A non-government entity
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 Eastern 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 (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 $10000.00 (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 $10000.00 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:
Sign up for Aetna Medicare Signature (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Aetna Medicare Signature (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when utilizing a preferred pharmacy or preferred mail-order service. Standard pharmacy and standard mail-order options require copays starting at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. Higher-tier medications under this plan require coinsurance instead of flat copays. Tier 3 preferred brand drugs carry a 24% coinsurance across all pharmacy options, while Tier 4 non-preferred drugs require 25% coinsurance. Tier 5 specialty drugs also require a 25% coinsurance for a one-month supply at both preferred and standard pharmacies.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive coverage for core medical services with many benefits requiring no coinsurance. Primary care visits require a low $5 copay, while specialist visits and outpatient services range from no copay up to $60 and $460 copays, respectively. For hospital stays, inpatient care features daily copays with no coinsurance, and emergency care is accessible with a $130 copay. Preventive care, annual physicals, routine hearing exams, and home health services are fully covered with no copay and no coinsurance. Dental and vision benefits include select routine services with no copay, alongside a $100 annual allowance for eyewear and coverage for up to two hearing aids per year. Other essential services like durable medical equipment and dialysis require no copay but carry coinsurance up to 25% and 20%, respectively.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital care with no coinsurance, but prior authorization is required. Medicare-covered acute stays require a $495 daily copay for days 1 to 5 (with no copay for days 6 and beyond), and psychiatric stays require a $360 daily copay for days 1 to 6 (with no copay for days 7 to 90). Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered under this benefit.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and blood services. Patients will pay a $0 to $460 copay for outpatient hospital services, a $495 copay per stay for observation services, and a $60 copay for outpatient substance abuse sessions, all with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, though prior authorization is required. Depending on the specific service, you will pay a copay of either $70.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $290 copay and no coinsurance for ground ambulance services, and a 20% coinsurance with no copay for air ambulance services. While some transportation services are covered, transportation to plan-approved health-related locations and any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay and no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum limit with a $130 copay, while worldwide emergency transportation requires a $290 copay, both with no coinsurance.
Primary Care See details
Primary care benefits under Aetna Medicare Signature (PPO) include primary care visits for a $5 copay and specialist visits ranging from no copay to a $60 copay, both with no coinsurance. Physical, occupational, and speech therapy require a $50 copay with no coinsurance, while mental health and psychiatric services carry a $60 copay and no coinsurance. Chiropractic and podiatry services are not covered, though telehealth is available with a copay ranging from no copay to $60 and 20% coinsurance.
Preventive Services See details
Preventive services are partially covered under the Aetna Medicare Signature (PPO) plan, offering no copay and no coinsurance for annual physical exams, glaucoma screenings, and fitness benefits, while kidney education services require no copay and a 20% coinsurance. Several supplemental options are not covered, including weight management programs, personal emergency response systems, in-home safety assessments, and medical nutrition therapy.
Hearing Services See details
Aetna Medicare Signature (PPO) provides partially covered hearing services, which include Medicare-covered exams for a $60 copay and no coinsurance, as well as annual routine exams and fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids are covered per year with copays ranging from no copay to $1,700 and no coinsurance, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no deductibles and no coinsurance, including eye exams with copays ranging from no copay to $60 and a $50 annual maximum. Eyewear benefits, including contact lenses and eyeglasses, are covered with no copay up to a combined yearly maximum of $100.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), offering Medicare-covered dental services for a $60 copay and no coinsurance, and select preventive services with no copay and no coinsurance. Fluoride, orthodontic, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, adjunctive general, maxillofacial prosthetics, and other diagnostic or preventive 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 and step therapy are 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 a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Aetna Medicare Signature (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required for these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, medical supplies, and diabetic services, with no copays and coinsurance ranging from no coinsurance up to 25%. Prior authorization is required for these covered benefits.
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 ranging from $0 to $45, lab services and diagnostic radiological services have no copay, and outpatient X-rays require a $10 copay while therapeutic radiological services have a 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are provided under the Aetna Medicare Signature (PPO) with no coinsurance, meaning some services are covered, but standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for peripheral artery disease (PAD) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers skilled nursing facility (SNF) services with no coinsurance, requiring a $10 copay per day for days 1 through 20 and a $218 copay per day for days 21 through 100. Prior authorization is required, a three-day prior inpatient hospital stay is not necessary for admission, and days beyond the standard 100-day benefit period are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), including a meal benefit for chronic illness, an annual wellness exam and screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture and over-the-counter (OTC) items are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved