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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.
Aetna Medicare Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Maricopa, Pima and Pinal Counties. 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 has a $500.00 health deductible. This means, every calendar year, you pay this amount towards covered services before your insurance coverage kicks in.
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 $8900.00 (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 $8900.00 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 features an Enhanced Alternative drug benefit with a $615.00 prescription drug deductible. After meeting this deductible, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through preferred mail order, while standard pharmacies and mail options require a $12.00 copay. For Tier 2 standard generic drugs, you will pay a 24% coinsurance regardless of the pharmacy or mail service you choose. Tier 3 preferred brand drugs and Tier 4 non-preferred drugs both require a 25% coinsurance during the initial coverage phase. Once your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and will pay nothing for covered Medicare Part D drugs. Additionally, if you qualify for the low-income subsidy, your Part D costs may be reduced to nothing.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides robust medical coverage with no copay and no coinsurance for primary care doctor visits and most preventive services. For hospital care, inpatient acute stays require a $425 daily copay for the first seven days before transitioning to no copay, while emergency room visits carry a $130 copay. Outpatient services, diagnostic tests, and home health care are also covered, generally requiring no coinsurance and low-to-no copays. Supplemental benefits include routine vision and hearing exams with no copay or coinsurance, alongside allowances for prescription hearing aids and eyewear. Preventive dental care is available with no copay, while comprehensive dental services and durable medical equipment require no copay and coinsurance ranging up to 50 percent. Other specialized care, such as dialysis and air ambulance transport, is covered with a standard 20 percent coinsurance and no copay.
Inpatient Hospital See details
Inpatient hospital benefits are partially covered by Aetna Medicare Signature (PPO) and require prior authorization, featuring no coinsurance for all covered services. Acute stays require a $425 daily copay for days 1 to 7 and no copay for days 8 to 90, while psychiatric stays require a $375 daily copay for days 1 to 5 and no copay for days 6 to 90. Upgrades, additional psychiatric days, and non-Medicare-covered stays are not covered under this plan.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature (PPO) with no coinsurance, though copays vary depending on the specific service. There is no copay for ambulatory surgical center and outpatient blood services, a $40 copay for outpatient substance abuse sessions, and a copay of up to $425 for outpatient hospital and observation services.
Partial Hospitalization See details
Partial hospitalization benefits are covered by Aetna Medicare Signature (PPO) with a copay of either $55 or $145 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) partially covers ambulance and transportation services, requiring prior authorization for ambulance care. Ground ambulance services have a $295 copay and no coinsurance, while air ambulance services require 20% coinsurance and no copay; however, transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, while worldwide emergency and transportation services are covered up to $250,000 with copays ranging from $130 to $295 and no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) provides partially covered primary care benefits with no copay and no coinsurance for primary care physician visits, and copays ranging from $15 to $50 with no coinsurance for specialist, therapy, and mental health services. Telehealth services require a 20% coinsurance and a $0 to $50 copay, while routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), with most benefits like annual physicals, health education, and screenings requiring no copay and no coinsurance, while kidney disease education has a 20% coinsurance and no copay. This plan does not cover In-Home Safety Assessments, Personal Emergency Response Systems (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 Benefits, 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, or Counseling Services.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), featuring annual routine exams and fitting evaluations with no copay or coinsurance. While prescription hearing aids are covered up to $1,000 per ear annually with no copay or coinsurance, OTC hearing aids and inner-ear, outer-ear, or over-the-ear models are not covered.
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. The plan offers up to a $50 annual maximum for eye exams and a $100 annual maximum for eyewear, applicable to both in-network and out-of-network services.
Dental Services See details
Aetna Medicare Signature (PPO) dental services are partially covered, as fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics are not covered. Covered preventive care has no copay and no coinsurance, comprehensive services require a 20% to 50% coinsurance and no copay, and Medicare-covered dental has a $50 copay and no coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) and require prior authorization. Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and range from no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (PPO) plan with 20% coinsurance and no copay. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with prior authorization required. These covered benefits feature no copays and coinsurance ranging from no coinsurance to 20%, with prosthetic devices specifically requiring 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature (PPO) with prior authorization. Lab services have no copay or coinsurance, diagnostic tests cost between no copay and $20 with no coinsurance, and outpatient X-rays require a $20 copay with no coinsurance. Diagnostic radiological services have a copay ranging from no copay to $160 with no coinsurance, while therapeutic radiological services require a 20% coinsurance with no copay.
Home Health Services See details
Aetna Medicare Signature (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the Aetna Medicare Signature (PPO) plan. This means there is no coverage, copay, or coinsurance for intensive cardiac, pulmonary, or supervised exercise therapy (SET) rehabilitation services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by Aetna Medicare Signature (PPO) with prior authorization, featuring no copay and no coinsurance for days 1 to 20, followed by a $218 daily copay and no coinsurance for days 21 to 100. Additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (PPO), which offers annual wellness exams, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter items, meal benefits, and dual eligible SNPs are not covered.
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