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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 Middle Tennessee. 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 $7750.00 (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 $7750.00 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 generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service for any supply length. If you choose standard retail or mail-order options, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36. Brand-name and specialty medications under this plan are subject to 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 carry a 25% coinsurance. These coinsurance rates apply to both preferred and standard pharmacies, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care doctor visits, routine physical exams, and home health services. Specialist visits and routine vision, hearing, and dental exams are also highly accessible, featuring no copay for standard preventive care. For inpatient hospital stays, members pay a daily copay of $382 for the first five days of acute care with no coinsurance. Emergency care is available with a $130 copay, while urgent care visits require a $45 copay, with no coinsurance required for either service. Diagnostic lab tests and home infusion services are covered with no copay, whereas dialysis and durable medical equipment require up to a 20% coinsurance. Prescription hearing aids and eyewear are also covered up to specified annual limits with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a $382 daily copay for days 1 to 5 of acute stays and a $292 daily copay for days 1 to 8 of psychiatric stays, with no copay for subsequent covered days. The benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) outpatient services are covered with no coinsurance, including no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $382, observation services require a $382 copay per stay, and outpatient substance abuse sessions carry a $40 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of $140.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services under Aetna Medicare Signature (PPO) cover 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. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $45 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum benefit with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Aetna Medicare Signature (PPO) provides primary care doctor visits with no copay and no coinsurance, while specialist visits range from a $0 to $55 copay with no coinsurance. Physical, occupational, and speech therapy services require a $35 copay with no coinsurance, psychiatric and mental health services have a $40 copay with no coinsurance, and chiropractic care is only partially covered since routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) partially covers preventive services, providing annual physical exams, screenings, and fitness benefits with no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Non-covered services include 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/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services are covered by Aetna Medicare Signature (PPO), offering routine exams and fitting evaluations yearly with no copay and no coinsurance, while Medicare-covered exams require a $55 copay and no coinsurance. Prescription hearing aids are partially covered up to $500 annually with no copay or coinsurance, but OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a $0 to $55 copay (including routine exams at no copay) up to a $50 annual limit. Covered eyewear, including contacts and eyeglasses, is available with no copay up to a $100 combined annual maximum.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring Medicare-covered dental services for a $55 copay and no coinsurance, plus select preventive services like exams, x-rays, and cleanings with no copay and no coinsurance. Non-covered dental services include fluoride, restorative care, endodontics, periodontics, prosthodontics, implants, and orthodontics.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy and other drugs have a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services feature no coinsurance, offering lab services with no copay and procedures with a $0 to $200 copay, while radiological services range from outpatient X-rays with no copay (coinsurance applies) to therapeutic radiology with a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, though only some services are covered in practice. Standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, though a prior three-day hospital stay is not necessary, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Other services under the Aetna Medicare Signature (PPO) are partially covered, 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 under this plan.
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