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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 Connecticut. 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 $9500.00 (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 $9500.00 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) prescription drug plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when utilizing preferred retail pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order services, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For higher-tier medications, your costs will be based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance regardless of the pharmacy type. Specialty medications on Tier 5 are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides comprehensive medical coverage with predictable cost-sharing, featuring no copay and no coinsurance for primary care doctor visits and annual wellness exams. Specialist visits and routine outpatient services generally carry low copayments with no coinsurance, while emergency room visits require a flat $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay daily copayments with no coinsurance for the first several days of care, after which there is no copay. This plan also includes essential supplemental benefits, offering routine dental, vision, and hearing exams with no copay and no coinsurance. While prescription hearing aids and specialized vision wear are available with varying copayments, home health services and select diagnostic lab tests are covered with no copay. Additionally, durable medical equipment, dialysis, and Part B drugs require coinsurance of up to 20% to 25% with no copay.
Inpatient Hospital See details
Inpatient hospital services are covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a $437 daily copay for days 1 through 7 of acute stays and a $334 daily copay for days 1 through 5 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and certain services such as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services have a copay of $0 to $475, observation services require a $395 copay per stay, and outpatient substance abuse sessions have a $55 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a copay of either $70.00 or $145.00 depending on the service. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature (PPO) plan require prior authorization and feature a $310 copay with no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. Transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (PPO) plan are covered with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $50 copay and no coinsurance, while worldwide emergency services are covered with no coinsurance and copays ranging from $130 to $310, up to a $250,000 maximum limit.
Primary Care See details
Primary care benefits under the Aetna Medicare Signature (PPO) plan feature no copay and no coinsurance for primary care physician visits, and a $0 to $55 copay with no coinsurance for specialist visits. Physical, occupational, and speech therapy services require a $50 copay with no coinsurance, while mental health, psychiatric, and opioid treatment services have a $55 copay with no coinsurance. Telehealth services carry a $0 to $55 copay with 20% coinsurance, podiatry is not covered, and some chiropractic services are covered although routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) preventive services are partially covered, offering no copay and no coinsurance for annual physicals, health education, fitness benefits, and glaucoma screenings, while kidney disease education has no copay and a 20% coinsurance. Uncovered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, 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 modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, including Medicare-covered exams for a $55 copay and no coinsurance, and annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $1,700 for up to two aids per year, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no coinsurance, featuring eye exams with a copay ranging from no copay to $55 and eyewear with no copay. Benefits include one routine eye exam per year with a $50 annual maximum benefit and a combined $100 annual maximum allowance for contact lenses and eyeglasses.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, providing Medicare-covered dental care with a $55 copay and no coinsurance, and select preventive services with no copay and no coinsurance. While up to four oral exams, one dental X-ray, and two cleanings per year are covered, fluoride, other diagnostic services, and comprehensive treatments like restorative care and endodontics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (PPO) covers Home Infusion bundled Services with no copay, although prior authorization is required. Covered Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance up to 20%, while Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers durable medical equipment (DME) and medical supplies with no copay and no coinsurance to 25% coinsurance. Prosthetic devices are covered with no copay and 25% coinsurance, and diabetic equipment and supplies are covered with no copay and no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO), with prior authorization required. Diagnostic tests and procedures have no coinsurance and a copay of $0 to $40, lab and diagnostic radiological services feature no copay, outpatient X-rays require a $20 copay, and therapeutic radiological services carry 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 for these services.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (PPO) with no coinsurance, though only some services are covered in practice as standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered. These non-covered services require copayments ranging from $15 to $25 per visit.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the 100-day Medicare limit are not covered.
Other Services See details
Other services are partially covered by the Aetna Medicare Signature (PPO), which offers a chronic illness meal benefit, annual wellness exams and screening mammographies, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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