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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 Central and North 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 drugs, you will pay no copay when utilizing preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, and Tier 2 copays range from $12 to $36 depending on the fill supply. For brand-name and specialty medications, costs are based on coinsurance regardless of the pharmacy type you choose. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance. Tier 5 specialty drugs are limited to a one-month supply, whereas other tiers offer one, two, or three-month supply options.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive coverage with no copay and no coinsurance for primary care doctor visits, annual wellness exams, and routine preventive screenings. For inpatient hospital stays, members pay no coinsurance and a $290 copay per day for the first four days, followed by no copay for days five through 90. Emergency room visits require a $130 copay, which is waived if you are admitted within 24 hours, while urgent care services carry a $50 copay. Routine dental, vision, and hearing exams are highly accessible under this plan, featuring no copays or coinsurance for standard preventive care. Specialist visits range from no copay to a $75 copay, while home health services are fully covered with no copay and no coinsurance. Prescription hearing aids and comprehensive dental services are also covered, though they may require copays up to $1,700 or coinsurance up to 50% depending on the specific treatment.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient acute and psychiatric hospital care with no coinsurance, requiring a $290 copay for days 1 through 4 and no copay for days 5 through 90 per stay. While unlimited additional acute care days are covered with no copay, additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring no copay for ambulatory surgical center and blood services. Outpatient hospital services carry a copay of $0 to $290, observation services have a $290 copay per stay, and outpatient substance abuse sessions require 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
Ambulance and transportation services are covered under the Aetna Medicare Signature (PPO) plan, with ground ambulance requiring a $275 copay and no coinsurance, and air ambulance requiring a 20% coinsurance and no copay. Prior authorization is required for all ambulance services, while transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 limit with no coinsurance and copays of $130 for emergency or urgent care and $275 for transportation.
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 $75 copay and no coinsurance. Chiropractic services are partially covered with a $15 copay and no coinsurance, excluding routine and other chiropractic care, while podiatry services are not covered. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, while telehealth services have a $0 to $75 copay and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for annual exams, routine screenings, and fitness benefits, though kidney education requires a 20% coinsurance and no copay. Specific excluded services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services with no coinsurance, offering annual routine hearing exams and fitting evaluations with no copay, and Medicare-covered exams for a $75 copay. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $0 to $1,700 for up to two devices per year, excluding OTC hearing aids as well as inner ear, outer ear, and over the ear prescription models.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no deductible, no copay, and no coinsurance for both eye exams and eyewear. This includes one routine eye exam per year up to a $50 annual maximum, and a $100 annual combined maximum for eyewear such as contact lenses, eyeglasses, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) provides partial coverage for dental services, offering preventive care like oral exams and cleanings with no copay and no coinsurance. Medicare-covered dental services require a $75 copay and no coinsurance, while comprehensive services like endodontics and prosthodontics carry no copay and 20% to 50% coinsurance up to a $1,750 annual limit. Fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers Home Infusion bundled Services 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 require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment with no copays, although prior authorization is required. Coinsurance ranges from no coinsurance to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices carry a 20% coinsurance and diabetic therapeutic shoes have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with no coinsurance for diagnostic services and no copay for lab services or outpatient X-rays. Diagnostic procedures and tests carry a copay of $0 to $100, diagnostic radiological services have a copay starting at $0, and therapeutic radiological services require a minimum 20% coinsurance, with prior authorization required.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature (PPO) covers some services under Cardiac Rehabilitation Services with no copay and no coinsurance, but cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD 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-day Medicare benefit are not covered.
Other Services See details
Other Services are partially covered by the Aetna Medicare Signature (PPO) plan, featuring no copay and no coinsurance for covered services including annual wellness exams, screening mammographies, and additional gFOBT and FIT. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered under this plan.
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