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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 WI Southern, North Central, Western, Central. 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 a $615 annual drug deductible. For Tier 1 preferred generics and Tier 2 generics, members pay no copay when using preferred pharmacies or preferred mail-order services. If using standard pharmacies or standard mail-order options, 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 under this plan, costs transition to coinsurance across all pharmacy types. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance for 1-month, 2-month, and 3-month supplies. Tier 5 specialty drugs also carry a 25% coinsurance, which is limited to a 1-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits, home health services, and annual physicals. Specialist visits, urgent care, and emergency room services are covered with flat copayments and no coinsurance, while inpatient hospital stays require a daily copay for the first six days. Additionally, diagnostic lab services and ambulatory surgical center visits are covered with no copay and no coinsurance. For routine care, this plan provides preventive dental, routine eye exams, and annual hearing exams with no copay or coinsurance, alongside allowances for eyewear and prescription hearing aids. Comprehensive dental services are covered up to a $1,500 annual limit with no copay and 20% to 50% coinsurance. Medical equipment, prosthetics, and dialysis services are also available with no copay and coinsurance up to 20%.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $410 daily copay for days 1 to 6 of acute stays and a $350 daily copay for days 1 to 6 of psychiatric stays, with no copay for remaining covered days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $0 to $410 for outpatient hospital services and a $410 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions have a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copayment of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with a $295 copay for ground transport and 20% coinsurance for air transport, with prior authorization required. Routine transportation services to health-related locations 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, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services feature a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $295.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, while specialist, occupational, physical, and speech therapy visits require a $45 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services feature a $40 copay and no coinsurance, whereas telehealth services require a $0 to $45 copay and 20% coinsurance. Podiatry is not covered, and although some chiropractic services are covered, routine and other chiropractic care are not.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (PPO) are partially covered, offering annual physicals, fitness benefits, and health education for no copay and no coinsurance, while kidney disease education has no copay but a 20% coinsurance. Several sub-services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and alternative therapies.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), with Medicare-covered exams requiring a $45 copay and no coinsurance, while annual routine exams and fittings have no copay and no coinsurance. Prescription hearing aids are covered with no copay or coinsurance up to $500 per ear annually, but OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles, featuring eye exams with a $0 to $45 copay and no coinsurance, including one routine exam per year with no copay. Eyewear is also covered with no copay and no coinsurance, up to a combined maximum benefit of $100 annually.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care like exams, cleanings, and x-rays. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $1,500 annual maximum, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive dental 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, Part B insulin drugs have a $35 copay and no coinsurance, while Part B chemotherapy and other Part B drugs carry a 0% to 20% coinsurance with no copay.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers durable medical equipment, medical supplies, and diabetic supplies with no copay and 0% to 20% coinsurance. Prosthetic devices are covered with no copay and a 20% coinsurance, while diabetic therapeutic shoes and inserts have no copay, though prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services with prior authorization, featuring no coinsurance for diagnostic services and no copay for lab services. Diagnostic procedures and tests have a copay of $0 to $100, while outpatient x-rays require a $20 copay plus coinsurance, diagnostic radiological services have a minimum $0 copay, and therapeutic radiological services carry a copay and 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, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, although some services are not covered. Specifically, cardiac rehabilitation and intensive cardiac rehabilitation are not covered and require a $20 copay, pulmonary rehabilitation is not covered with a $15 copay, and SET for PAD services are not covered with a $25 copay.
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 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, a three-day prior hospital stay is not, and additional days beyond the standard 100-day Medicare limit 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 with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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