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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.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in South FL, Treasure Coast FL. 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 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 (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. If you use a standard pharmacy or standard mail-order service, Tier 1 drugs require a copay starting at $2 and Tier 2 drugs require a copay starting at $12 for a one-month supply. For higher-tier medications, costs transition to coinsurance percentages instead of flat copays. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options, while Tier 4 non-preferred drugs require a 25% coinsurance. Tier 5 specialty medications also carry a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust coverage with low out-of-pocket costs, featuring no copays or coinsurance for primary care doctor visits and routine home health services. Specialist visits range from no copay up to a $70 copay, while inpatient hospital stays require a $395 daily copay for the first six days and no copay thereafter. Emergency care is accessible with a $130 copay, which is waived if you are admitted to the hospital. For routine care, the plan provides preventive dental, routine vision, and annual hearing exams with no copays or coinsurance. Comprehensive dental services are covered with coinsurance ranging from 20% to 50% up to a $1,500 annual limit, and vision benefits include a $100 annual allowance for eyewear. Additionally, diagnostic lab work and outpatient X-rays are available with no copay, helping you manage your health affordably.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute care, you pay a $395 daily copay for days 1 to 6 and no copay for days 7 to 90, with unlimited additional days covered at no copay. Psychiatric care requires a $390 daily copay for days 1 to 6 and no copay for days 7 to 90, while non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) outpatient services are covered with no coinsurance, featuring no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $395, observation services carry a $395 copay per stay, and outpatient substance abuse sessions have a copay of $25 to $30.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $55.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $275 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to plan-approved or any other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both featuring no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, and worldwide emergency transportation has a $275 copay, all with no coinsurance up to a maximum plan benefit of $250,000.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $70 copay and no coinsurance. Physical therapy, occupational therapy, and mental health services are covered with copays ranging from $25 to $40 and no coinsurance, whereas telehealth services require a $0 to $70 copay and 20% coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services under the Aetna Medicare Signature (PPO) are partially covered, featuring an annual physical, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance, while kidney disease education has a 20% coinsurance and no copay. Several supplemental benefits like health education, remote access technologies, and memory fitness are covered at no cost, but other services—including weight management, nutritional benefits, in-home support, and personal emergency response systems—are not covered.
Hearing Services See details
Hearing services are partially covered under the Aetna Medicare Signature (PPO) plan with no deductible and no coinsurance. Routine hearing exams and fitting evaluations have no copay, Medicare-covered exams require a $70 copay, and up to two yearly prescription hearing aids are covered with copays ranging from $0 to $1,700, though OTC, inner ear, outer ear, and over-the-ear models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) offers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Covered benefits include one routine eye exam per year up to a $50 annual limit, alongside a combined $100 annual maximum allowance for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered under the Aetna Medicare Signature (PPO) plan, offering no copay and no coinsurance for preventive care like cleanings and exams, and a $70 copay with no coinsurance for Medicare-covered dental. Covered comprehensive services require no copay and 20% to 50% coinsurance up to a $1,500 annual limit, though 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 (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays, although prior authorization is required. Coinsurance ranges from no coinsurance up to 20% for durable medical equipment (DME), medical supplies, and diabetic supplies, while prosthetic devices require 20% coinsurance and diabetic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with lab services and outpatient X-rays available with no copay. Outpatient diagnostic procedures and tests carry a $0 to $100 copay with no coinsurance, while therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature (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 (PPO) with no copay and no coinsurance, but some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) partially covers skilled nursing facility (SNF) services with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day hospital stay is not, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (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 under this benefit.
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