A non-government entity
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 Counties in Northern and Tuscaloosa Markets. 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.
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 $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:
Sign up for Aetna Medicare Signature Plus (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature Plus (PPO) plan features an Enhanced Alternative drug benefit with a $615 prescription drug deductible. Once you meet this deductible, you will enjoy no copay for Tier 1 preferred generic drugs at preferred retail pharmacies or through preferred mail order, while standard pharmacies and mail options require a $12 copay. For other formulary tiers, you will pay a 24% coinsurance for Tier 2 standard generics and a 25% coinsurance for Tier 3 preferred brand and Tier 4 non-preferred drugs. These cost-sharing rates apply until your total yearly out-of-pocket drug costs reach $2,100, after which you enter the catastrophic coverage phase and pay nothing for covered Part D prescriptions. Additionally, individuals who qualify for the low-income subsidy can reduce their Part D premium cost to zero.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan offers comprehensive coverage with predictable out-of-pocket costs, featuring no copay for primary care visits, annual physicals, home health services, and routine preventive care. For specialized medical care, members will encounter varying copays, such as $0 to $45 for specialists, a $115 copay for emergency services, and daily copays for inpatient hospital stays with no coinsurance. Many outpatient, diagnostic, and laboratory services also require no copay or coinsurance, helping to keep common healthcare expenses low. Additionally, this plan covers essential vision, dental, and hearing benefits, providing no copay for routine eye exams, dental cleanings, and hearing fittings, alongside a $200 annual allowance for eyewear. While major services like durable medical equipment, dialysis, and comprehensive dental require a 20% to 50% coinsurance, members can also access convenient extras like over-the-counter item allowances and meal benefits at no cost.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Aetna Medicare Signature Plus (PPO) with no coinsurance, requiring a daily copay of $388 for days 1-7 of acute stays and $407 for days 1-5 of psychiatric stays, with no copay for subsequent days. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under Aetna Medicare Signature Plus (PPO) with no coinsurance required. Members will pay no copay for ambulatory surgical center and blood services, a $30 copay for outpatient substance abuse sessions, a $388 copay per stay for observation services, and a copay of $0 to $450 for outpatient hospital services.
Partial Hospitalization See details
Partial Hospitalization benefits are covered under the Aetna Medicare Signature Plus (PPO) plan with a copay ranging from $105.00 to $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature Plus (PPO), as transportation services to health-related locations are not covered. Covered ground ambulance services require a $295 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay, with prior authorization required for all ambulance services.
Emergency Services See details
Aetna Medicare Signature Plus (PPO) covers emergency services for a $115 copay and urgent care services for a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $115 to $295, up to a maximum benefit limit of $250,000.
Primary Care See details
Primary Care is partially covered by Aetna Medicare Signature Plus (PPO), as podiatry services and routine chiropractic care are not covered. Covered services feature no copay for primary care physician visits, copays ranging from $0 to $45 for specialists, and a 20% coinsurance with a $0 to $45 copay for telehealth benefits.
Preventive Services See details
Aetna Medicare Signature Plus (PPO) offers partial coverage for preventive services, with no copays or coinsurance for annual physicals, fitness benefits, and screenings, while kidney disease education requires a 20% coinsurance and no copay. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature Plus (PPO) provides partial coverage for hearing services, excluding OTC hearing aids and inner ear, outer ear, or over the ear prescription hearing aids. Routine exams, fittings, and general prescription hearing aids are covered with no copay and no coinsurance, while other covered hearing exams require a $45 copay and no coinsurance.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Plus (PPO) with no deductible or coinsurance, offering yearly routine eye exams and follow-up diabetic exams for no copay, while other exams require a copay of $0 to $45. Eyewear, including contact lenses and eyeglasses, is also covered with no copay up to a combined maximum of $200 per year.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Plus (PPO), featuring no copay for oral exams, cleanings, and dental x-rays, alongside a $45 copay for Medicare dental services. Comprehensive treatments require 20% to 50% coinsurance, while fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Plus (PPO) covers Home Infusion bundled Services, featuring a $35 copay and no coinsurance for Medicare Part B insulin. Other covered Part B chemotherapy, radiation, and miscellaneous drugs require no copay and carry a coinsurance ranging from no coinsurance up to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Plus (PPO) with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
Aetna Medicare Signature Plus (PPO) covers durable medical equipment, prosthetic devices, and medical supplies with a 20% coinsurance and no copay. Diabetic supplies require a 0% to 20% coinsurance and no copay, while diabetic therapeutic shoes and inserts are covered with no copay.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Plus (PPO) covers diagnostic and radiological services, with prior authorization required for these benefits. Lab services and outpatient X-rays feature no copay and no coinsurance, while therapeutic radiological services require a 20% coinsurance and no copay. Diagnostic procedures and tests carry a copay of $0 to $95, and diagnostic radiological services have a copay of up to $300, with no coinsurance required for either service.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature Plus (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under Aetna Medicare Signature Plus (PPO), as there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation sub-services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Plus (PPO) partially covers Skilled Nursing Facility (SNF) services with prior authorization, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no coinsurance. Additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature Plus (PPO), featuring no copay and no coinsurance for meal benefits, wellness exams, and over-the-counter (OTC) items. Acupuncture and dual-eligible SNP services are not covered, and the OTC benefit is limited to a $15 allowance every three months.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved