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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 2026 to people living in West. 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 generic and Tier 2 generic drugs, you will pay no copay when using preferred retail pharmacies or preferred mail-order services. If you choose standard pharmacies or standard mail-order services, Tier 1 copays start at $2.00 and Tier 2 copays start at $12.00 for a one-month supply. For higher-tier medications, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance across all network pharmacies and mail-order options. Tier 4 non-preferred drugs and Tier 5 specialty drugs both require a 25% coinsurance, with specialty prescriptions restricted to a one-month fill.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, routine preventive screenings, and home health services. Specialist visits require a $60 copay, while emergency room care is covered with a $130 copay that is waived if you are admitted. For hospitalizations, inpatient acute stays require a $395 daily copay for the first seven days, after which there is no copay. This plan also includes routine dental, vision, and hearing exams with no copay or coinsurance, alongside annual allowances for eyewear and hearing aids. For specialized needs, diagnostic lab tests, cardiac rehabilitation, and the first 20 days of skilled nursing facility care are available with no copay. Other services, such as medical equipment, dialysis, and select Part B drugs, are covered with no copay and coinsurance ranging up to 20 percent.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, but prior authorization is required. Acute stays require a $395 daily copay for days 1 to 7 and no copay for days 8 and beyond, while psychiatric stays require a $334 daily copay for days 1 to 7 and no copay for days 8 to 90. 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, including ambulatory surgical center and outpatient blood services with no copay. Outpatient hospital services have a copay ranging from no copay to $395, observation services require a $395 copay per stay, and outpatient substance abuse services carry a copay of $25 to $30 per session.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with a copay of either $55.00 or $145.00 and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services under the Aetna Medicare Signature (PPO) are covered with a $305 copay for ground transport and a 20% coinsurance for air transport, both of which require prior authorization. Additional transportation services to health-related locations are not covered under this plan.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (PPO) with a $130 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgent care has a $50 copay and no coinsurance. Worldwide emergency services are also covered up to a $250,000 maximum limit with no coinsurance, featuring a $130 copay for emergency or urgent care and a $305 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care physician visits with no copay and no coinsurance, while specialist visits require a $60 copay and no coinsurance. Physical, occupational, and speech therapy services have a $30 copay with no coinsurance, but chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered under Aetna Medicare Signature (PPO), offering an annual physical exam, fitness benefits, and screenings with no copay and no coinsurance, while kidney disease education has no copay but a 20% coinsurance. Supplemental services that are not covered include 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 and bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) covers hearing services, offering one routine exam and one fitting evaluation annually with no copay and no coinsurance, while Medicare-covered exams require a $60 copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and copays ranging from $0 to $1,700 for up to two devices per year, though OTC, inner ear, outer ear, and over-the-ear aids are not covered.
Vision Services See details
Vision Services through Aetna Medicare Signature (PPO) feature no copay, no coinsurance, and no deductible for both eye exams and eyewear. The plan covers one routine eye exam per year up to a $50 annual maximum, and offers a $100 combined annual maximum for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), offering routine exams, cleanings, and x-rays with no copay and no coinsurance, while Medicare-covered dental requires a $60 copay and no coinsurance. Non-covered services include fluoride, restorative care, endodontics, periodontics, prosthodontics, implants, oral surgery, and orthodontics.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Under this benefit, Medicare Part B insulin is covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies carry a 0% to 20% coinsurance, while prosthetic devices require a 20% coinsurance and diabetic therapeutic shoes or inserts have no coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (PPO) with prior authorization required. Diagnostic services feature no coinsurance, offering lab services with no copay and diagnostic procedures with a copay ranging from $0 to $200. Radiological services have copays starting at $0, with outpatient X-rays requiring no copay and therapeutic services requiring a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the Aetna Medicare Signature (PPO) with no copay and no coinsurance. Although some services are covered, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature (PPO) with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, and while a three-day inpatient hospital stay is not required before admission, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering 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 under this plan.
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