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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 Rhode Island. 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 $5900.00 (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 $5900.00 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 an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using preferred retail pharmacies or preferred mail-order services. If standard pharmacies or standard mail services are used, copays range from $2 to $12 for a one-month supply. For higher-tier medications, the plan utilizes coinsurance instead of flat copays across all pharmacy networks. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance. These cost-sharing rates apply to both preferred and standard pharmacy options, helping you estimate your out-of-pocket prescription costs.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage for core medical needs with no copay and no coinsurance for primary care visits, home health services, and most preventive care. Specialist visits range from no copay up to a $45 copay, while emergency care carries a $130 copay that is waived if you are admitted. For hospital stays, inpatient care features no coinsurance with daily copays for the first seven days, and outpatient hospital services range from no copay to a $295 copay. Additional benefits include routine dental, vision, and hearing exams with no copay, though comprehensive dental and certain hearing aids are not covered. Diagnostic lab tests and wellness programs also feature no copay, while skilled nursing facility stays require daily copays starting at $10 for the first 20 days. Medical equipment and dialysis services generally require no copay but carry coinsurance ranging up to 25%.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring prior authorization for both acute and psychiatric stays. Acute stays require a $295 copay for days 1 through 7 with no copay for days 8 through 90 and unlimited additional days, while psychiatric stays require a $310 copay for days 1 through 7 and no copay for days 8 through 90. Non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance for all services, though prior authorization is required for some benefits. There are no copays for ambulatory surgical center and outpatient blood services, while outpatient hospital services carry a $0 to $295 copay, observation services cost a $295 copay per stay, and outpatient substance abuse sessions require a $45 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $85.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance services under Aetna Medicare Signature (PPO) require prior authorization, featuring a $280 copay for ground ambulance services and a 20% coinsurance for air ambulance services. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $40 copay and no coinsurance, and worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $280.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with no copay to a $45 copay and no coinsurance. Physical, occupational, speech, and mental health therapies are covered with copays ranging from $35 to $45 and no coinsurance, while podiatry and routine chiropractic services are not covered. Telehealth options are also available with no copay to a $45 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Signature (PPO) plan, with no copay and no coinsurance for annual physicals, health education, and most screenings, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional or 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
Hearing services are partially covered by the Aetna Medicare Signature (PPO) plan, which offers Medicare-covered exams for a $45 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to two per year with no coinsurance and copays ranging from $0 to $1,700, while OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, featuring eye exams with a $0 to $45 copay and eyewear with no copay. Annual routine eye exams have a $50 maximum benefit, while covered eyewear—including contacts, lenses, and frames—has a combined maximum benefit of $100 per year.
Dental Services See details
Aetna Medicare Signature (PPO) dental services are partially covered, featuring Medicare-covered dental care with a $45 copay and no coinsurance, and select preventive services like cleanings, exams, and x-rays with no copay and no coinsurance. Fluoride, other diagnostic or preventive services, and all comprehensive care—including restorative, endodontic, periodontic, and orthodontic 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 chemotherapy and other drugs carry a 0% to 20% coinsurance with no copay, 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 (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copay for durable medical equipment, prosthetics, and diabetic therapeutic shoes, though coinsurance ranges from 0% to 25% depending on the item. Diabetic supplies are covered with 0% to 20% coinsurance, and prior authorization is required for most equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with diagnostic services requiring no coinsurance, no copay for lab services, and a $0 to $45 copay for other tests. Covered radiological services feature a $10 copay for X-rays, a minimum $0 copay for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
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, although some services are covered while cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and SET for PAD services ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring a $10 daily copay for days 1 to 20 and a $208 daily copay for days 21 to 100. Prior authorization is required, a prior three-day inpatient hospital stay is not necessary, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) provides coverage for several additional services with no copay and no coinsurance, including a $30 quarterly over-the-counter (OTC) item reimbursement, chronic illness meal benefits, and annual wellness exams. Acupuncture is not covered under this plan.
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