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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 MI 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 $8250.00 (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 $8250.00 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 Extra (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using preferred pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order options, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply fill. For brand-name and specialty medications, your costs transition to coinsurance. 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 across all pharmacy and mail-order channels. This straightforward cost structure helps you easily estimate your out-of-pocket prescription drug costs throughout the plan year.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan provides comprehensive medical coverage with no copay for primary care doctor visits and annual physicals, while specialist visits require a copay ranging from $0 to $40. For hospital care, inpatient acute stays require a $300 daily copay for the first eight days, whereas outpatient hospital services feature copays from $0 to $300 with no coinsurance. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. This plan also includes valuable supplemental benefits, featuring no copay for routine vision, hearing, and preventive dental exams. Additionally, members receive up to $1,000 per ear annually for prescription hearing aids and a $250 annual allowance for eyewear with no copays. Comprehensive dental services are covered with 20% to 50% coinsurance up to a $2,000 annual limit, and an over-the-counter allowance provides up to $75 every three months with no copay.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) offers partial coverage for inpatient hospital stays with no coinsurance, requiring a $300 daily copay for days 1 through 8 of acute stays and a $315 daily copay for days 1 through 7 of psychiatric stays, with no copay for subsequent days. 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, featuring no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $300, observation services require a $300 copay per stay, and outpatient substance abuse sessions carry a $40 copay, with prior authorization required for most services.
Partial Hospitalization See details
Partial hospitalization is covered under the Aetna Medicare Signature Extra (PPO) plan with a copay of either $75.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $255.00 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (PPO) with a $130 copay and no coinsurance, and the copay is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $35 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum limit with no coinsurance and copays ranging from $130 to $255.
Primary Care See details
Aetna Medicare Signature Extra (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $40 copay and no coinsurance. Physical, occupational, and speech therapies have a $35 copay and no coinsurance, while mental health, psychiatric, and opioid treatment services require a $40 copay with no coinsurance. Podiatry is not covered, and although some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) partially covers preventive services, providing no copay and no coinsurance for annual physicals, screenings, and fitness benefits, though kidney disease education requires a 20% coinsurance and no copay. Sub-services including in-home safety assessments, PERS, medical nutrition therapy, medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, disease management, telemonitoring, safety devices, and counseling are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers Medicare-covered hearing exams for a $40 copay and no coinsurance, as well as annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are partially covered up to $1,000 per ear annually with no copay or coinsurance—excluding inner ear, outer ear, and over-the-ear types—while OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no coinsurance, offering routine eye exams with no copay up to a $50 annual limit and other exams with copays up to $40. Eyewear, including contacts and eyeglasses, is covered with no copay and no coinsurance up to a combined maximum of $250 per year.
Dental Services See details
Aetna Medicare Signature Extra (PPO) offers partially covered dental services, including Medicare-covered dental care for a $40 copay and no coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $2,000 annual limit, but 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 Extra (PPO) with no copay and no coinsurance, subject to prior authorization. Medicare Part B chemotherapy and other drugs have no copay and 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 under the Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (PPO) with no copays for durable medical equipment, prosthetics, and diabetic shoes, though coinsurance ranges from no coinsurance up to 20% depending on the item. Prior authorization is required for most equipment, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature Extra (PPO) with prior authorization required. Outpatient diagnostic tests and procedures have no coinsurance and a copay of $0 to $75, while lab services, outpatient X-rays, and diagnostic radiology have no copay. Therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature Extra (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 Extra (PPO) with no coinsurance, but in practice, only some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the Aetna Medicare Signature Extra (PPO) plan with no coinsurance, featuring a $10 daily copay for days 1 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the standard 100-day limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering no copay and no coinsurance for over-the-counter (OTC) items up to $75 every three months, annual wellness exams, screening mammographies, and additional colorectal cancer screenings. Acupuncture and meal benefits are not covered under this plan.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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