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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 Puget Sound Area and Spokane County. 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 $13900.00 (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 $13900.00 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, members pay no copay when using a preferred pharmacy or preferred mail-order service. If standard pharmacies or standard mail-order options are used, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the supply length. For higher-tier prescription drugs, cost sharing transitions to a percentage-based coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance across all pharmacy types. Specialty tier medications are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust coverage with no copays for primary care visits, annual physicals, and home health services. Specialist visits require a low copay of $0 to $55, while inpatient hospital stays carry a $475 daily copay for the first five days, followed by no copay for subsequent days. Emergency care is also accessible with a $115 copay, which is waived if you are admitted to the hospital. Routine dental cleanings, annual vision exams, and hearing tests are covered with no copays or coinsurance, helping you save on essential wellness care. The plan also features no copays for diagnostic lab tests and routine X-rays, though a 20% coinsurance applies to durable medical equipment and dialysis services. Additionally, members receive allowances for eyewear and hearing aids to significantly reduce out-of-pocket expenses.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) partially covers inpatient hospital services with no coinsurance, requiring prior authorization. Acute stays carry a $475 daily copay for days 1 to 5 and no copay for days 6 and beyond, while psychiatric stays require a $415 daily copay for days 1 to 5 and no copay for days 6 to 90; however, hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services covered by Aetna Medicare Signature Extra (PPO) feature no coinsurance, with no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay of $0 to $425, while observation services cost $475 per stay and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature Extra (PPO) covers partial hospitalization with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services are not covered by the plan, as trips to plan-approved or other health-related locations are excluded.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if 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 up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $300.
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 $55 copay and no coinsurance. Physical and occupational therapies require a $35 copay and no coinsurance, while podiatry is not covered, and chiropractic services are only partially covered with routine and other chiropractic services not covered.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) provides partially covered preventive services, offering no copay and no coinsurance for annual physicals, fitness benefits, and diabetes training. While kidney disease education has no copay but requires a 20% coinsurance, other supplemental benefits like personal emergency response systems, weight management, and nutritional counseling are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers routine hearing exams and fitting evaluations annually with no copay and no coinsurance. Hearing aids are partially covered with no copay and no coinsurance up to a $1,000 maximum per ear every year, 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) offers comprehensive vision services with no copay, no coinsurance, and no deductible for covered eye exams and eyewear. Members receive coverage for one annual routine eye exam up to a $50 maximum, as well as a $125 annual combined allowance for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by the Aetna Medicare Signature Extra (PPO), offering preventive care like oral exams, cleanings, and X-rays with no copay and no coinsurance. Medicare-covered dental services require a $55 copay and no coinsurance, while restorative, endodontic, periodontic, implant, and orthodontic 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 is required. Medicare Part B insulin drugs under this benefit require a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered under Aetna Medicare Signature Extra (PPO), including durable medical equipment (DME), prosthetics, and medical supplies, all featuring no copay and a 20% coinsurance. Diabetic supplies and therapeutic shoes are also covered with no copay and coinsurance ranging from no coinsurance to 20%.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and tests with a $0 to $20 copay, while radiological services offer outpatient X-rays and diagnostic radiology with no copay, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by 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 offered under the Aetna Medicare Signature Extra (PPO) plan with no coinsurance, although only some services are covered in practice. Specifically, cardiac rehabilitation and intensive cardiac rehabilitation (both with no copay), pulmonary rehabilitation (with a $15 copay), and SET for PAD services (with a $20 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 prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20, followed by a daily copay of $218 for days 21 through 100, while additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature Extra (PPO), offering 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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