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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 Central Massachusetts. 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 $500.00 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 $9550.00 (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 $9550.00 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 a $500 annual drug deductible. You can save on prescriptions by using preferred pharmacies or preferred mail-order services, which offer no copay for Tier 1 preferred generic and Tier 2 generic drugs. Standard pharmacies and standard mail-order services charge a copay starting at $2.00 for Tier 1 and $12.00 for Tier 2 for a one-month supply. For higher-tier medications, cost-sharing transitions to coinsurance across all pharmacy and mail-order options. Tier 3 preferred brand drugs require a 22% coinsurance, and Tier 4 non-preferred drugs carry a 25% coinsurance. Specialty drugs under Tier 5 require a 27% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan provides comprehensive healthcare coverage with predictable out-of-pocket costs and many services featuring no copay. Members benefit from no copays for primary care visits, annual wellness exams, and home health services, while specialist visits require a copay of up to $40. Inpatient hospital stays require a daily copay of $395 for the first seven days, with no copay thereafter and no coinsurance. Emergency care is covered worldwide with a $130 copay, and urgent care visits require a $40 copay. Routine dental, hearing, and vision exams are available with no copay, and the plan includes up to $225 annually for prescription eyewear. Skilled nursing facility care requires a low $10 daily copay for the first 20 days, and durable medical equipment is provided with no copay and coinsurance up to 25%.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) covers inpatient hospital services with no coinsurance, requiring a $395 daily copay for days 1 to 7 of acute stays (no copay thereafter) and a $320 daily copay for days 1 to 6 of psychiatric stays (no copay thereafter). This benefit is partially covered, as prior authorization is required, and upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services, a $395 copay per stay for observation services, and a $40 copay for substance abuse sessions. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, though prior authorization is required for several of these services.
Partial Hospitalization See details
Partial hospitalization services are covered under the Aetna Medicare Signature Extra (PPO) plan with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Aetna Medicare Signature Extra (PPO), with ground ambulance services requiring a $285 copay and air ambulance services requiring a 20% coinsurance, subject to prior authorization. Although transportation is technically covered, some services are covered but transportation to plan-approved health-related locations and any other health-related locations are not covered in practice.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered with a $130 copay, and worldwide emergency transportation has a $285 copay, all with no coinsurance up to a $250,000 maximum plan benefit limit.
Primary Care See details
Aetna Medicare Signature Extra (PPO) offers primary care physician services with no copay and no coinsurance, while specialist visits require a $0 to $40 copay and no coinsurance. Other covered services like physical therapy, mental health, and psychiatric care have a $40 copay and no coinsurance, whereas podiatry and chiropractic services are not covered. Telehealth benefits are also available with a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) provides partially covered preventive services, featuring no copay and no coinsurance for annual exams, fitness benefits, and screenings, while kidney disease education has a 20% coinsurance and no copay. Non-covered sub-services include in-home safety assessments, personal emergency response systems, medical nutrition therapy, weight management, and alternative therapies.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers Medicare-covered hearing exams for a $40 copay and no coinsurance, while routine exams and fittings are provided with no copay. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $1,700 for up to two devices per year, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature Extra (PPO) with no deductible and no coinsurance, offering routine eye exams with no copay (one per year, up to a $50 limit) and Medicare-covered exams with a $0 to $40 copay. Prescription eyewear, including contacts and eyeglasses, is also covered with no copay and no coinsurance up to a combined annual maximum of $225.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Extra (PPO), offering Medicare-covered dental for a $40 copay and no coinsurance, and select preventive services like exams, cleanings, and x-rays with no copay and no coinsurance. Non-covered services include fluoride, restorative, endodontic, periodontic, prosthodontic, orthodontic, implant, and oral surgery treatments.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (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 and other Part B drugs require 0% to 20% coinsurance.
Dialysis Services See details
Aetna Medicare Signature Extra (PPO) covers Dialysis Services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (PPO) with prior authorization, offering no copay for durable medical equipment (DME), prosthetics, and diabetic shoes. Depending on the item, coinsurance ranges from no coinsurance up to 25% for DME and medical supplies, up to 20% for diabetic supplies, and a flat 25% for prosthetic devices.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Aetna Medicare Signature Extra (PPO) plan, with prior authorization required for all services. Diagnostic services feature no coinsurance, offering a $0 to $40 copay for procedures and no copay for lab tests, while radiological services require a $10 copay for X-rays, a minimum 20% coinsurance for therapeutic services, and a $0 minimum copay for diagnostic radiology.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, but only some services are covered in practice. Under this plan, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a daily copay of $10 for days 1 through 20 and $212 for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond the standard 100-day Medicare limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering a chronic illness meal benefit, annual wellness exams, screening mammographies, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered under this benefit.
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