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Aetna Medicare Signature Giveback (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Giveback (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 Giveback (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Giveback (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in AL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Giveback (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 Giveback (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 Giveback (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. Additionally, this plan comes with a Part B Premium reduction of $50.00. You must continue to pay paying your reduced 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 $13900.00 (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 $13900.00 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 Giveback (PPO) plan features an Enhanced Alternative drug benefit with a $615 annual prescription drug deductible. After meeting this deductible, you enter the initial coverage phase where Tier 1 preferred generic drugs have no copay at preferred pharmacies and mail-order services, or a $12 copay at standard pharmacies. Tier 2 standard generics require a 24% coinsurance, while Tier 3 preferred brands and Tier 4 non-preferred drugs both carry a 25% coinsurance. Once your yearly out-of-pocket drug costs reach $2,100, you enter the catastrophic coverage phase and pay nothing for covered Part D prescription drugs. Additionally, individuals who qualify for full Low-Income Subsidy (LIS or Extra Help) will benefit from a reduced $0 Part D premium. This structured plan offers clear, predictable cost-sharing stages to help you manage your prescription drug expenses.
Additional Benefits
The Aetna Medicare Signature Giveback (PPO) plan offers robust medical coverage with no copay for primary care visits, preventive screenings, and home health services. For inpatient hospital stays, members pay a $388 daily copay for days one through seven, while emergency room visits require a $115 copay. Outpatient services range from no copay up to a $450 copay, and diagnostic lab tests and X-rays are covered with no copay. Additional benefits include routine dental, vision, and hearing care with no copay for preventive dental cleanings, annual eye exams, and routine hearing exams. The plan provides a $100 annual eyewear allowance and up to $500 per ear annually for prescription hearing aids, though comprehensive dental services require a 20% to 50% coinsurance up to a $1,500 limit. Skilled nursing facility stays feature no copay for the first 20 days, while durable medical equipment and dialysis require up to 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature Giveback (PPO) covers inpatient acute hospital stays with a $388 daily copay for days 1 through 7 and psychiatric stays with a $407 daily copay for days 1 through 5, with no coinsurance and no copay for subsequent days. While unlimited additional acute days are covered, certain services such as upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature Giveback (PPO) covers outpatient services with no coinsurance and copays ranging from no copay for ambulatory surgical center and blood services up to $450 for outpatient hospital services. Additionally, there is a $30 copay for outpatient substance abuse sessions and a $388 copay per stay for observation services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Giveback (PPO) with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Giveback (PPO) partially covers ambulance and transportation services, as transportation services to plan-approved or any health-related locations are not covered. Covered ground ambulance services require a $295 copay and no coinsurance, while air ambulance services require a 20% coinsurance and no copay.
Emergency Services See details
Aetna Medicare Signature Giveback (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with copays ranging from $115 to $295 and no coinsurance.
Primary Care See details
Aetna Medicare Signature Giveback (PPO) offers primary care physician services with no copay, though podiatry and routine chiropractic care are not covered. Specialist, therapy, and mental health services feature copays ranging from $0 to $50, while additional telehealth benefits require a 20% coinsurance and a $0 to $50 copay.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Giveback (PPO). Covered benefits like annual physical exams and health screenings feature no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. Non-covered sub-services include In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services.
Hearing Services See details
Aetna Medicare Signature Giveback (PPO) partially covers hearing services, offering routine hearing exams and fittings with no copay or coinsurance, while Medicare-covered exams require a $50 copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC hearing aids, along with inner ear, outer ear, and over the ear prescription models, are not covered.
Vision Services See details
Aetna Medicare Signature Giveback (PPO) covers routine eye exams and eyewear with no copay and no coinsurance, providing a combined annual eyewear allowance of $100. Other eye exams are covered with a copay ranging from $0 to $50 and no coinsurance.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Giveback (PPO), featuring no copay for preventive care like oral exams, cleanings, and x-rays, and a $50 copay for Medicare-covered dental services. Comprehensive services require a 20% to 50% coinsurance up to a $1,500 annual limit, though fluoride treatments, maxillofacial prosthetics, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under Aetna Medicare Signature Giveback (PPO), though prior authorization is required. Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs require no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Aetna Medicare Signature Giveback (PPO) covers Dialysis Services with a 20% coinsurance and no copay. Prior authorization is required for these covered services.
Medical Equipment See details
Aetna Medicare Signature Giveback (PPO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic equipment, with prior authorization required. There is no copay for these services, and coinsurance ranges from no coinsurance up to 20% depending on the specific item.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature Giveback (PPO) with prior authorization required. Lab services have no copay or coinsurance, outpatient X-ray services have no copay, diagnostic procedures have a $0 to $95 copay, diagnostic radiology has a $0 to $300 copay, and therapeutic radiology requires 20% coinsurance with no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Signature Giveback (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Aetna Medicare Signature Giveback (PPO) provides coverage for cardiac rehabilitation, but in practice only some services are covered as Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and SET for PAD services are not covered. Since these specific services are not covered, there are no active copayments or coinsurance benefits available for them.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are partially covered by Aetna Medicare Signature Giveback (PPO) with no copay for days 1 to 20 and a $218 daily copay for days 21 to 100, with no coinsurance. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Giveback (PPO) partially covers other services, offering no copay and no coinsurance for chronic illness meal benefits, annual wellness exams, screening mammography, and additional gFOBT and FIT screenings. Acupuncture, over-the-counter (OTC) items, and Dual Eligible SNPs with highly integrated services are not covered.
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