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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.
This summary reflects 2026 plan information. Where this plan continues in 2027, the full plan details page links to its 2027 benefits and costs.
Aetna Medicare Signature (PPO) is a PPO plan offered by Aetna Life Insurance Company available for the 2026 plan year to people living in Greater Portland Metro Area. 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 that applies only to drugs in certain tiers. You pay this amount toward covered prescriptions in those tiers before the plan's cost sharing begins; drugs in the other tiers are not subject to the deductible. See the full plan details page for the tier table.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6900.00 for in-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $6900.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
This plan has a Maximum Out-Of-Pocket cost of $13900.00 (in-network and out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your out-of-pocket costs reach $13900.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
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 drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, there is no copay for one-month, two-month, or three-month supplies when filled at a preferred pharmacy or through preferred mail order. If you use a standard pharmacy or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For brand-name and specialty medications, costs are structured as coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance across all pharmacy options and supply lengths. Tier 5 specialty drugs also carry a 25% coinsurance but are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, annual physicals, and home health services. Specialist office visits range from no copay to a $55 copay, while emergency care carries a $115 copay that is waived if you are admitted. For hospital care, inpatient acute stays require a $475 daily copay for the first five days, and outpatient hospital services range from no copay to a $450 copay. Routine dental, vision, and hearing exams are highly accessible with no copay and no coinsurance, including a $125 eyewear allowance and a $1,000 annual limit per ear for prescription hearing aids. Comprehensive dental services are covered up to a $1,250 annual maximum with no copay and 20% to 50% coinsurance. Finally, diagnostic lab tests and X-rays require no copay, while durable medical equipment is covered with no copay and a 20% coinsurance.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, requiring a daily copay of $475 for days 1 to 5 of acute stays and $415 for days 1 to 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
Outpatient services covered under the Aetna Medicare Signature (PPO) plan feature no coinsurance across all categories, with no copays required for ambulatory surgical center and blood services. Patients will pay a copay of $0 to $450 for outpatient hospital services, $475 per stay for observation services, and $40 per session for outpatient substance abuse services, with prior authorization required for most of these benefits.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of $105.00 or $110.00 and no coinsurance. Prior authorization is required to access these covered benefits.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $280 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services are not covered, which includes transportation to plan-approved or any health-related locations.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $115 copay (waived if admitted to the hospital within 24 hours) and urgent care with a $40 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 limit with no coinsurance, carrying a $115 copay for care and a $280 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $0 to $55 copay and no coinsurance. Physical, occupational, and speech therapies require a $35 copay and no coinsurance, telehealth services carry a $0 to $55 copay and 20% coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by the Aetna Medicare Signature (PPO), offering annual physicals, select screenings, and memory fitness with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but other supplemental services like weight management, nutritional benefits, personal emergency response systems, and in-home safety assessments are not covered.
Hearing Services See details
Hearing Services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for routine exams, fitting evaluations, and covered prescription hearing aids. The benefit is partially covered, as OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered, though a $1,000 annual maximum per ear applies to covered prescription aids.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (PPO) with no copay, no coinsurance, and no deductible for both eye exams and eyewear. This coverage includes one routine eye exam per year up to a $50 maximum and a $125 annual combined allowance for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, including Medicare-covered dental for a $55 copay and no coinsurance, and preventive care like exams and cleanings with no copay and no coinsurance. Comprehensive services are covered up to a $1,250 annual maximum with no copay and 20% to 50% coinsurance, though 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. 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 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, offering durable medical equipment (DME) and prosthetics with no copay and 20% coinsurance. Diabetic supplies and therapeutic shoes or inserts are also covered with no copays and coinsurance ranging from 0% to 20%, though prior authorization is required.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for all services. Diagnostic procedures and tests carry a $0 to $25 copay with no coinsurance, lab services and outpatient X-rays are covered with no copay, and therapeutic radiological services require 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 covered under the Aetna Medicare Signature (PPO) with no copay and no coinsurance, but in practice, some services are covered while standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers skilled nursing facility (SNF) care with no coinsurance, featuring no copay for days 1 through 20 and a $218 copay for days 21 through 100. Prior authorization is required, and while a three-day prior hospital stay is not necessary, additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for covered benefits, which include a $25 quarterly over-the-counter item reimbursement, annual wellness exams, and additional colorectal screenings. Acupuncture and meal benefits are not covered under this plan.
Plan Providers
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpringSM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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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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