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Aetna Medicare Signature Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Plus (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 Plus (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Plus (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Montgomery Counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Plus (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 Plus (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 Plus (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. Additionally, this plan comes with a Part B Premium reduction of $10.00. You must continue to pay paying your reduced 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 $13900.00 (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 $13900.00 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 Plus (PPO) plan features an enhanced alternative drug benefit with an annual prescription drug deductible of $615. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through preferred mail order, while standard pharmacies and mail options charge a $12 copay. For Tier 2 standard generic drugs, you will pay a 24% coinsurance regardless of the pharmacy type you choose. For Tier 3 preferred brand drugs and Tier 4 non-preferred drugs, the plan requires a 25% coinsurance across all pharmacy and mail order locations. Once your annual out-of-pocket drug costs reach $2,100, you will enter the catastrophic coverage phase and pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan provides comprehensive medical coverage, featuring no copay and no coinsurance for primary care visits, home health services, and routine preventive care. For specialist visits, outpatient services, and emergency care, members will pay set copays—such as a $115 copay for emergency room visits—with no coinsurance. Inpatient hospital stays require daily copays for the first several days, after which there is no copay and no coinsurance. Supplemental benefits include routine dental, vision, and hearing exams with no copay and no deductible, alongside allowances for eyewear and hearing aids. Comprehensive dental services and durable medical equipment are covered with no copays, though they carry coinsurance fees ranging up to 50% and 20% respectively. Members also enjoy extra perks like over-the-counter items, home-delivered meals, and fitness benefits with no copay and no coinsurance.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Aetna Medicare Signature Plus (PPO) with no coinsurance, though prior authorization is required. Acute care requires a $388 copay per day for days 1 to 7 and no copay for days 8 to 90, but upgrades and non-Medicare-covered stays are not covered. Psychiatric care requires a $355 copay per day for days 1 to 5 and no copay for days 6 to 90, but additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services are covered under Aetna Medicare Signature Plus (PPO) with no coinsurance for all services. Members pay no copay for ambulatory surgical center and outpatient blood services, a $30 copay for outpatient substance abuse sessions, a $388 copay per stay for observation services, and a $0 to $450 copay for outpatient hospital services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature Plus (PPO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature Plus (PPO), requiring a $270 copay and no coinsurance for ground ambulance services, and a 20% coinsurance and no copay for air ambulance services. Prior authorization is required for all ambulance services, while transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Plus (PPO) covers emergency services with a $115 copay, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services with a $40 copay, with no coinsurance required for either. Worldwide emergency and urgent care are also covered up to a $250,000 lifetime limit, featuring a $115 copay for emergency or urgent care, a $270 copay for emergency transportation, and no coinsurance.
Primary Care See details
Aetna Medicare Signature Plus (PPO) covers primary care physician visits with no copay and no coinsurance, and specialist visits with no copay to a $45 copay and no coinsurance. Physical, occupational, speech, psychiatric, and opioid treatment therapies require a $30 copay and no coinsurance, while telehealth has a range of no copay to a $40 copay and 20% coinsurance. Podiatry and routine chiropractic care are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Plus (PPO), offering most covered services, such as annual physicals and fitness benefits, with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance with no copay. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home/bathroom safety devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Plus (PPO), which offers routine hearing exams, fitting evaluations, and prescription hearing aids up to $750 annually with no copay, coinsurance, or deductible. Other covered exams require a $45 copay and no coinsurance, while OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Plus (PPO) covers vision services with no deductibles and no coinsurance, including annual routine eye exams with no copay. Other eye exams have a copay ranging from $0 to $45, and eyewear is covered up to a $200 annual limit with no copay.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Plus (PPO), offering preventive care like exams and cleanings with no copay and no coinsurance, while Medicare-covered dental has a $45 copay and no coinsurance. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $2,000 yearly limit, but fluoride, implants, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by Aetna Medicare Signature Plus (PPO) and require prior authorization. Medicare Part B insulin drugs are available with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Aetna Medicare Signature Plus (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment benefits are covered by Aetna Medicare Signature Plus (PPO) with no copays required for any services. Durable medical equipment, medical supplies, and diabetic supplies carry coinsurance ranging from no coinsurance to 20%, prosthetic devices require 20% coinsurance, and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Plus (PPO) covers diagnostic and radiological services with prior authorization, featuring no copay for lab services and outpatient X-rays. Diagnostic procedures and tests have a copay ranging from $0 to $95, diagnostic radiological services require a copay of up to $300, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Plus (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Plus (PPO) indicates some services are covered, but in practice, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. Because these services are not covered, there are no copays or coinsurance fees.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Plus (PPO) partially covers Skilled Nursing Facility (SNF) services with no copay for days 1 through 20, a $218 copay for days 21 through 100, and no coinsurance. Prior authorization is required, and additional days beyond Medicare-covered SNF care are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Plus (PPO), offering no copay and no coinsurance for covered benefits like over-the-counter items, meal benefits, and select wellness exams. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered under this plan.
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