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Aetna Medicare Signature Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Plus (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 Plus (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Plus (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Select Counties in AL. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Plus (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 Plus (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 Plus (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 $13900.00 (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 $13900.00 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 Plus (PPO) plan features an Enhanced Alternative drug benefit with a $615.00 prescription drug deductible. Once this deductible is met, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies or through preferred mail order, while standard pharmacies and mail orders charge 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 across all pharmacy and mail options. After your yearly out-of-pocket drug costs reach $2,100.00, you enter the catastrophic coverage phase and pay nothing for covered Part D drugs. Additionally, individuals who qualify for the full Low-Income Subsidy will pay $0.00 for their Part D coverage.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan offers robust coverage with many essential healthcare services requiring no copay or coinsurance. For hospital care, inpatient stays feature daily copays for the first several days with no copay thereafter, while outpatient and emergency services generally carry fixed copays and no coinsurance. Routine preventive screenings, home health visits, and primary care doctor appointments are fully covered with no copay or coinsurance. Specialist visits require a $55 copay, whereas routine dental, vision, and hearing exams are available with no copay. The plan provides valuable allowances, including up to $500 per ear annually for prescription hearing aids with no copay and up to a $1,500 annual limit for comprehensive dental care with 20% to 50% coinsurance. Additionally, skilled nursing facility stays require no copay or coinsurance for the first 20 days, ensuring affordable transitional care.
Inpatient Hospital See details
Aetna Medicare Signature Plus (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $388 daily copay for days 1 to 7 of acute stays and a $407 daily copay for days 1 to 5 of psychiatric stays, with no copay for subsequent days. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Plus (PPO) covers outpatient services with no coinsurance, though copays vary by service. There is no copay for ambulatory surgical center and blood services, a $40 copay for outpatient substance abuse sessions, a $388 copay per stay for observation services, and a copay ranging from $0 to $475 for outpatient hospital services.
Partial Hospitalization See details
Partial Hospitalization benefits are covered by Aetna Medicare Signature Plus (PPO) with a copay ranging from $105.00 to $110.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Aetna Medicare Signature Plus (PPO), with ground ambulance services requiring a $295 copay and no coinsurance, and air ambulance services requiring a 20% coinsurance and no copay. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
Aetna Medicare Signature Plus (PPO) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services are available with a $40 copay and no coinsurance, while worldwide emergency services, urgent care, and transportation are covered up to a $250,000 lifetime limit with copays ranging from $115 to $295 and no coinsurance.
Primary Care See details
Primary Care benefits are partially covered by Aetna Medicare Signature Plus (PPO), as podiatry services and routine chiropractic care are not covered. Most covered services require no coinsurance and feature copays ranging from no copay for primary care physician visits up to $55 for specialists, though telehealth services carry a 20% coinsurance.
Preventive Services See details
Aetna Medicare Signature Plus (PPO) partially covers preventive services, offering annual exams, health education, and screenings with no copay or coinsurance. Kidney disease education requires a 20% coinsurance and no copay, while several services, including personal emergency response systems, in-home safety assessments, and weight management programs, are not covered.
Hearing Services See details
Aetna Medicare Signature Plus (PPO) partially covers hearing services, providing routine exams and fitting evaluations with no copay and no coinsurance, while Medicare-covered exams require a $55 copay. Prescription hearing aids are covered up to $500 per ear annually with no copay or coinsurance, but OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Plus (PPO) covers vision services with no deductible and no coinsurance. Eye exams are covered with copays ranging from no copay up to $55, while eyewear services like contacts, lenses, and frames are covered with no copay up to a $100 annual limit.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature Plus (PPO), excluding fluoride treatment, maxillofacial prosthetics, implant services, and orthodontics. Preventive care has no copay or coinsurance, Medicare dental services require a $55 copay and no coinsurance, and comprehensive services require no copay and 20% to 50% coinsurance up to a $1,500 annual limit.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered under the Aetna Medicare Signature Plus (PPO) plan, requiring prior authorization and step therapy. Covered Medicare Part B insulin drugs require a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs have no copay and a coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature Plus (PPO) with a 20% coinsurance and no copay. Prior authorization is required for these services.
Medical Equipment See details
Medical Equipment is covered by Aetna Medicare Signature Plus (PPO) with prior authorization, featuring no copay and a coinsurance ranging from 0% (no coinsurance) to 20% for durable medical equipment, prosthetic devices, and medical or diabetic supplies. Diabetic therapeutic shoes and inserts are also covered under this plan with a $10 copay and no coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Plus (PPO) covers diagnostic and radiological services, with prior authorization required. Lab services have no copay and no coinsurance, diagnostic tests range from no copay to $95 with no coinsurance, diagnostic radiology ranges from no copay to $300 with no coinsurance, and therapeutic radiology requires a 20% coinsurance and no copay.
Home Health Services See details
Home Health Services are covered under the Aetna Medicare Signature Plus (PPO) plan with no copay and no coinsurance. Prior authorization is required to access these benefits.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under Aetna Medicare Signature Plus (PPO), as all sub-services—including cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation—are excluded from coverage. Consequently, there is no plan coverage, copay, or coinsurance for these rehabilitation services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Plus (PPO) partially covers Skilled Nursing Facility (SNF) services, requiring prior authorization but excluding additional days beyond Medicare-covered limits. For covered stays, there is no copay or coinsurance for days 1 through 20, followed by a $218 daily copay and no coinsurance for days 21 through 100.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature Plus (PPO), offering covered benefits like Over-the-Counter items, meals for chronic illness, and select wellness exams with no copay and no coinsurance. Acupuncture and Dual Eligible SNPs with Highly Integrated Services are not covered.
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