A non-government entity
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 MI Northern. 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:
Sign up for Aetna Medicare Signature (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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, members pay no copay when using preferred pharmacies or preferred mail-order services. Standard pharmacies and standard mail-order options require a copay, starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. For brand-name and specialty drugs, costs are structured as a percentage of the drug cost rather than flat copays. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Coinsurance rates remain the same across preferred and standard pharmacies, with specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers affordable healthcare coverage with a low $5 copay for primary care visits and a $45 copay for specialists. For inpatient hospital stays, members pay a $315 daily copay for the first several days and no copay for subsequent days, with no coinsurance required. Emergency care is available for a $130 copay, which is waived upon hospital admission, while urgent care visits require a $35 copay. Routine preventive services, annual physicals, and home health services are fully covered with no copay and no coinsurance. Routine dental, vision, and hearing exams also feature no copay, though comprehensive dental services require a 20% to 50% coinsurance and prescription hearing aids are covered up to a $500 annual limit per ear. Additionally, diagnostic lab services and ambulatory surgical center visits are provided with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, there is a $315 daily copay for days 1-8 and no copay for days 9 and beyond, while psychiatric stays require a $315 daily copay for days 1-7 and no copay for days 8-90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $315, while outpatient observation services require a $315 copay per stay and no coinsurance. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $75.00 or $145.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and transportation services under the Aetna Medicare Signature (PPO) plan include covered ground ambulance services for a $275 copay and air ambulance services with a 20% coinsurance, both of which require prior authorization. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (PPO) are covered with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $35 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits for a $5 copay and specialist visits for a $45 copay with no coinsurance, while physical, occupational, and mental health therapies require copays from $35 to $40 and no coinsurance. Telehealth services are available with copays up to $45 and a 20% coinsurance, but podiatry and routine chiropractic care are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) covers annual physical exams and standard preventive services with no copay and no coinsurance, while kidney disease education has no copay but a 20% coinsurance. Additional supplemental preventive benefits are partially covered, offering services like health education, smoking cessation, and memory fitness with no copay and no coinsurance, while benefits like nutritional therapy and in-home safety assessments are not covered.
Hearing Services See details
Hearing Services are partially covered by the Aetna Medicare Signature (PPO) plan, offering routine hearing exams and fitting evaluations once per year with no copay and no coinsurance, while Medicare-covered exams require a $45 copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to a $500 annual limit per ear, but 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 coinsurance and no deductibles, offering routine eye exams and eyewear with no copay. While routine exams and eyewear have annual coverage limits of $50 and $100 respectively, Medicare-covered eye exams may require a copay of up to $45.
Dental Services See details
Dental Services are partially covered by Aetna Medicare Signature (PPO), with Medicare-covered dental requiring a $45 copay and no coinsurance, and preventive services like cleanings and exams available with no copay and no coinsurance. Other covered comprehensive services have no copay and 20% to 50% coinsurance up to a $500 annual limit, though fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) 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, radiation, and other Part B drugs carry no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan 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 for durable medical equipment, prosthetics, and diabetic shoes, though coinsurance ranges from no coinsurance up to 20% depending on the item. Prior authorization is required for these services, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $100 copay for diagnostic tests. Diagnostic radiological services carry a minimum $0 copay, outpatient X-rays have a $20 copay, and therapeutic radiological services require a minimum 20% coinsurance, with prior authorization required.
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
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, and while some services are covered, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) services are covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $10 daily 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, and additional days beyond Medicare-covered limits are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved