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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 IN Central. 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:
Sign up for Aetna Medicare Signature (PPO)
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Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when utilizing preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order services, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications, cost-sharing transitions to coinsurance across all pharmacy and mail-order options under this plan. 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. These coinsurance rates apply equally regardless of whether you use preferred or standard pharmacies, or mail-order delivery.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for everyday healthcare needs, featuring no copays for primary care visits, annual wellness exams, and routine preventive screenings. Specialist visits require a $35 copay, while routine dental, hearing, and vision exams are also available with no copay. Additionally, the plan provides valuable allowances for extras, including up to $500 per ear annually for prescribed hearing aids and a $100 annual allowance for eyewear. For more intensive medical needs, inpatient hospital stays require a $310 daily copay for the first seven days and no copay thereafter, while home health services are covered with no copay. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care is available for a $40 copay. Diagnostic lab services and various medical equipment are also highly accessible, often requiring no copays, though some equipment and dialysis services carry a standard 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $310 daily copay for days 1 through 7 and no copay for days 8 through 90. Prior authorization is required, and coverage excludes upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $310 (including a $310 copay per stay for observation services), while individual and group outpatient substance abuse sessions require a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $75.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered under the Aetna Medicare Signature (PPO) plan, as transportation to health-related locations is not covered. Ground ambulance services require a $295 copay plus coinsurance, while air ambulance services require a 20% coinsurance plus a copay, with prior authorization required for all ambulance services.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted within 24 hours, and urgent care with a $40 copay, both featuring no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 limit with no coinsurance, requiring a $130 copay for medical care and a $295 copay for emergency transportation.
Primary Care See details
Primary Care benefits under Aetna Medicare Signature (PPO) are provided with no copay and no coinsurance for primary care visits, while specialist visits require a $35 copay and no coinsurance. Physical, occupational, and speech therapies require a $30 copay and no coinsurance, mental health services require a $40 copay and no coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (PPO), offering no copay and no coinsurance for annual exams, screenings, and fitness benefits, while kidney disease education requires a 20% coinsurance and no copay. Several supplemental services are not covered, including weight management, personal emergency response systems, in-home support, and medical nutrition therapy.
Hearing Services See details
Aetna Medicare Signature (PPO) covers routine hearing exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $35 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no deductible and no coinsurance, offering a copay of $0 to $35 for eye exams and no copay for eyewear. The plan provides up to $50 annually for eye exams, including one routine exam, and a $100 combined annual limit for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) dental services are partially covered, featuring Medicare-covered dental for a $35 copay and no coinsurance, and preventive care like cleanings and exams with no copay and no coinsurance. Comprehensive dental care, including restorative services, endodontics, periodontics, prosthodontics, and oral surgery, is available with no copay and 20% to 50% coinsurance up to a $750 annual limit; however, fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive 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. Covered Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays for durable medical equipment, prosthetics, medical supplies, and diabetic therapeutic shoes. Coinsurance for these covered items ranges from no coinsurance up to 20%, and prior authorization is required for most services.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $100 copay, while radiological services require a $20 copay for X-rays, no minimum copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance. Prior authorization is required to receive this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, though copays apply to specific services. Members will pay a $20 copay for cardiac and intensive cardiac rehabilitation, a $15 copay for pulmonary rehabilitation, and a $25 copay for supervised exercise therapy (SET) for symptomatic peripheral artery disease.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), 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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