A non-government entity
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 Southwest. 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. If you use a standard pharmacy or standard mail order, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For higher-tier medications, the plan transitions to coinsurance rather than 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 options. Specialty medications in Tier 5 are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with predictable costs, including no copay for routine preventive services and a low $5 copay for primary care visits. Specialist visits range from no copay to a $40 copay, while inpatient hospital stays require a $300 daily copay for the first seven days and no copay for days eight through ninety. Outpatient services and emergency care are also covered, with emergency visits requiring a $130 copay that is waived if you are admitted. This plan also includes valuable supplemental benefits, featuring routine vision and hearing exams with no copay alongside annual allowances for eyewear and hearing aids. Preventive dental care requires no copay or coinsurance, while comprehensive dental services are covered with a 20% to 50% coinsurance up to a $1,250 annual limit. Additionally, members benefit from no copay for home health services and a $35 allowance every three months for over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 to 7 and no copay for days 8 to 90. 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, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $300, observation services have a $300 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copayment of $75.00 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) require prior authorization and feature a $285 copay (and no coinsurance) for ground transport and a 20% coinsurance (and no copay) for air transport, with fees not waived if you are admitted to the hospital. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $45 copay, both featuring no coinsurance. Worldwide emergency and urgent care are covered with a $130 copay, and worldwide emergency transportation carries a $285 copay, all with no coinsurance up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits for a $5 copay and specialist visits for no copay to a $40 copay, both with no coinsurance, while chiropractic and podiatry services are not covered. Other covered benefits, including physical therapy, mental health, and opioid treatment, require copays of $30 to $40 with no coinsurance, and telehealth options have no copay to a $45 copay with 20% coinsurance.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (PPO) are partially covered, offering annual physical exams, health education, and various screenings with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Several sub-services are not covered under this plan, including weight management programs, personal emergency response systems, in-home safety assessments, and nutritional/dietary benefits.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (PPO), featuring Medicare-covered exams for a $40 copay and annual routine exams or fitting evaluations for no copay, with no coinsurance or deductibles. Prescription hearing aids are partially covered with no copay or coinsurance up to a $1,000 maximum per ear annually, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) vision services are covered with no deductibles or coinsurance, featuring no copay for annual routine eye exams and up to a $40 copay for Medicare-covered exams. Covered eyewear, including lenses, frames, and contacts, also has no copay and is subject to a $225 annual combined maximum allowance.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental with a $40 copay and no coinsurance. Comprehensive benefits like restorative care and endodontics have no copay and 20% to 50% coinsurance up to a $1,250 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while other Medicare Part B chemotherapy and radiation drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays and coinsurance ranging from no coinsurance up to 20% depending on the item. Prior authorization is required for durable medical equipment, prosthetics, and diabetic supplies, with diabetic supplies limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay of $0 to $75, while lab services and diagnostic radiology have no copay. Outpatient X-rays require a $20 copay, and therapeutic radiology services carry a minimum 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
Cardiac Rehabilitation Services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, but standard cardiac rehabilitation (with a $20 copay), intensive cardiac rehabilitation (with a $20 copay), pulmonary rehabilitation (with a $15 copay), and supervised exercise therapy for peripheral artery disease (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, requiring a daily copay of $10 for days 1 to 20 and $218 for days 21 to 100. Prior authorization is required, a prior three-day hospital stay is not, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services with no copay and no coinsurance, including an annual wellness exam, additional screenings, and up to $35 every three months for over-the-counter (OTC) items. Acupuncture and meal benefits are not covered under this benefit.
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