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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 North FL, Central FL. 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 $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 (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose a standard retail pharmacy or standard mail-order service, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the supply length. For higher-tier prescription drugs, cost-sharing transitions to coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy types, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both incur a 25% coinsurance. Specialty medications under Tier 5 are limited to a one-month supply at this 25% coinsurance rate.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for core medical services, often featuring no copays and no coinsurance for routine care. You will pay no copay or coinsurance for primary care visits, annual physicals, and home health services, while specialist visits range from no copay to a $75 copay. Inpatient hospital stays require a $350 daily copay for the first six days with no coinsurance, and emergency room visits carry a $130 copay. For ancillary care, the plan provides excellent vision coverage with no copay, coinsurance, or deductible, alongside no copay for preventive dental and routine hearing exams. Comprehensive dental services are covered with no copay and a 20% to 50% coinsurance up to a $1,000 annual limit. Other services like diagnostic lab tests and home infusions feature no copay, while dialysis and durable medical equipment require up to a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. For both acute and psychiatric stays, you will pay a $350 copay per day for days 1 through 6 and no copay for days 7 through 90, but upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered under the Aetna Medicare Signature (PPO) with no coinsurance, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $350, observation services carry a $350 copay per stay, and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, though a copayment of either $55.00 or $145.00 is required. Prior authorization is also required for these covered benefits.
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, both requiring prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are covered with a $130 copay, while worldwide emergency transportation has a $250 copay, all featuring no coinsurance up to a $250,000 maximum plan benefit limit.
Primary Care See details
Primary care benefits under Aetna Medicare Signature (PPO) feature no copay and no coinsurance for primary care visits, and a $0 to $75 copay with no coinsurance for specialists. Other covered services like therapies and mental health sessions require copays of $30 to $35 with no coinsurance, and telehealth has a $0 to $75 copay with 20% coinsurance, while routine chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services under the Aetna Medicare Signature (PPO) are partially covered, offering no copay and no coinsurance for annual physical exams, health education, fitness benefits, and preventive screenings, while kidney disease education requires no copay and a 20% coinsurance. However, several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Hearing services covered by Aetna Medicare Signature (PPO) include Medicare-covered exams for a $75 copay and no coinsurance, as well as annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from no copay up to $1,700 for up to two devices per year, though inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Covered benefits include one routine eye exam per year up to a $50 maximum and a combined $100 annual allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering Medicare-covered dental with a $75 copay and no coinsurance, and preventive cleanings, exams, and x-rays with no copay and no coinsurance. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $1,000 annual limit, though fluoride, 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 chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Depending on the service, coinsurance ranges from no coinsurance up to 20% for durable medical equipment, medical supplies, and diabetic equipment, while prosthetic devices require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for most procedures. Diagnostic services feature no coinsurance, offering no copay for lab services and copays ranging from no copay to $100 for diagnostic tests. Radiological services include no copay for outpatient X-rays, copays starting at no copay for diagnostic radiological services, and a minimum 20% coinsurance for therapeutic radiological services.
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 are covered with no copay and no coinsurance under the Aetna Medicare Signature (PPO) plan, although only some services are covered in practice. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) services are not covered.
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, a prior three-day hospital stay is not required for admission, and additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, providing 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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