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Aetna Medicare Signature Care (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in HVP New Orleans Metro Parishes in LA. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (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. Additionally, this plan comes with a Part B Premium reduction of $30.00. You must continue to pay paying your reduced 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 $13900.00 (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 $13900.00 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 Care (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, you pay no copay when utilizing preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply length. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance for all fulfillment methods, with Tier 5 drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Care (PPO) plan offers robust healthcare coverage with no copay for primary care doctor visits, routine preventive screenings, and home health services. Specialist physician visits require a copay of $10 to $45, while emergency room services carry a $115 copay that is waived upon admission. For inpatient hospital stays, patients pay a daily copay of $299 for days one through seven, with no coinsurance required. Ancillary benefits include routine dental, vision, and hearing exams with no copay and no coinsurance. Eyewear is covered up to a $175 annual limit with no copay, while prescription hearing aids are covered with no copay up to $500 per ear annually. Additionally, durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature Care (PPO) with no coinsurance, though the benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are excluded. Patients pay a $299 daily copay for days 1-7 of acute stays and a $407 daily copay for days 1-5 of psychiatric stays, with no copay for subsequent days.
Outpatient Services See details
Aetna Medicare Signature Care (PPO) covers outpatient services with no coinsurance, including outpatient hospital services with a $0 to $299 copay and observation services with a $299 copay per stay. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature Care (PPO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance services are covered by Aetna Medicare Signature Care (PPO) with a $295 copay for ground transport and a 20% coinsurance for air transport, with prior authorization required. Routine transportation services to plan-approved or health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the Aetna Medicare Signature Care (PPO) are covered with a $115 copay and no coinsurance, with the copay waived if admitted within 24 hours, while urgent care has a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are covered up to a $250,000 limit with no coinsurance and copays ranging from $115 to $295, with no deductible applying to any of these services.
Primary Care See details
Aetna Medicare Signature Care (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $10 to $45 copay and no coinsurance. Other services like physical therapy, mental health, and podiatry are covered with copays ranging from $35 to $50 and no coinsurance, while telehealth is available with a $0 to $50 copay and 20% coinsurance. Chiropractic services are not covered under this plan.
Preventive Services See details
Preventive services under the Aetna Medicare Signature Care (PPO) are partially covered, offering no copay and no coinsurance for annual physical exams, health education, fitness benefits, and screenings, while kidney disease education requires no copay but carries a 20% coinsurance. Uncovered services under this benefit include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Care (PPO) covers hearing services with no deductible and no coinsurance, featuring a $45 copay for Medicare-covered exams and no copay for annual routine exams and fittings. Prescription hearing aids are partially covered with no copay up to $500 per ear annually, but inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Care (PPO) covers vision services with no deductibles and no coinsurance, offering eye exams with a copay of up to $45 (and no copay for routine exams) up to a $50 annual limit. Eyewear, including contact lenses and eyeglasses, is covered with no copay and no coinsurance up to a combined annual maximum benefit of $175.
Dental Services See details
Aetna Medicare Signature Care (PPO) offers partially covered dental services, featuring a $45 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive cleanings, exams, and x-rays. Comprehensive dental services have no copay and 20% to 50% coinsurance up to a $2,000 annual limit, 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 Care (PPO) with no copay and require prior authorization. Under this benefit, Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature Care (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Care (PPO) with no copay and 20% coinsurance for durable medical equipment, prosthetics, and medical supplies. Diabetic supplies are covered with no copay and 0% to 20% coinsurance, while diabetic therapeutic shoes or inserts require a $10 copay and no coinsurance, with prior authorization required for most items.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Care (PPO) with prior authorization required. Diagnostic services have no coinsurance, featuring no copay for lab services and a $0 to $120 copay for other tests, while radiological services offer outpatient X-rays and diagnostic radiology with no copay, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature Care (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under Aetna Medicare Signature Care (PPO) with no coinsurance, though some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered and require copayments of $30, $40, $25, and $20 respectively.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Care (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, while additional days beyond the standard Medicare-covered benefit are not covered.
Other Services See details
Aetna Medicare Signature Care (PPO) provides partial coverage for other services with no copay and no coinsurance, which includes OTC items up to $15 every three months, chronic illness meals, annual wellness exams, and additional colorectal screenings. Acupuncture is not covered under these benefits.
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