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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 Panhandle/NW 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 drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using preferred pharmacies or preferred mail order services for one, two, or three-month supplies. If standard pharmacies or standard mail services are used, generic drug copays range from $2 to $12 for a one-month supply. Brand-name and specialty medications under this plan are subject to coinsurance rather than set copays. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail order options, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Specialty drugs are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage featuring no copay for primary care doctor visits and copays ranging from no copay to $75 for specialists. For hospital care, inpatient stays require a $325 daily copay for days one through five, with no copay for days six through 90, while emergency services carry a $130 copay. Additionally, outpatient hospital services and home health care are highly accessible, with many services requiring no copay or coinsurance. Supplemental benefits include preventive dental, annual hearing exams, and routine vision care with no copays or coinsurance, plus allowances for glasses and hearing aids. Skilled nursing facility stays are also covered with no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100. By eliminating deductibles and coinsurance for many key services, this plan helps beneficiaries manage their healthcare budget effectively.
Inpatient Hospital See details
Inpatient hospital care is covered by Aetna Medicare Signature (PPO) with no coinsurance and a copay of $325 per day for days 1 through 5, and no copay for days 6 through 90. Unlimited additional days are covered for acute care, but psychiatric additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including no copay for ambulatory surgical center and blood services. Outpatient hospital services have a copay of $0 to $325, observation services require a $325 copay per stay, and outpatient substance abuse services carry a copay of $25 for group sessions and $30 for individual sessions.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with no coinsurance and a copay of either $55.00 or $145.00. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $275 copay and no coinsurance for ground services, and a 20% coinsurance and no copay for air services. Although some transportation services are covered, transportation to plan-approved health-related locations and any other health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay with no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays ranging from $130 to $275.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician visits with no copay and no coinsurance, alongside specialist visits with a $0 to $75 copay and no coinsurance. Physical, occupational, speech, psychiatric, mental health, and opioid treatment therapies are covered with copays ranging from $25 to $35 and no coinsurance, while podiatry is not covered. Some chiropractic services are covered, though routine and other chiropractic services are not, and telehealth is available with a $0 to $75 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature (PPO), featuring no copay and no coinsurance for annual exams, screenings, and select supplemental benefits, while kidney disease education has no copay but a 20% coinsurance. Excluded sub-services include In-Home Safety Assessments, PERS, Medical Nutrition Therapy, post-discharge 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 safety devices, and counseling.
Hearing Services See details
Hearing services under the Aetna Medicare Signature (PPO) are partially covered with no deductible, offering Medicare-covered exams for a $75 copay and no coinsurance, alongside annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to two per year with no coinsurance and copays ranging from no copay to $1,700, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision Services through Aetna Medicare Signature (PPO) are covered with no copays, no coinsurance, and no deductibles for both exams and eyewear. The plan includes one routine eye exam per year up to a $50 maximum benefit, alongside a $100 combined annual maximum benefit for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring Medicare-covered care for a $75 copay and no coinsurance, and preventive services with no copay and no coinsurance. Comprehensive benefits require no copay and 20% to 50% coinsurance up to a $1,000 yearly limit, though other diagnostic dental services, fluoride treatment, other preventive dental services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B insulin is covered with a $35 copay and no coinsurance, while Part B chemotherapy and other drugs are covered with no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copays, though prior authorization is required for most items. Durable medical equipment, medical supplies, and diabetic supplies feature no copay and range from no coinsurance to 20% coinsurance, while prosthetic devices require 20% coinsurance and diabetic therapeutic shoes or inserts have no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Aetna Medicare Signature (PPO) plan, with prior authorization required for all services. Diagnostic procedures and tests have no coinsurance and a copay ranging from $0 to $100, while lab services and outpatient X-rays have no copay. Diagnostic radiological services have a minimum copay of $0, and therapeutic radiological services require a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by 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 by Aetna Medicare Signature (PPO) with no copay and no coinsurance, though only some services are covered because standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no 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 100 days are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering no copay and no coinsurance for an annual wellness exam, screening mammography, and additional gFOBT and FIT. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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