with no coinsurance for diagnostic services, which feature no copay for lab services and a copay of up to $75 for diagnostic procedures. Radiological services require no copay for diagnostic radiology, a $10 copay for outpatient X-rays, and a 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers some cardiac rehabilitation services with no coinsurance, but standard cardiac rehabilitation ($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
Aetna Medicare Signature (PPO) covers skilled nursing facility services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering no copay and no coinsurance for covered benefits like annual wellness exams, select cancer screenings, and up to $60 every three months in over-the-counter items. Acupuncture and meal benefits are not covered under this plan.
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