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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 LA Parishes. 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 annual prescription drug deductible of $615. For Tier 1 (Preferred Generic) and Tier 2 (Generic) medications, policyholders enjoy no copay when filling prescriptions through preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options are also available with low copays ranging from $2 to $12 for a one-month supply. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 (Preferred Brand) drugs require a 24% coinsurance, while Tier 4 (Non-Preferred) and Tier 5 (Specialty) drugs carry a 25% coinsurance across all pharmacy and mail-order networks. This prescription drug coverage offers significant savings on generic medications while providing predictable cost-sharing for specialized brand-name drugs.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan offers comprehensive coverage featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits range from no copay to a fifty dollar copay, while inpatient hospital stays require a daily copay of two hundred seventy-two dollars for the first ten days with no coinsurance. Emergency care is accessible with a one hundred fifteen dollar copay, which is waived if you are admitted to the hospital. Routine dental preventive care and annual hearing exams are available with no copay, while vision exams range from no copay to fifty dollars. For specialized medical needs, durable medical equipment and dialysis services require no copay alongside a twenty percent coinsurance. Additionally, essential services like home infusion Part B insulin are covered with a thirty-five dollar copay and no coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Plus (PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $272 for days 1 to 10 of acute stays and $407 for days 1 to 5 of psychiatric stays, with no copay for remaining covered days. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Plus (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copays. Outpatient hospital services require a copay of $0 to $272, observation services have a $272 copay per stay, and outpatient substance abuse sessions require a $30 copay.
Partial Hospitalization See details
Partial hospitalization services 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 access this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Plus (PPO) covers ground ambulance services with a $295 copay and air ambulance services with a 20% coinsurance, with prior authorization required for all ambulance services. Transportation services to plan-approved or any health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature Plus (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $295.
Primary Care See details
Primary care benefits under Aetna Medicare Signature Plus (PPO) are covered with no copay and no coinsurance for primary care physician services, and a $0 to $50 copay with no coinsurance for specialists. Physical, occupational, and speech therapies require a $25 copay with no coinsurance, while mental health services have a $30 copay with no coinsurance, and podiatry and routine chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Plus (PPO) covers preventive services with no copay and no coinsurance for annual physicals, glaucoma screenings, and diabetes self-management, though kidney disease education requires a 20% coinsurance with no copay. The benefit is partially covered, as several supplemental services like in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered under the Aetna Medicare Signature Plus (PPO) plan, featuring a $50 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Plus (PPO) with no deductibles and no coinsurance. Eye exams carry a copay ranging from no copay to $50 with a $50 annual limit, while covered eyewear like contacts and eyeglasses has no copay up to a $250 combined annual limit.
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, and Medicare-covered dental with a $50 copay and no coinsurance. Comprehensive benefits such as restorative care and endodontics have no copay and 20% to 50% coinsurance up to a $2,000 annual limit, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Plus (PPO) covers home infusion bundled services with no copay, requiring prior authorization. Under this benefit, Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature Plus (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature Plus (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and 20% coinsurance. Diabetic supplies are covered with no copay and 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts carry no copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Plus (PPO) with prior authorization required. Outpatient diagnostic procedures feature no coinsurance and a copay of $0 to $95, lab and outpatient X-ray services have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
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
Aetna Medicare Signature Plus (PPO) covers cardiac rehabilitation services with no coinsurance. Covered services require a $25 copay for cardiac and intensive cardiac rehabilitation, a $15 copay for pulmonary rehabilitation, and a $20 copay for supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD).
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Plus (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other Services under the Aetna Medicare Signature Plus (PPO) are partially covered, featuring no copay and no coinsurance for covered benefits such as chronic illness meals, wellness screenings, and over-the-counter items up to $30 every three months. Acupuncture is not covered under this plan.
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