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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 Midland and Surrounding Area South Carolina. 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 $9750.00 (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 $9750.00 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 prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using preferred pharmacies or preferred mail order services. If you use standard pharmacies or standard mail order, copays start at $2 for Tier 1 and $12 for Tier 2 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 drugs and Tier 5 specialty drugs require a 25% coinsurance across all pharmacy options. Tier 5 specialty medications are limited to a one-month supply, while Tier 3 and Tier 4 drugs offer multi-month supply options.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with predictable cost-sharing, featuring no copay and no coinsurance for primary care visits and many preventive services. For hospital care, inpatient stays require a daily copay of $388 for the first seven days of acute care with no coinsurance, while outpatient hospital services range from no copay up to a $388 copay. Emergency room visits carry a $115 copay, which is waived if you are admitted, and urgent care visits require a $40 copay. This plan also includes valuable supplemental benefits with no deductibles and no coinsurance for routine vision and hearing services, featuring no copay for routine exams alongside allowances for eyewear and hearing aids. Preventive dental care has no copay, while comprehensive dental services are covered with no copay and a 20% to 50% coinsurance up to a $1,000 annual limit. Additionally, members benefit from a $30 quarterly over-the-counter reimbursement and no copays for the first 20 days of skilled nursing facility stays.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, featuring a $388 daily copay for days 1 to 7 of acute stays and a $260 daily copay for days 1 to 8 of psychiatric stays, with no copay for remaining covered days. This benefit is partially covered, as upgrades and non-Medicare-covered stays for acute care, and additional days and non-Medicare-covered stays for psychiatric care, are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $388, observation services carry a $388 copay per stay, and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Routine transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $115 copay (waived if admitted to the hospital within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $115 copay, and worldwide emergency transportation is covered with a $275 copay, all featuring no coinsurance up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Covered therapy, mental health, and psychiatric services require copays ranging from $35 to $40 with no coinsurance, while telehealth services have a $0 to $40 copay and 20% coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, but routine chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), with most benefits like annual physicals, glaucoma screenings, and fitness programs featuring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several services—including weight management, therapeutic massage, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services under Aetna Medicare Signature (PPO) are partially covered with no deductible and no coinsurance. Medicare-covered hearing exams require a $50 copay, while routine exams, fitting evaluations, and prescription hearing aids (up to $1,250 per ear annually) have no copay, but 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 (PPO) covers vision services with no deductible and no coinsurance, offering routine and diabetic eye exams with no copay and Medicare-covered exams with a $0 to $50 copay. Eyewear, including contacts, lenses, and frames, is covered with no copay up to a combined annual maximum of $100.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering preventive care such as cleanings and exams with no copay and no coinsurance, while Medicare-covered dental services require a $50 copay and no coinsurance. Comprehensive dental services are covered with no copay and 20% to 50% coinsurance up to a $1,000 annual limit, but fluoride, other diagnostic or preventive services, maxillofacial prosthetics, implants, and orthodontics 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. Medicare Part B chemotherapy and other Part B drugs carry a coinsurance of 0% to 20%, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive coverage for these services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with no copays for most services. Coinsurance ranges from no coinsurance to 20% depending on the item, and prior authorization is required for many of these benefits.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization, featuring no copay for lab and outpatient X-ray services. Diagnostic procedures and tests have a copay ranging from $0 to $200 with no coinsurance, diagnostic radiological services have a copay starting at $0, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services under Aetna Medicare Signature (PPO) feature no coinsurance, and while some services are covered, specific programs including cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered and require copayments ranging from $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services with no copay and no coinsurance, including a $30 quarterly over-the-counter reimbursement benefit, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings. Acupuncture, meal benefits, and dual-eligible SNP services are not covered.
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