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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 Southwest. 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 prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose standard pharmacies or standard mail-order services, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, cost-sharing is based on a percentage of the drug cost rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy and mail-order channels. Specialty medications in Tier 5 also carry a 25% coinsurance, which is restricted to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust medical coverage with no copay or coinsurance for primary care visits and routine preventive services like annual physicals. For specialist visits, copays range from $0 to $40, while emergency room visits require a $130 copay that is waived if you are admitted to the hospital. Inpatient hospital stays have no coinsurance but require a $300 daily copay for the first seven or eight days, with no copay for subsequent days. This plan also includes valuable supplemental benefits, featuring preventive dental care with no copay and comprehensive dental covered up to $1,000 annually with a 20% to 50% coinsurance. Routine vision and hearing exams are available with no copay, alongside annual allowances of up to $175 for eyewear and up to $500 per ear for prescription hearing aids. Additionally, home health services and diagnostic lab tests are covered with no copay or coinsurance, helping you manage your healthcare costs effectively.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, requiring a $300 daily copay for days 1 through 8 for acute stays and days 1 through 7 for psychiatric stays, with no copay for subsequent days. This benefit is partially covered, as 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 a $0 to $300 copay for outpatient hospital and observation services, and a $40 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for certain benefits.
Partial Hospitalization See details
Aetna Medicare Signature Extra (PPO) covers partial hospitalization services with a copay of $75.00 or $145.00 and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by the Aetna Medicare Signature Extra (PPO) plan, which features a $285 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. Prior authorization is required for ambulance services, and fees are not waived upon hospital admission, while transportation services are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Extra (PPO) with a $130 copay and no coinsurance, with the copay 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 benefits are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $285.
Primary Care See details
Primary Care benefits under the Aetna Medicare Signature Extra (PPO) feature no copay and no coinsurance for primary care visits, and a $0 to $40 copay with no coinsurance for specialists. Physical, occupational, and speech therapy require a $30 copay and no coinsurance, while telehealth services carry a $0 to $40 copay and 20% coinsurance. Mental health, psychiatric, and opioid treatment services have a $40 copay with no coinsurance, whereas podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature Extra (PPO), offering no copay and no coinsurance for the annual physical exam, fitness benefits, and glaucoma screenings, though kidney disease education has no copay and a 20% coinsurance. Multiple supplemental services are not covered, including in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management programs.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature Extra (PPO), featuring Medicare-covered exams for a $40 copay and no coinsurance, alongside annual routine exams and fittings with no copay or coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but 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, offering eye exams with a $0 to $40 copay and no coinsurance, including an annual routine exam up to a $50 limit. Eyewear is covered with no copay and no coinsurance, providing a combined maximum benefit of $175 every year for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature Extra (PPO) partially covers dental services, offering Medicare-covered dental with a $40 copay and no coinsurance, and preventive services like cleanings and exams with no copay and no coinsurance. Comprehensive services are covered up to a $1,000 annual limit with no copay and 20% to 50% coinsurance, 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, although prior authorization is required. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy and chemotherapy-related drugs carry a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Extra (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 Extra (PPO) with no copays, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies carry a coinsurance ranging from no coinsurance to 20%, while prosthetic devices have a 20% coinsurance and diabetic therapeutic shoes or inserts are covered with no copay.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature Extra (PPO) with prior authorization required. Lab services and outpatient X-rays have no copay or coinsurance, diagnostic procedures carry a $0 to $100 copay, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature Extra (PPO) with no coinsurance, though in practice, some services are covered while cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered. These non-covered services require copayments of $20 for cardiac and intensive cardiac rehab, $15 for pulmonary rehab, and $25 for SET for PAD.
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 $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered period are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering select benefits like an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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