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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 IN Northwest and Northeast. 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:
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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 services, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply length. For higher-tier medications, cost-sharing is based on coinsurance rather than flat copays. 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, with specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust coverage for essential medical services with predictable out-of-pocket costs. Beneficiaries enjoy no copay for primary care physician visits, annual physicals, and home health services, while specialist visits require a $45 copay. For hospital stays, inpatient services feature a $320 daily copay for the first seven days and no copay for days eight through 90, with no coinsurance required. This plan also provides valuable supplemental benefits, including routine hearing and vision exams with no copay, plus up to $500 per ear annually for prescription hearing aids and a $100 annual eyewear allowance. Preventive dental care like cleanings and exams features no copay, while comprehensive dental services are covered with 20% to 50% coinsurance up to a $2,000 yearly limit. Emergency care is accessible worldwide with a $130 copay, which is waived if you are admitted to the hospital within 24 hours.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, featuring a copay of $320 per day for days 1 through 7 and no copay for days 8 through 90. While unlimited additional acute care 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 Extra (PPO) covers outpatient services with no coinsurance, featuring a $0 to $320 copay for outpatient hospital services and a $320 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse individual and group sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Extra (PPO) with a copay of $75 or $145 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $285 copay and air ambulance services with a 20% coinsurance, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
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 urgently needed services with a $40 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $130 to $285, up to a maximum plan benefit of $250,000.
Primary Care See details
Primary care benefits under the Aetna Medicare Signature Extra (PPO) feature primary care physician visits with no copay and no coinsurance, while specialist, physical therapy, and occupational therapy visits require a $45 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services carry a $40 copay and no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Extra (PPO), with no copay and no coinsurance for annual physicals, fitness benefits, and most screenings. While kidney disease education has no copay but requires a 20% coinsurance, several supplemental services such as personal emergency response systems, weight management, and in-home safety assessments are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) partially covers hearing services, offering routine exams and fitting evaluations with no copay or coinsurance, while Medicare-covered exams require a $45 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no deductibles and no coinsurance. Eye exams have a copay ranging from $0 to $45, which includes one routine exam per year with no copay, while eyewear is covered with no copay up to a combined annual limit of $100.
Dental Services See details
Dental services are partially covered under Aetna Medicare Signature Extra (PPO), offering no copay and no coinsurance for preventive care like exams and cleanings, and a $45 copay with no coinsurance for Medicare-covered dental. Comprehensive options like restorative care and endodontics have no copay and 20% to 50% coinsurance up to a $2,000 annual maximum, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or 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, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy and other drugs carry a 0% to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance.
Dialysis Services See details
Aetna Medicare Signature Extra (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (PPO) with no copays, though prior authorization is required for most items. Beneficiaries will pay between no coinsurance and 20% coinsurance for durable medical equipment, prosthetics, medical supplies, and diabetic equipment.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature Extra (PPO) plan, with prior authorization required for both. Diagnostic services feature no coinsurance, offering no copay for lab tests and a $0 to $100 copay for procedures, while radiological services require a $20 copay for X-rays, a $0 minimum copay for diagnostic radiology, and a 20% minimum coinsurance for therapeutic 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. Standard 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 Extra (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copayment for days 1 through 20 and a $218 daily copayment for days 21 through 100. Prior authorization is required, no prior three-day hospital stay is needed, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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