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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 Southwest 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service for any supply length. 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. Higher-tier medications under this plan are subject to 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. These coinsurance percentages remain the same whether you use preferred or standard pharmacies, or choose mail-order delivery.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for core medical needs, featuring no copay for primary care physician visits and annual physicals. For hospital care, members pay no coinsurance and a $290 daily copay for the first six days of inpatient stays, while outpatient hospital services range from no copay up to a $290 copay. Emergency room visits require a $130 copay, which is waived if you are admitted, and urgent care is available for a $25 copay. This plan also includes key supplemental benefits, providing routine vision care and preventive dental cleanings with no copay or coinsurance. Specialist visits and Medicare-covered hearing exams carry a copay of up to $75, while home health services and home infusions require no copay. Durable medical equipment and dialysis services are covered with no copay and coinsurance ranging up to 20 percent.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a $290 daily copay for days 1 through 6 and no copay for days 7 through 90 per stay. While unlimited additional days are covered for acute care, psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, offering ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay between $0 and $290, observation services have a $290 copay per stay, and outpatient substance abuse sessions require a $30 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $200 copay and no coinsurance, and air ambulance services with no copay and a 20% coinsurance, with prior authorization required for both. Transportation services are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) with a $130 copay and no coinsurance, and this copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $25 copay with no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 for emergency and urgent care to $200 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) features primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $75 copay and no coinsurance. Physical, occupational, mental health, psychiatric, and opioid treatment therapies are covered with copays ranging from $25 to $30 and no coinsurance, while telehealth services require a $0 to $75 copay and 20% coinsurance, and podiatry and routine chiropractic care are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) offers partially covered preventive services, with no copay and no coinsurance for annual physicals, health education, and various screenings, while kidney disease education requires a 20% coinsurance and no copay. Several supplemental services are not covered, including weight management, nutritional benefits, personal emergency response systems, and in-home safety assessments.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), offering Medicare-covered exams for a $75 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $0 to $1,700, though OTC models and inner-ear, outer-ear, or over-the-ear prescription types 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 eye exams and eyewear. The plan provides up to a $50 annual maximum for eye exams and a $100 combined annual maximum for eyewear, including contacts, lenses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering preventive care like exams and cleanings with no copay and no coinsurance, while Medicare-covered services require a $75 copay and no coinsurance. Comprehensive services are covered up to a $2,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, and maxillofacial prosthetics 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. Medicare Part B chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20% with no copay, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copays, subject to prior authorization. Coinsurance ranges from 0% to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices require a 20% coinsurance and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, with prior authorization required for these services. Diagnostic tests have no coinsurance and copays ranging from $0 to $100, while lab services and outpatient X-rays feature no copays. Diagnostic radiological services have a $0 minimum copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) with no copay and no coinsurance, though 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. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered under this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the Aetna Medicare Signature (PPO) plan, offering annual wellness exams, 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.
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