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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 Greenville/Spartanburg SC and Surrounding Area. 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 $500.00 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 $9200.00 (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 $9200.00 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)
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Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual drug deductible of $500. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic drugs when using a preferred pharmacy or preferred mail-order service for up to a 3-month supply. If you choose a standard pharmacy or standard mail-order service, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, costs are based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 22% coinsurance, and Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy and mail-order options. Specialty medications in Tier 5 carry a 27% coinsurance for a 1-month supply at both preferred and standard locations.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers affordable medical coverage with no copay and no coinsurance for primary care doctor visits, routine preventive services, and home health care. Specialist visits feature a copay of up to $40, while emergency room visits require a $115 copay, which is waived if you are admitted. Inpatient hospital stays require a copay of $388 per day for days 1 through 7 with no coinsurance. This plan also includes valuable extra benefits, offering routine vision and hearing exams with no copay, along with allowances for hearing aids and eyewear. Preventive dental care features no copay or coinsurance, while comprehensive dental services are covered up to a $1,750 annual limit with no copay and 20% to 50% coinsurance. Additionally, members receive a $30 over-the-counter allowance every three months and skilled nursing facility stays with no copay for the first 20 days.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a copay of $388 per day for days 1 through 7 for acute stays and $260 per day for days 1 through 8 for psychiatric stays. While unlimited additional acute days are covered with no copay, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services, and a $0 to $388 copay for outpatient hospital services. Observation services require a $388 copay per stay, while outpatient substance abuse sessions carry a $40 copay with no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature (PPO) plan with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to receive this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (PPO), offering ground ambulance services for a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, and transportation services are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed care has a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with copays ranging from $115 to $275 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) features primary care doctor visits with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies require a $30 copay and no coinsurance, while podiatry is not covered, and chiropractic care covers some services with a $15 copay and no coinsurance but routine and other chiropractic services are not covered. Mental health, psychiatric, and opioid treatments have a $40 copay and no coinsurance, whereas telehealth options carry a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature (PPO) offers preventive services with no copay and no coinsurance for annual physical exams, diabetes self-management, and glaucoma screenings, though kidney disease education requires a 20% coinsurance with no copay. These additional benefits are partially covered, as services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and counseling are not covered.
Hearing Services See details
Aetna Medicare Signature (PPO) partially covers hearing services with no deductible, featuring a $40 copay and no coinsurance for Medicare-covered exams, alongside routine exams and fitting evaluations at no copay and no coinsurance. Prescription hearing aids are covered with no copay and no coinsurance up to a $1,250 annual limit per ear, but OTC hearing aids and inner ear, outer ear, and over the ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, featuring no copay for routine eye exams and eyewear up to annual maximums of $50 and $150, respectively. Medicare-covered eye exams are also available with a copay of $0 to $40 and no coinsurance.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, including Medicare-covered dental for a $40 copay and no coinsurance, and preventive care with no copay or coinsurance. Comprehensive services are covered up to a $1,750 annual limit with no copay and 20% to 50% coinsurance, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive 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. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs are covered with no copay and 0% to 20% coinsurance.
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, including durable medical equipment, prosthetics, and diabetic supplies, with no copays and coinsurance ranging from no coinsurance to 20%. Prior authorization is required for these services, and diabetic supplies are limited to specific manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with prior authorization required. Diagnostic procedures feature no coinsurance and a $0 to $200 copay, while lab services, outpatient X-rays, and diagnostic radiology have no copay, and therapeutic radiology requires 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 coinsurance, but some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a three-day inpatient hospital stay is not required prior to admission, additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), featuring OTC items (up to $30 every three months), an annual wellness exam, and additional screenings with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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