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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 West 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, there is no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose a standard pharmacy or standard mail-order service, copays range from $2 to $6 for Tier 1 drugs and $12 to $36 for Tier 2 drugs depending on the supply duration. For higher-tier medications, the plan transitions from copays to coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with no copay or coinsurance for primary care visits and most preventive services. Specialist visits range from no copay up to a $75 copay, while inpatient hospital stays require a $350 daily copay for the first seven days of acute care. Emergency care is accessible with a $130 copay, which is waived if you are admitted, and outpatient services generally feature no coinsurance. Members also benefit from routine vision, hearing, and preventive dental care with no copays or coinsurance, alongside allowances for eyewear and hearing aids. For specialized needs, home health services require no copay, while durable medical equipment and dialysis services generally carry a coinsurance of up to 20%. Diagnostic lab tests feature no copay, helping to keep your routine wellness and diagnostic costs highly predictable.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $350 copay for days 1 to 7 of acute stays and a $334 copay for days 1 to 7 of psychiatric stays, with no copay for subsequent days. 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, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $350, while outpatient substance abuse sessions have a $30 copay and observation services require a $350 copay per stay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with a copay of either $55.00 or $145.00 and no coinsurance, depending on the service. Prior authorization is required for these covered services.
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, subject to prior authorization. Transportation services to plan-approved or any other health-related locations are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) offers emergency services for a $130 copay, which is waived if you are admitted to the hospital within 24 hours, and urgently needed services for a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are covered with a $130 copay, and worldwide emergency transportation has a $275 copay, all featuring no coinsurance up to a maximum plan limit of $250,000.
Primary Care See details
Aetna Medicare Signature (PPO) primary care benefits feature no copay and no coinsurance for primary care visits, alongside specialist visits costing a $0 to $75 copay and no coinsurance. Therapy and mental health services require copays of $30 to $40 with no coinsurance, telehealth carries a $0 to $75 copay and 20% coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered under the Aetna Medicare Signature (PPO) plan, with most covered benefits like annual physicals and screenings requiring no copay and no coinsurance, except for kidney disease education which has no copay but a 20% coinsurance. However, several sub-services are not covered, including weight management, alternative therapies, therapeutic massage, personal emergency response systems, in-home safety assessments, nutritional benefits, and caregiver support.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams with a $75 copay and no coinsurance, while routine hearing exams and fitting evaluations are covered with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay of $0 to $1,700, 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. The plan provides one routine eye exam per year up to a $50 maximum, alongside a $100 annual combined allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring no copay or coinsurance for preventive care like exams and cleanings, and a $75 copay with no coinsurance for Medicare-covered dental. Comprehensive services have no copay and 20% to 50% coinsurance up to a $1,500 annual maximum, but fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive 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 plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require a 0% to 20% coinsurance.
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
Aetna Medicare Signature (PPO) covers medical equipment with no copays, though prior authorization is required. Under this plan, members pay a coinsurance of 0% to 20% for durable medical equipment, medical supplies, and diabetic supplies, a flat 20% coinsurance for prosthetic devices, and no coinsurance for diabetic therapeutic shoes or inserts.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic services with no coinsurance, providing lab services with no copay and diagnostic tests with copays ranging from $0 to $200. Radiological services are also covered under the plan, featuring outpatient X-rays and diagnostic radiology with no copays, and therapeutic radiology with 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
Aetna Medicare Signature (PPO) covers cardiac rehabilitation services with no copay and no coinsurance, though only some services are covered in practice. Under this plan, 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, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard 100-day benefit period 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 with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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