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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 Bowling Green/Southwest KY Area. 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 $9550.00 (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 $9550.00 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) prescription drug plan has an annual drug deductible of $615. You will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using preferred retail pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12. For brand-name and specialty 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 networks. This plan structure helps maximize savings on everyday generic medications while offering predictable cost-sharing for advanced prescriptions.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with predictable out-of-pocket costs and no coinsurance for many key services. Primary care doctor visits require a low $5 copay, specialist visits have a $40 copay, and emergency room visits feature a $130 copay that is waived if you are admitted. For hospital care, there is a $300 daily copay for the first six days of an inpatient stay, while skilled nursing facility stays require no copay for the first 20 days. This plan also prioritizes preventive and supplemental health care by offering annual physicals, routine dental cleanings, and routine vision and hearing exams with no copay. Members receive a $200 annual eyewear allowance and coverage for up to two prescription hearing aids with no copay, alongside a quarterly $60 allowance for over-the-counter items. Other essential services like home health care require no copay, while dialysis and durable medical equipment are covered with coinsurance ranging up to 20 percent.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 through 6 and no copay for days 7 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and blood services, and a $40 copay for substance abuse sessions. Outpatient hospital services require a copay of $0 to $300, while observation services have a $300 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of either $40.00 or $145.00 and no coinsurance, with prior authorization required.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $250 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Non-emergency 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 $130 copay, which is waived if admitted to the hospital within 24 hours, and no coinsurance. Urgently needed services require a $50 copay with no coinsurance, while worldwide emergency and urgent services are covered up to a $250,000 maximum plan benefit with no coinsurance and copays of $130 (or $250 for worldwide emergency transportation).
Primary Care See details
Primary care benefits under the Aetna Medicare Signature (PPO) feature a $5 copay for primary care visits and no copay to a $40 copay for specialists, both with no coinsurance. Most other services, including physical therapy, psychiatric, and podiatry, require a $40 copay with no coinsurance, while telehealth has no copay to a $50 copay and 20% coinsurance. Some chiropractic services are covered for a $15 copay and no coinsurance, but routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) covers preventive services, including annual physicals, screenings, and select supplemental benefits, with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. This benefit is partially covered, as several additional services such as weight management, therapeutic massage, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO) with no deductible, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Up to two prescription hearing aids are covered annually with no copay or coinsurance up to a $1,250 maximum per ear, but OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring a $0 to $40 copay for eye exams and no copay for eyewear. This includes one routine eye exam per year with no copay (up to a $50 annual limit) and a $200 yearly allowance with no copay for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are covered by the Aetna Medicare Signature (PPO), featuring a $40 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care like exams and cleanings. Comprehensive services like restorative care and endodontics are covered with no copay and 20% to 50% coinsurance up to a $1,000 annual limit, though fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, although prior authorization is required. Under this benefit, covered Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
Dialysis Services See details
The Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance, though 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 0% to 20%. 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 by Aetna Medicare Signature (PPO) under prior authorization, with diagnostic services requiring no coinsurance, no copay for lab work, and a $0 to $50 copay for outpatient procedures. Radiological services feature no copay for outpatient X-rays, copays starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
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; however, only some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation are not covered in practice and require copays of $15 to $20.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring 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 100 Medicare-covered days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services with no copay and no coinsurance, which includes up to $60 every three months for over-the-counter items, annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture and meal benefits are not covered under this plan.
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