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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 2025, 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 Select Parishes in LA. This plan received an overall rating of 4.5 out of 5 stars in 2025.
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 $590.00 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 $14000.00 (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 $14000.00 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 (PPO) plan has an enhanced alternative drug benefit. The plan has a $590 deductible. In the initial coverage phase, you will pay a $0 copay for preferred generic drugs at preferred and mail-order pharmacies, and a $12 copay at standard pharmacies and standard mail order. For other tiers, you will pay coinsurance of 24% or 25%. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers a wide range of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the service. You'll have no copay for services like primary care visits, routine eye exams, and many preventive services, including annual physical exams. The plan also covers dental and vision services, with a $40 copay for Medicare dental services and eye exams with a copay between $0 and $40. Additional benefits include coverage for hearing services, with hearing exams with a $40 copay, and prescription hearing aids up to $500 per year. Emergency and ambulance services are covered, with a $110 copay for emergency services and a $295 copay for ground ambulance services. The plan also includes coverage for home health services with no copay, and skilled nursing facility (SNF) services, with a copay for days 21-100.
Inpatient Hospital See details
Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you have a copay of $380 for days 1-7, and no copay for days 8-90; additional days are covered with no copay. For Inpatient Hospital Psychiatric, you have a copay of $407 for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services, are covered. Outpatient Hospital Services have a copay between $0 and $380, Observation Services have a copay of $380, Ambulatory Surgical Center (ASC) Services have no copay, and Individual and Group Sessions for Outpatient Substance Abuse have a copay of $40.
Partial Hospitalization See details
Partial Hospitalization is covered by the Aetna Medicare Signature (PPO) plan, requiring prior authorization, with an $80 copay.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Aetna Medicare Signature (PPO), with a $295 copay for ground ambulance services and 20% coinsurance for air ambulance services. Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Aetna Medicare Signature (PPO). Emergency Services and Worldwide Emergency Coverage have a $110 copay, Urgently Needed Services have a $40 copay, and Worldwide Emergency Transportation has a $295 copay; all services have no coinsurance.
Primary Care See details
Primary Care Physician Services have no copay, while Chiropractic Services have a $15 copay. Occupational Therapy Services have a $35 copay, and Physician Specialist Services have a copay between $10 and $40. Mental Health and Psychiatric Specialty Services, Opioid Treatment Program Services, and Other Health Care Professional services have a copay that varies. Physical Therapy and Speech-Language Pathology Services have a $35 copay, and Additional Telehealth benefits have a 20% coinsurance and a copay between $0 and $40. Podiatry Services are not covered.
Preventive Services See details
Preventive Services include no copay for annual physical exams, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following welcome visits. Kidney Disease Education Services have a 20% coinsurance. Other covered services include Health Education, Additional Sessions of Smoking and Tobacco Cessation Counseling, and Fitness Benefit with no copay.
Hearing Services See details
Hearing services include hearing exams with a $40 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay, each limited to one visit per year. Prescription hearing aids are covered up to $500 per year, and the plan covers two visits per year for prescription hearing aids of all types with no copay, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including eye exams and eyewear. Eye exams have a copay between $0 and $40, while routine eye exams have no copay. Eyewear, including contact lenses, eyeglasses, and upgrades, has no copay, with a combined maximum benefit of $140 per year.
Dental Services See details
The Aetna Medicare Signature (PPO) plan covers dental services, with a $40 copay for Medicare dental services. Other services like oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered with no copay. However, maxillofacial prosthetics, implant services, and orthodontics are not covered. The plan has an annual maximum benefit of $1,000 for both in-network and out-of-network services.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required for these services.
Dialysis Services See details
Dialysis Services are covered with a coinsurance of 20%. Prior authorization is required for this benefit.
Medical Equipment See details
Medical Equipment is covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 19% coinsurance and requires authorization, while Prosthetic Devices and Medical Supplies have a 19% coinsurance, and Diabetic Therapeutic Shoes/Inserts have a $10 copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Aetna Medicare Signature (PPO) plan. Diagnostic Procedures/Tests have a copay between $0 and $95, while Lab Services have no copay. Diagnostic Radiological Services have a copay up to $300, and Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the Aetna Medicare Signature (PPO) plan, but the plan does not cover any specific services. The plan has a copay, but specific information about the copay is not available.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Aetna Medicare Signature (PPO) plan, but require prior authorization. There is no copay for days 1-20, but there is a $214 copay for days 21-100. Additional days beyond Medicare-covered for SNF and Non-Medicare-covered stays for SNF are not covered.
Other Services See details
Under "Other Services," acupuncture, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered. Over-the-counter items have no copay, and meal benefits have no copay. Additionally, other services like an annual wellness exam, screening mammography, gFOBT, and FIT have no copay.
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