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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 Pee Dee 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 $9200.00 (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 $9200.00 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 (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members enjoy no copay when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options require copays ranging from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply. For higher-tier medications, cost-sharing transitions to coinsurance across all pharmacy and mail-order options. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These clear pricing tiers allow beneficiaries to easily project their out-of-pocket prescription costs.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copays or coinsurance for primary care visits and annual preventive exams. Specialist visits require no copay to a $50 copay, while emergency room services carry a $115 copay that is waived upon admission. For hospital stays, inpatient acute care requires a $388 daily copay for the first seven days, whereas home health services are available with no copay. This plan also includes valuable supplemental benefits, providing routine hearing exams and prescription hearing aids up to a $1,250 annual limit per ear with no copay. Routine eye exams feature no copay to a $50 copay alongside a $100 annual eyewear allowance, and preventive dental care is fully covered with no copay or coinsurance. Additionally, durable medical equipment is covered with no copay and coinsurance ranging from 0 to 20 percent.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, you pay a $388 daily copay for days 1 to 7 and no copay for subsequent days, while psychiatric stays require a $260 daily copay for days 1 to 8 and no copay for days 9 to 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this benefit.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, although copays vary by service and prior authorization may be required. Outpatient hospital services have a copay of $0 to $388, observation services carry a $388 copay per stay, and substance abuse sessions require a $40 copay, while ambulatory surgical center and blood services have no copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services under the Aetna Medicare Signature (PPO) plan cover ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, subject to prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) with a $115 copay (waived if admitted within 24 hours) and no coinsurance, while urgently needed services require a $40 copay and no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 lifetime maximum with no coinsurance, featuring a $115 copay for emergency or urgent care and a $275 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while mental health, psychiatric, and opioid treatment services have a $40 copay and no coinsurance. Chiropractic and podiatry services are not covered, and telehealth benefits are available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) provides coverage for preventive services, including annual physical exams and select screenings with no copay and no coinsurance, though kidney disease education requires no copay and a 20% coinsurance. Additional supplemental benefits are only partially covered, with services like fitness benefits and health education covered with no copay and no coinsurance, while personal emergency response systems, in-home safety assessments, and weight management programs are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), which offers routine hearing exams and fitting evaluations with no copay and no coinsurance, and Medicare-covered exams for a $50 copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $1,250 maximum benefit per ear every year, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, featuring a $0 to $50 copay for eye exams and no copay for eyewear. Eye exams are capped at a $50 annual maximum benefit, while eyewear has a combined annual maximum benefit of $100 for contacts, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by the Aetna Medicare Signature (PPO) plan, featuring no copay and no coinsurance for preventive care like exams and cleanings, and a $50 copay with no coinsurance for Medicare-covered dental. Comprehensive services such as restorative care and endodontics are covered with no copay and 20% to 50% coinsurance up to a $1,000 yearly limit. Fluoride treatments, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Medicare Part B chemotherapy and other Part B drugs require a 0% to 20% coinsurance and no copay.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copay for durable medical equipment (DME), prosthetics, and diabetic shoes, while coinsurance ranges from no coinsurance up to 20% depending on the service. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, requiring prior authorization for all services. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $200 copay for procedures, while radiological services require no copay for X-rays and diagnostic imaging, and a copay plus a minimum 20% coinsurance for therapeutic services.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature (PPO) plan with no coinsurance, but specific sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are not covered and carry 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, 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), featuring no copay and no coinsurance for annual wellness exams, screening mammographies, additional gFOBT and FIT tests, and over-the-counter items up to $30 every three months. Acupuncture and meal benefits are not covered under this plan.
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