A non-government entity
Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in WI Southeast. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 Extra (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 Extra (PPO) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when using a preferred pharmacy or preferred mail-order service. If you use a standard pharmacy or standard mail order, Tier 1 drugs have a $2 copay and Tier 2 drugs have a $12 copay for a one-month supply. For brand-name and specialty medications, costs are based on coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance. These coinsurance rates remain the same whether you use preferred or standard pharmacies and mail-order services.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers comprehensive medical coverage with no deductibles for emergency, vision, and hearing services, focusing primarily on predictable copayments. Beneficiaries enjoy no copay for primary care visits, routine annual physicals, and home health services, while specialist visits and outpatient hospital services feature copays ranging from no copay up to $45 and $355 respectively. For inpatient hospital stays, the plan features daily copays for the first seven to eight days with no copay for subsequent days, and emergency room visits require a $130 copay. Ancillary benefits include routine dental, vision, and hearing exams with no copays, alongside annual allowances for eyewear and hearing aids. Comprehensive dental care is covered up to a $2,000 annual limit with coinsurance ranging from 20% to 50%, while preventive dental services require no copay. Additionally, medical equipment and diagnostic lab tests are available with no copays, though some specialized services like dialysis and air ambulance require a 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) partially covers inpatient hospital services with no coinsurance, featuring a $355 copay for days 1 to 8 of acute stays and a $295 copay for days 1 to 7 of psychiatric stays. There is no copay for subsequent days, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance, offering no copay for ambulatory surgical center and blood services, a $40 copay for outpatient substance abuse sessions, and copays ranging from $0 to $355 for outpatient hospital and observation services. Prior authorization is required for outpatient hospital, ambulatory surgical, and substance abuse services.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature Extra (PPO) plan with a copayment of $75.00 or $145.00 and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $275 copay and air ambulance services with a 20% coinsurance, both of which require prior authorization. Transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours, and urgent care with a $35 copay and no coinsurance. Worldwide emergency services are covered up to a $250,000 maximum benefit with no coinsurance and copays ranging from $130 to $275, and none of these services are subject to a plan-level deductible.
Primary Care See details
Primary care benefits under Aetna Medicare Signature Extra (PPO) are partially covered, featuring no copay and no coinsurance for primary care physician visits, while chiropractic and podiatry services are not covered. Other services like specialist visits, physical therapy, and mental health care range from no copay to a $45 copay with no coinsurance, while telehealth services require a 20% coinsurance and copays up to $45.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (PPO), offering an annual physical, glaucoma screenings, and fitness benefits with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while several services—including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs—are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers hearing services with no deductible, providing routine hearing exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $45 copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance up to $500 per ear annually, though OTC hearing aids and inner ear, outer ear, and over the ear prescription aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no deductibles and no coinsurance, featuring routine eye exams with no copay and Medicare-covered exams for a $0 to $45 copay. Covered eyewear, including contacts and eyeglasses, has no copay up to a combined annual maximum of $150 for both in-network and out-of-network services.
Dental Services See details
Aetna Medicare Signature Extra (PPO) partially covers dental services, offering preventive care like cleanings and exams with no copay and no coinsurance, and Medicare-covered dental with a $45 copay and no coinsurance. Comprehensive dental services are covered up to a $2,000 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, though prior authorization and step therapy are required. Medicare Part B insulin is covered under this benefit with a $35 copay and no coinsurance, while chemotherapy and other Part B drugs require no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
The Aetna Medicare Signature Extra (PPO) plan covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by the Aetna Medicare Signature Extra (PPO) with no copays, and coinsurance ranging from no coinsurance up to 20%. This benefit includes durable medical equipment, prosthetics, medical supplies, and diabetic equipment, although prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (PPO) with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a $0 to $100 copay. Radiological services require a $15 copay and coinsurance for outpatient X-rays, a minimum 20% coinsurance for therapeutic radiology, and a $0 minimum copay for diagnostic radiology.
Home Health Services See details
Aetna Medicare Signature Extra (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, though only some services are covered in practice. Specifically, Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered and require copayments ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $200 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100 days are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering select benefits like annual wellness exams, screening mammographies, and additional gFOBT and FIT with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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