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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Davis, Iron, Salt Lake and Utah 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 Extra (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 Extra (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 Extra (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 $8950.00 (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 $8950.00 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 Extra (PPO)
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Drug Coverage
The Aetna Medicare Signature Extra (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic drugs, members pay no copay when using a preferred retail pharmacy or preferred mail-order service. Standard pharmacies and standard mail-order services require copays starting at $2 for Tier 1 and $12 for Tier 2 drugs. Higher-tier medications are subject to coinsurance rather than flat copays under this plan. Tier 3 preferred brand drugs carry a 24% coinsurance, while Tier 4 non-preferred drugs require a 25% coinsurance at all pharmacy types. Tier 5 specialty drugs also require a 25% coinsurance and are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers robust medical coverage with no copay or coinsurance for primary care visits and routine preventive services. Specialist visits require a $40 copay, while emergency care is covered with a $130 copay that is waived if you are admitted. For hospital stays, members pay a daily copay with no coinsurance, such as $425 daily for the first seven days of acute inpatient care. This plan also includes valuable supplemental benefits, featuring no copay or coinsurance for routine vision and hearing exams alongside annual allowances for eyewear and hearing aids. Dental care is partially covered, offering preventive services with no copay and comprehensive coverage up to a $2,500 annual limit with 20% to 50% coinsurance. Additionally, diagnostic tests and home health services are available with no copay, while durable medical equipment features coinsurance up to 20%.
Inpatient Hospital See details
Aetna Medicare Signature Extra (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1-7 of acute stays (no copay for days 8 and beyond) and a $370 daily copay for days 1-5 of psychiatric stays (no copay for days 6-90). Prior authorization is required for these services, while upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature Extra (PPO) covers outpatient services with no coinsurance, including no copays for ambulatory surgical center and outpatient blood services. Outpatient hospital services require a copay ranging from $0 to $425, observation services cost a $425 copay per stay, and outpatient substance abuse sessions have a $30 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Extra (PPO) with no coinsurance and a copay of either $55.00 or $145.00, depending on the service. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $240 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgent care with a $45 copay, both with no coinsurance. Worldwide emergency and urgent services are covered with a $130 copay, and worldwide emergency transportation is covered with a $240 copay, all featuring no coinsurance up to a $250,000 lifetime maximum.
Primary Care See details
Primary care benefits under the Aetna Medicare Signature Extra (PPO) include primary care physician visits with no copay and no coinsurance, and specialist visits with a $40 copay and no coinsurance. Physical, occupational, speech, mental health, psychiatric, and opioid treatment services require a $30 copay and no coinsurance, while telehealth is covered with a $0 to $45 copay and 20% coinsurance. Podiatry services are not covered, and while some chiropractic services are covered, routine and other chiropractic services are not covered.
Preventive Services See details
Aetna Medicare Signature Extra (PPO) covers annual physical exams and most preventive services with no copay and no coinsurance, though kidney disease education requires a 20% coinsurance and no copay. Additional preventive benefits are partially covered with no copay and no coinsurance, but do not cover 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, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers hearing services with no copay or coinsurance for routine exams, fittings, and prescription hearing aids, which include a $1,000 annual maximum benefit. This benefit is partially covered because OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) offers vision services with no copay and no coinsurance for both eye exams and eyewear, with no deductible required. Covered services include one annual routine eye exam up to a $50 maximum benefit, and a combined $150 annual allowance for contacts, frames, lenses, and upgrades.
Dental Services See details
Aetna Medicare Signature Extra (PPO) provides partially covered dental services, featuring Medicare-covered dental for a $40 copay and no coinsurance, alongside preventive care with no copay and no coinsurance. Comprehensive services are covered up to a $2,500 annual limit with no copay and 20% to 50% coinsurance, though fluoride, implants, orthodontics, maxillofacial prosthetics, other diagnostic, and other preventive services are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature Extra (PPO) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Part B insulin drugs require a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis services are covered by Aetna Medicare Signature Extra (PPO) with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
Aetna Medicare Signature Extra (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with prior authorization required. Covered equipment features no copays, with coinsurance ranging from no coinsurance up to 20% depending on the item, except for prosthetic devices which carry a flat 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Signature Extra (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic tests, lab services, and diagnostic radiology have no copay and no coinsurance, while outpatient X-rays have no copay but require coinsurance, and therapeutic radiology requires a copay and a minimum 20% coinsurance.
Home Health Services See details
Aetna Medicare Signature Extra (PPO) covers home health services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by Aetna Medicare Signature Extra (PPO) because none of the individual rehabilitation sub-services are covered under the plan.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature Extra (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day hospital stay is not needed, and additional days beyond standard Medicare coverage are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature Extra (PPO), which provides an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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