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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature (PPO) is a PPO plan offered by Aetna Life Insurance Company available for the 2026 plan year to people living in South FL, Treasure Coast 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6350.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6350.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $10100.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $10100.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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:
Sign up for Aetna Medicare Signature (PPO)
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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 preferred pharmacies or preferred mail-order services for any supply length. If you choose standard pharmacies or standard mail-order services, Tier 1 drugs carry a copay starting at $2.00, while Tier 2 drugs start at a $12.00 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance percentages rather than flat copayments. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance across all pharmacy and mail-order types. Note that Tier 5 specialty drugs are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for essential medical services with manageable out-of-pocket costs. Members enjoy no copay for primary care visits, home health services, and routine preventive care, while specialist visits feature a copay of up to $75. For hospital care, inpatient stays require a daily copay of $390 to $395 for the first six days with no copay thereafter, while emergency room visits carry a $130 copay. This plan also includes valuable supplemental benefits, such as routine vision exams and eyewear with no copays, deductibles, or coinsurance. Preventive dental and routine hearing exams are also available with no copay, though comprehensive dental services require a 20% to 50% coinsurance. Additionally, skilled nursing facility stays feature no copay for the first 20 days, and diagnostic lab work and X-rays are covered with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital stays with no coinsurance, requiring a daily copay of $395 for days 1 to 6 of acute stays and $390 for days 1 to 6 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and the plan does not cover upgrades, non-Medicare-covered stays, or additional psychiatric days.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $395 copay per stay for observation services. There is no copay and no coinsurance for ambulatory surgical center and outpatient blood services, while outpatient substance abuse sessions require a $30 copay with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, requiring a copay of either $55.00 or $145.00 depending on the service. Prior authorization is required for these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $275 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Non-emergency transportation services, including trips to plan-approved or any health-related locations, are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent services are also covered with no coinsurance up to a $250,000 maximum limit, requiring a $130 copay for emergency or urgent care and a $275 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits with no copay and specialist visits with a $0 to $75 copay, both with no coinsurance. Therapies and mental health services require copays ranging from $30 to $40 with no coinsurance, while podiatry and routine chiropractic services are not covered.
Preventive Services See details
Preventive services under the Aetna Medicare Signature (PPO) are partially covered, offering annual physical exams, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several supplemental benefits like weight management programs, personal emergency response systems, and in-home safety assessments are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) provides partially covered hearing services with no deductible and no coinsurance. Medicare-covered exams require a $75 copay, while annual routine exams and fitting evaluations have no copay and no coinsurance. Prescription hearing aids are covered with a copay ranging from $0 to $1,700 and no coinsurance for up to two devices per year, 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 deductibles for both eye exams and eyewear. This benefit includes one routine exam per year up to a $50 annual limit and a $100 combined annual allowance for contacts, frames, lenses, and upgrades.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (PPO), offering preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental services for a $75 copay and no coinsurance. Comprehensive services, including endodontics and periodontics, have no copay and a 20% to 50% coinsurance up to a $750 annual maximum, though fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or 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. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copays, though prior authorization is required for these services. Durable medical equipment, medical supplies, and diabetic supplies range from no coinsurance to 20% coinsurance, while prosthetic devices carry a flat 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, featuring no copay or coinsurance for lab services. Diagnostic procedures and tests carry a copay of $0 to $100 with no coinsurance, outpatient X-rays have no copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) offers Cardiac Rehabilitation Services with no copay and no coinsurance, but in practice only some services are covered. Standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) rehabilitation services are not covered.
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 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a prior 3-day inpatient hospital stay is not required, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), which offers annual wellness exams, screening mammographies, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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