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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Central and Eastern Pennsylvania. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 has a $1000.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $10100.00 (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 $10100.00 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 Extra (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when filling prescriptions through preferred pharmacies or preferred mail order services. If you use standard pharmacies or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs are structured as coinsurance across all pharmacy and mail order options. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Specialty tier prescriptions are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, preventive care, and home health services. Specialist visits require a copay ranging from no copay to $50, while emergency room visits carry a $130 copay that is waived upon admission. For inpatient hospital stays, members pay a daily copay of $435 for days one through seven, with no coinsurance or copays required for the remainder of the stay. Ancillary benefits include routine hearing and vision exams with no copay, supported by a $500 annual hearing aid allowance and a $150 eyewear limit. Dental benefits feature no copay or coinsurance for preventive care, while comprehensive dental services require a 20% to 50% coinsurance up to a $500 yearly limit. Diagnostic lab services and home infusion bundled services are also covered with no copay.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, requiring a $435 daily copay for days 1-7 of acute stays (no copay thereafter) and a $350 daily copay for days 1-5 of psychiatric stays (no copay thereafter). This benefit is partially covered, requiring prior authorization and excluding upgrades, non-Medicare-covered stays, and additional psychiatric days.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from no copay to $435, observation services require a $435 copay per stay, and outpatient substance abuse sessions carry a $40 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance and copays ranging from no copay to $145. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $265 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. For transportation benefits, some services are covered but transportation to plan-approved locations or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature Extra (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 $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays of $130 for emergency or urgent care and $265 for emergency transportation.
Primary Care See details
Aetna Medicare Signature Extra (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Other outpatient services like therapy, mental health, and podiatry require copays ranging from $35 to $50 and no coinsurance, while telehealth has a $0 to $50 copay and 20% coinsurance. For chiropractic services, some services are covered but routine chiropractic care and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) provides partial coverage for preventive services, offering no copay and no coinsurance for annual physical exams, health education, select screenings, and fitness benefits. Kidney disease education services require no copay and a 20% coinsurance, while several supplemental services such as medical nutrition therapy, weight management, and personal emergency response systems are not covered.
Hearing Services See details
Hearing services under Aetna Medicare Signature Extra (PPO) are covered with no deductible, featuring a $50 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fittings. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual limit, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no deductibles and no coinsurance, offering routine eye exams and eyewear with no copay, though Medicare-covered exams may have a copay up to $50. The plan features a $50 annual maximum for eye exams and a combined $150 annual limit for eyewear, including contacts, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (PPO), 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 oral surgery are covered with no copay and 20% to 50% coinsurance up to a $500 annual limit, though fluoride, implants, orthodontics, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Covered Part B insulin drugs require a $35 copay and no coinsurance, while other Part B chemotherapy and radiation drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature Extra (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with no copay and prior authorization required. Coinsurance ranges from no coinsurance to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices require 20% coinsurance and diabetic therapeutic shoes have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature Extra (PPO) plan, with prior authorization required. Lab services feature no copay and no coinsurance, diagnostic procedures range from a $0 to $20 copay with no coinsurance, and radiological services vary from a $0 minimum copay for diagnostic radiology to a $30 copay for X-rays and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, though in practice only some services are covered as cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $198 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not necessary for admission, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, providing a meal benefit for chronic illnesses, annual wellness exams, screening mammographies, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered.
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