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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 North FL, Central FL. 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 prescription drugs, members enjoy no copay on Tier 1 (Preferred Generic) and Tier 2 (Generic) medications when using preferred pharmacies or preferred mail order services. If you choose a standard pharmacy or standard mail order, Tier 1 drugs carry a copay starting at $2.00, while Tier 2 drugs start at a $12.00 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance across all pharmacy and mail order options. Tier 3 (Preferred Brand) drugs require a 24% coinsurance, while Tier 4 (Non-Preferred) drugs require a 25% coinsurance. Tier 5 (Specialty) drugs also have a 25% coinsurance, which is limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers robust medical coverage featuring no copay for primary care visits and routine annual physical exams. Specialist visits require a $70 copay, while inpatient hospital stays incur a $430 daily copay for the first seven days with no copay thereafter. Emergency care is covered with a $130 copay, which is waived if you are admitted within 24 hours. For extra wellness benefits, this plan provides routine vision exams and select preventive dental services with no copay or coinsurance. Routine hearing exams are covered with no copay, while prescription hearing aids require copays up to $1,700. Additionally, home health services, diagnostic lab tests, and outpatient X-rays are fully covered with no copay.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, though prior authorization is required. For acute stays, there is a $430 copay per day for days 1 through 7 and no copay for days 8 and beyond, while psychiatric stays require a $334 copay per day for days 1 through 7 and no copay for days 8 through 90. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $430, alongside observation services at a $430 copay per stay with no coinsurance. Ambulatory surgical and outpatient blood services are covered with no copays or coinsurance, while outpatient substance abuse services have no coinsurance and copays of $30 for individual and $25 for group sessions.
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. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ground ambulance services with a $305 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services are not covered under this plan.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay (waived if admitted within 24 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered with a $130 copay, while worldwide emergency transportation carries a $305 copay, both featuring no coinsurance up to a $250,000 maximum benefit limit.
Primary Care See details
Aetna Medicare Signature (PPO) features no copay and no coinsurance for primary care visits, while specialist visits require a $70 copay and no coinsurance. Physical, occupational, and speech therapies carry a $50 copay and no coinsurance, telehealth requires a 20% coinsurance with a $0 to $70 copay, podiatry is not covered, and chiropractic care is partially covered with a $15 copay and no coinsurance (excluding routine and other chiropractic services).
Preventive Services See details
Preventive services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance for annual physical exams and select screenings, though kidney disease education requires no copay and a 20% coinsurance. Additional preventive benefits are partially covered with no copay and no coinsurance, excluding in-home safety assessments, PERS, medical nutrition therapy, post-discharge medication reconciliation, re-admission 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/bathroom safety devices, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) covers Medicare-covered hearing exams with a $70 copay and no coinsurance, while routine exams and fitting evaluations are covered annually with no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $0 to $1,700 for up to two devices per year, though inner ear, outer ear, over the ear, and OTC 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. This benefit includes one routine eye exam per year up to a $50 maximum coverage limit and a $100 annual combined maximum limit for eyewear, including contacts and eyeglasses.
Dental Services See details
Aetna Medicare Signature (PPO) partially covers dental services, offering Medicare-covered dental care for a $70 copay and no coinsurance, and select preventive services like cleanings, exams, and X-rays with no copay and no coinsurance. However, fluoride, restorative services, endodontics, periodontics, prosthodontics, implants, oral surgery, 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 require 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, although prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (PPO) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic equipment, with no copay, though prior authorization is required. Coinsurance ranges from 0% to 20% for DME, medical supplies, and diabetic supplies, while prosthetic devices carry 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 diagnostic services featuring no coinsurance, no copay for lab services, and a $0 to $100 copay for diagnostic procedures. Covered radiological services require prior authorization and include outpatient X-rays with no copay, diagnostic radiological services with a $0 minimum copay, and therapeutic radiological services with a 20% minimum coinsurance.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (PPO) with no copay and no coinsurance, although 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. While 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) care is partially covered by Aetna Medicare Signature (PPO) with no coinsurance, as additional days beyond the Medicare-covered limit are not covered. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with prior authorization required and no prior three-day inpatient hospital stay needed.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, offering an annual wellness exam, screening mammography, and additional gFOBT and FIT tests with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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