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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature (PPO) is a PPO plan offered by Aetna Life Insurance Company available for the 2026 plan year to people living in Los Angeles and Orange Counties. 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 has a $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
This plan has a $615.00 drug deductible that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6350.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6350.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $9500.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $9500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 Enhanced Alternative drug benefit with a $615.00 annual prescription drug deductible. After meeting this deductible, you pay no copay for Tier 1 preferred generic drugs at preferred retail pharmacies or through preferred mail order, while standard pharmacies and mail options require a $12.00 copay. For other tiers, you will pay a 24% coinsurance for Tier 2 standard generics and a 25% coinsurance for both Tier 3 preferred brands and Tier 4 non-preferred drugs. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, beneficiaries who qualify for the full Low-Income Subsidy (LIS) will benefit from a $0.00 cost-share.
Additional Benefits
Aetna Medicare Signature (PPO) offers comprehensive healthcare coverage featuring no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist visits, urgent care, and outpatient diagnostic tests require a $40 copay, while inpatient hospital stays incur a daily copay of $375 for the first six to seven days. Emergency room visits carry a $130 copay and ground ambulance services require a $265 copay, both with no coinsurance. Routine dental, vision, and hearing services are covered with no copays or coinsurance, although annual limits apply to prescription hearing aids and eyewear. Durable medical equipment and diabetic supplies require no copays, but carry coinsurance rates of up to 17% and 20% respectively. Some services are excluded from coverage, including routine transportation, cardiac rehabilitation, and over-the-counter items.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) offers partially covered inpatient hospital benefits, excluding acute care upgrades, non-Medicare-covered stays, and additional psychiatric days. Acute stays cost a $375 daily copay for days 1 through 7, while psychiatric stays cost a $375 daily copay for days 1 through 6, with no copay for subsequent days and no coinsurance required for either service.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copay for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $375, observation services carry a $375 copay, and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature (PPO) with prior authorization required, featuring a copay of either $70.00 or $145.00 and no coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered under Aetna Medicare Signature (PPO), as transportation services to both plan-approved and any health-related locations are not covered. Covered ground ambulance services require a $265 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $265.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care visits with no copay and no coinsurance, while specialist, psychiatric, and therapy services require a $40 copay and no coinsurance. Chiropractic care is partially covered with a $15 copay and no coinsurance, excluding routine chiropractic services, while podiatry is not covered, and telehealth services carry a 20% coinsurance with a $0 to $40 copay.
Preventive Services See details
Aetna Medicare Signature (PPO) offers partially covered preventive services, featuring no copay and no coinsurance for annual physicals, fitness benefits, and health education, while kidney disease education requires a 20% coinsurance and no copay. Uncovered sub-services include in-home safety assessments, personal emergency response systems, 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, home modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) partially covers hearing services, offering routine hearing exams, fitting evaluations, and prescription hearing aids with no copay and no coinsurance. Covered prescription hearing aids have an annual maximum benefit of $1,250 per ear, but OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copay and no coinsurance for both eye exams and eyewear. This plan includes a $50 annual maximum for eye exams and a combined $150 annual allowance for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), which features Medicare-covered dental services for a $40 copay and no coinsurance, plus routine exams, cleanings, and x-rays with no copay or coinsurance. Sub-services that are not covered under this plan include fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers Home Infusion bundled Services, which require prior authorization. Under this benefit, Medicare Part B Insulin Drugs require a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs have no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with a 20% coinsurance and no copay. Prior authorization is required to receive these benefits.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copays, though prior authorization is required. Covered items require no coinsurance to 17% coinsurance for durable medical equipment (DME) and medical supplies, 17% coinsurance for prosthetics, and no coinsurance to 20% coinsurance for diabetic supplies.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature (PPO) with prior authorization, featuring no copay or coinsurance for lab services and up to a $40 copay with no coinsurance for diagnostic tests. Outpatient X-rays have a $40 copay and diagnostic radiology costs up to a $295 copay with no coinsurance, while therapeutic radiology requires 20% coinsurance and no copay.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (PPO) plan, meaning there is no coverage, copay, or coinsurance for cardiac, intensive cardiac, pulmonary, or SET for PAD rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Signature (PPO), as additional days beyond the Medicare-covered limit are not covered. Covered stays require prior authorization and incur a $10 copay for days 1 through 20 and a $218 copay for days 21 through 100, with no coinsurance.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering annual wellness exams, screening mammographies, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, meal benefits, and Dual Eligible SNPs are not covered.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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1-877-649-2073 / TTY 711. Call-center hours (ET): Mon-Fri 8am-10pm; Sat 9am-8pm; Sun closed.
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