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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 Central. 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. 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 $10100.00 (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 $10100.00 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 annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, you will pay no copay when using a preferred pharmacy or preferred mail-order service for any supply length. If you choose standard pharmacies or standard mail order, Tier 1 copays range from $2 to $6, while Tier 2 copays range from $12 to $36 depending on the supply duration. For higher-tier medications, the plan transitions from flat copays to coinsurance percentages. Tier 3 preferred brands require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs carry a 25% coinsurance across all pharmacy and mail-order options. Specialty tier medications are limited to a one-month supply at this 25% coinsurance rate.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust core medical coverage with no copay or coinsurance for primary care physician visits and preventive services. Specialist office visits require a $60 copay, while inpatient hospital stays incur a daily copay of $425 for the first seven days of acute care. Emergency room visits are covered with a $130 copay, which is waived if you are admitted to the hospital within 24 hours. For supplemental care, the plan features no copay or coinsurance for routine vision and hearing exams, alongside preventive dental services up to a $1,000 annual limit. Vision benefits include a $170 annual allowance for eyewear, and prescription hearing aids are covered with copays ranging up to $1,700. Additionally, home health services are covered with no copay, while durable medical equipment requires no copay and a 0% to 20% coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1 to 7 of acute stays and a $334 daily copay for days 1 to 7 of psychiatric stays, followed by no copay for subsequent days. These services are partially covered, as upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $395 copay for outpatient hospital services and a $425 copay per stay for observation services. Outpatient substance abuse services require a $60 copay per session, while ambulatory surgical center and blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization with a copay of either $105.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $290 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. Transportation services to health-related locations are not covered under this plan.
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 require a $50 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $130 to $290.
Primary Care See details
Primary care services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for primary care physician visits, while specialist visits require a $60 copay and no coinsurance. Other covered benefits include physical, occupational, mental health, and psychiatric therapies with copays ranging from $45 to $65 and no coinsurance, plus telehealth benefits with a $0 to $65 copay and 20% coinsurance. Podiatry is not covered, and while some chiropractic services are covered with a $15 copay and no coinsurance, routine and other chiropractic services are excluded.
Preventive Services See details
Aetna Medicare Signature (PPO) covers preventive services and annual physical exams with no copay and no coinsurance, while kidney disease education is covered with no copay and a 20% coinsurance. This benefit is partially covered, as sub-services such as in-home safety assessments, personal emergency response systems, 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 are not covered.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), featuring no coinsurance for all covered services, a $60 copay for Medicare-covered exams, and no copay for annual routine exams and fitting evaluations. Prescription hearing aids are covered up to twice per year with no coinsurance and copays ranging up to $1,700, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) covers vision services with no copays, no coinsurance, and no deductibles for both eye exams and eyewear. The plan provides up to a $50 annual maximum for eye exams, including one routine exam yearly, and a $170 annual combined allowance for contact lenses, eyeglasses, and frames.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services with a $60 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for other preventive and comprehensive services up to a $1,000 annual limit. Maxillofacial prosthetics, implant services, and orthodontics 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. Under this plan, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy and other Part B drugs have no copay and a coinsurance ranging from 0% to 20%.
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
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays, although prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies carry a coinsurance of 0% to 20%, while prosthetic devices require 20% coinsurance and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic services with no coinsurance and a $0 to $75 copay for procedures, alongside lab services with no copay or coinsurance. Diagnostic radiological and outpatient X-ray services feature no copay, while therapeutic radiological services require a minimum 20% coinsurance.
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, as none of the sub-services, including intensive cardiac, pulmonary, and SET for PAD rehabilitation, are covered in practice. While the plan technically lists no copay and no coinsurance for these services, they are not covered by the plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. This benefit is partially covered because additional days beyond the standard Medicare-covered limit are not covered, though prior authorization is required and a prior three-day hospital stay is not.
Other Services See details
Aetna Medicare Signature (PPO) offers partial coverage for other services, including an annual wellness exam, screening mammography, and additional gFOBT and FIT screenings with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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