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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 Central FL, North 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 prescription 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. Standard pharmacies and standard mail order options require copays starting at $2.00 for Tier 1 and $12.00 for Tier 2 for a one-month supply. Brand-name and specialty medications under this plan are subject to coinsurance rather than flat copays. You will pay a 24% coinsurance for Tier 3 preferred brand drugs and a 25% coinsurance for Tier 4 non-preferred drugs. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply, regardless of whether you use a preferred or standard pharmacy.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copays or coinsurance for primary care visits and wellness exams. Specialist visits require a low copay of up to $30, while inpatient hospital stays have no coinsurance and a $300 daily copay for the first five days. Emergency room visits carry a $130 copay, which is waived if you are admitted, and urgent care is available for a $35 copay. This plan also includes essential routine benefits, including dental care with no copay for many services and vision care with no copay, coinsurance, or deductible. Hearing exams feature no deductible and no copay for annual routine visits, while medical equipment and dialysis services are covered with no copay and coinsurance up to 20%. Additionally, members receive a $45 quarterly allowance for over-the-counter items and have access to home health services with no copay or coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital stays with no coinsurance, requiring a $300 daily copay for days 1 through 5 and no copay for days 6 through 90. This benefit is partially covered, excluding upgrades, non-Medicare-covered stays, and additional psychiatric hospital days beyond 90.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient hospital services with no coinsurance and a copay ranging from no copay to $250, alongside observation services for a $300 copay per stay with no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $30 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of $55.00 or $145.00 and no coinsurance. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (PPO), with ground ambulance services requiring a $275 copay and air ambulance services requiring a 20% coinsurance, both subject to prior authorization. While some transportation services are covered, trips to plan-approved or any 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. Urgent care is covered with a $35 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays of $130 for emergency or urgent care and $275 for transportation.
Primary Care See details
Aetna Medicare Signature (PPO) provides primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $30 copay and no coinsurance. Standard therapies, psychiatric services, and opioid treatments carry a $30 to $35 copay and no coinsurance, while telehealth is available with a $0 to $35 copay and 20% coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) provides partially covered preventive services with no copay and no coinsurance for annual physicals, glaucoma screenings, and fitness benefits, though kidney disease education has no copay and a 20% coinsurance. Several sub-services are not covered, including weight management, therapeutic massage, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Aetna Medicare Signature (PPO) provides partially covered hearing services with no deductible, featuring a $30 copay for Medicare-covered exams and no copay for annual routine exams and fittings, both with no coinsurance. Prescription hearing aids are covered with copays ranging from $0 to $1,700 and no coinsurance, but OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Signature (PPO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Benefits include one routine eye exam per year up to a $50 annual maximum, alongside a combined $150 annual maximum allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), excluding other diagnostic dental services, fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics. Medicare-covered dental services require a $30 copay and no coinsurance, while other covered services feature no copay and coinsurance ranging from 0% to 50% up to a $1,500 annual limit.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay, although prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry 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, although prior authorization is required.
Medical Equipment See details
Medical Equipment benefits under the Aetna Medicare Signature (PPO) plan are covered with no copay, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies carry a coinsurance ranging from no coinsurance up to 20%, while prosthetic devices require a 20% coinsurance and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic tests and procedures have a copay ranging from $0 to $100 with no coinsurance, lab and X-ray services have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance. Although some services are covered, 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, 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 Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), offering no copay and no coinsurance for annual wellness exams, screening mammographies, and over-the-counter (OTC) items up to $45 every three months via reimbursement. Acupuncture and meal benefits are not covered.
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