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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 Parishes in LA. 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:
Sign up for Aetna Medicare Signature Plus (PPO)
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Drug Coverage
The Aetna Medicare Signature Plus (PPO) plan features a $615 annual drug deductible. You will pay no copay for Tier 1 preferred generic and Tier 2 generic prescription drugs when using a preferred pharmacy or preferred mail order. If you utilize a standard pharmacy or standard mail-order service, copays start at $2 for Tier 1 drugs and $12 for Tier 2 drugs. For brand-name and specialty medications, your costs are determined by coinsurance regardless of which pharmacy you choose. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance. Specialty drugs in Tier 5 also carry a 25% coinsurance for a one-month supply.
Additional Benefits
The Aetna Medicare Signature Plus (PPO) plan offers comprehensive medical coverage with predictable costs, including no copays or coinsurance for primary care visits and routine preventive services. Specialist visits feature low copays ranging from no copay to fifty dollars, while inpatient hospital stays require a daily copay for the first several days with no coinsurance. Emergency care is available with a one hundred fifteen dollar copay, which is waived if you are admitted, and urgent care visits require a forty dollar copay. For ancillary care, the plan provides routine dental, vision, and hearing exams with no copays, alongside allowances for prescription hearing aids and eyewear. While home health services and laboratory tests have no copays or coinsurance, skilled nursing facility stays feature no copay for the first twenty days followed by a daily copay. Other essential services, such as durable medical equipment and dialysis, require a twenty percent coinsurance with no copay.
Inpatient Hospital See details
Aetna Medicare Signature Plus (PPO) covers inpatient hospital services with no coinsurance, requiring a copay of $355 for days 1 to 7 of acute care and $407 for days 1 to 5 of psychiatric care, with no copay for subsequent days. Prior authorization is required, and non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Plus (PPO) covers outpatient services with no coinsurance, offering no copays for ambulatory surgical center and blood services. Outpatient hospital services require a copay of $0 to $375, observation services cost a $355 copay per stay, and outpatient substance abuse sessions carry a $40 copay, with prior authorization required for most of these benefits.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Plus (PPO) with a copay of $105.00 or $110.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Aetna Medicare Signature Plus (PPO) covers ground ambulance services with a $295 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. While some transportation services are covered, transportation to plan-approved health-related locations or any other health-related locations is not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature Plus (PPO) with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency, urgent, and transportation services are covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $295.
Primary Care See details
Aetna Medicare Signature Plus (PPO) features primary care physician visits with no copay and no coinsurance, and specialist visits with a $0 to $50 copay and no coinsurance. Therapy services require a $35 copay and mental health sessions require a $40 copay, both with no coinsurance, while chiropractic and podiatry services are not covered. Telehealth benefits are also available with a $0 to $50 copay and 20% coinsurance.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Plus (PPO), offering no copay and no coinsurance for annual physicals, glaucoma screenings, and fitness benefits, while kidney disease education has no copay but a 20% coinsurance. Supplemental benefits such as medical nutrition therapy, weight management, personal emergency response systems, and therapeutic massage are not covered.
Hearing Services See details
Aetna Medicare Signature Plus (PPO) provides partially covered hearing services, featuring Medicare-covered exams for a $50 copay and no coinsurance, plus annual routine exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are covered up to $500 per ear yearly with no copay and no coinsurance, though OTC hearing aids and inner ear, outer ear, and over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature Plus (PPO) covers vision services with no deductibles or coinsurance, offering routine eye exams and eyewear with no copay. Medicare-covered eye exams have a copay ranging from $0 to $50, and the plan includes an annual maximum coverage of $50 for exams and $175 for eyewear.
Dental Services See details
Aetna Medicare Signature Plus (PPO) provides partially covered dental services, featuring preventive care like exams and cleanings with no copay and no coinsurance, and Medicare-covered dental services for a $50 copay and no coinsurance. Comprehensive services like restorative care, endodontics, periodontics, prosthodontics, and oral surgery are covered with no copay and 20% to 50% coinsurance up to a $1,500 annual maximum. Fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive dental services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Plus (PPO) covers Home Infusion bundled Services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs carry a $35 copay and no coinsurance, while Part B chemotherapy, radiation, and other drugs have no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature Plus (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature Plus (PPO) covers durable medical equipment, prosthetics, and medical supplies with no copay and a 20% coinsurance. Diabetic supplies are covered with a 0% to 20% coinsurance, while diabetic therapeutic shoes and inserts require a $10 copay, with prior authorization required for these benefits.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by Aetna Medicare Signature Plus (PPO) with prior authorization required for all services. Lab services, diagnostic radiological services, and outpatient x-rays have no copay and no coinsurance, diagnostic procedures and tests have a copay ranging from $0 to $95, and therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature Plus (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered with no coinsurance under Aetna Medicare Signature Plus (PPO), though only some services are covered. Specifically, standard cardiac rehabilitation (requiring a $30.00 copay), intensive cardiac rehabilitation (requiring a $40.00 copay), pulmonary rehabilitation (requiring a $25.00 copay), and SET for PAD services (requiring a $20.00 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Plus (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20, followed by a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Plus (PPO) partially covers other services with no copay and no coinsurance for chronic illness meals, select wellness screenings, and over-the-counter items up to $15 every three months, while acupuncture is not covered.
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