A non-government entity
Aetna Medicare Signature Care (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Care (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 Care (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Care (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in South Carolina metro areas. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Care (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 Care (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 Care (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 $10250.00 (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 $10250.00 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 Care (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 Care (PPO) plan features an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose standard pharmacies or standard mail order, Tier 1 drugs carry a low copay starting at $2, while Tier 2 drugs start at a $12 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance instead of copays across all pharmacy and mail-order options. 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. Specialty medications under Tier 5 are limited to a one-month supply for this plan.
Additional Benefits
The Aetna Medicare Signature Care (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, routine physicals, and home health services. For inpatient hospital stays, members pay a copay of $388 per day for days 1 to 7, while specialist visits require a copay ranging from $10 to $55. Emergency care is available with a $115 copay, which is waived if you are admitted within 24 hours. This plan also features supportive routine care, providing no copay and no coinsurance for preventive dental services, routine hearing exams, and routine eye exams. Prescription hearing aids are covered up to $500 per ear with no copay, and there is a combined $100 annual allowance for eyewear with no copay or coinsurance. Additionally, outpatient x-rays and home infusions are covered with no copay, while durable medical equipment and dialysis require a coinsurance of up to 20%.
Inpatient Hospital See details
Inpatient hospital stays are covered by Aetna Medicare Signature Care (PPO) with no coinsurance, requiring a $388 copay for days 1 to 7 of acute stays and a $260 copay for days 1 to 8 of psychiatric stays, with no copay thereafter. This benefit is partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Care (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services carry a copay of $0 to $388, while outpatient substance abuse sessions require a $40 copay, with prior authorization needed for most of these services.
Partial Hospitalization See details
Aetna Medicare Signature Care (PPO) covers partial hospitalization services 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 Care (PPO) covers ground ambulance services with a $290 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Care (PPO) covers emergency services with a $115 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $40 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $115 to $290, up to a maximum plan benefit of $250,000.
Primary Care See details
Primary care benefits under Aetna Medicare Signature Care (PPO) feature no copay and no coinsurance for primary care visits, and a $10 to $55 copay with no coinsurance for specialists. Therapy services require a $35 copay with no coinsurance, while chiropractic care is partially covered—excluding routine and other chiropractic services—and podiatry is not covered.
Preventive Services See details
Preventive Services are partially covered under Aetna Medicare Signature Care (PPO), with most covered options like annual physicals and glaucoma screenings requiring no copay and no coinsurance, while kidney disease education carries no copay and a 20% coinsurance. Sub-services that are not covered include in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, 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 devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Care (PPO) covers Medicare-covered hearing exams for a $55 copay and no coinsurance, while routine exams and fittings have no copay and no coinsurance. Prescription hearing aids are partially covered with no copay or coinsurance up to a $500 annual limit per ear, but inner ear, outer ear, over-the-ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Care (PPO) covers vision services with no deductibles and no coinsurance, featuring eye exam copays ranging from $0 to $55 and no copay for eyewear. The plan includes a $50 annual maximum benefit for routine eye exams (one per year) and a combined $100 annual maximum benefit for contacts, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature Care (PPO) offers partial coverage for dental services, featuring Medicare-covered dental care for a $55 copay and no coinsurance. Preventive services like exams, cleanings, and x-rays are covered with no copay and no coinsurance, but other sub-services including fluoride, restorative, endodontics, periodontics, prosthodontics, implants, and oral surgery are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered under the Aetna Medicare Signature Care (PPO) 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 have a coinsurance ranging from 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature Care (PPO) 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 Care (PPO) with no copays and coinsurance ranging from no coinsurance up to 20% for durable medical equipment, prosthetics, and diabetic supplies. Prior authorization is required for these benefits, and diabetic supplies are limited to specified manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Care (PPO) covers diagnostic and radiological services with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic tests with a $0 to $200 copay, while radiological services include outpatient x-rays with no copay, diagnostic radiology starting at a $0 copay, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature Care (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Some Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature Care (PPO) plan with no copay and no coinsurance, but standard cardiac, intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Care (PPO) covers Skilled Nursing Facility (SNF) care with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day hospital stay is not needed, though additional days beyond the Medicare-covered 100 days are not covered.
Other Services See details
Other Services are partially covered under the Aetna Medicare Signature Care (PPO) plan, featuring no copay and no coinsurance for annual wellness exams, screening mammographies, additional gFOBT and FIT screenings, and up to $15 every three months in over-the-counter item reimbursements. Acupuncture, meal benefits, and other services are not covered under this plan.
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