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Aetna Medicare Advantra Signature (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Advantra 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 Advantra Signature (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Advantra Signature (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Central Pennsylvania. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Advantra 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 Advantra 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 Advantra 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 $11300.00 (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 $11300.00 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 Advantra Signature (PPO) prescription drug plan has an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, there is no copay when you fill your prescription at a preferred pharmacy or through preferred mail order. If you choose standard pharmacies or standard mail order, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. Higher tier medications under this plan transition from copays to coinsurance. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance. These coinsurance rates apply across all preferred and standard pharmacy and mail-order options, with specialty drugs limited to a one-month supply.
Additional Benefits
The Aetna Medicare Advantra Signature (PPO) plan offers robust coverage with no copays and no coinsurance for primary care doctor visits, diagnostic lab tests, and home health services. Specialist visits and urgent care require low copays ranging from $0 to $40, while emergency room visits carry a $115 copay that is waived if you are admitted. For hospital stays, there is no coinsurance, though inpatient services require a $350 daily copay for the first few days before transitioning to no copay for longer stays. Routine dental, vision, and hearing exams are fully covered with no copays, no deductibles, and no coinsurance. The plan also provides partial coverage for comprehensive dental services with a 20% to 50% coinsurance and hearing aids up to $500 per ear. Additionally, skilled nursing facility care features no copay for the first 20 days, while medical equipment is available with no copays and coinsurance up to 20%.
Inpatient Hospital See details
Aetna Medicare Advantra Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a $350 daily copay for days 1 through 7 for acute stays (with no copay for days 8 and beyond) and a $350 daily copay for days 1 through 5 for psychiatric stays (with no copay for days 6 through 90). This benefit is partially covered because upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Advantra Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $350 copay per stay for observation services. Ambulatory surgical center and outpatient blood services are covered with no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay and no coinsurance.
Partial Hospitalization See details
Aetna Medicare Advantra Signature (PPO) covers partial hospitalization with either no copay or a $110 copay, and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Advantra Signature (PPO) covers ground ambulance services with a $275 copay and applicable coinsurance, and air ambulance services with a 20% coinsurance and an applicable copay, with prior authorization required for both. Non-emergency transportation services to plan-approved or other health-related locations are not covered.
Emergency Services See details
Aetna Medicare Advantra Signature (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 covered with a $40 copay and no coinsurance, while worldwide emergency and urgent care is covered up to a $250,000 maximum with no coinsurance and copays ranging from $115 to $275.
Primary Care See details
Aetna Medicare Advantra Signature (PPO) provides primary care doctor visits with no copay and no coinsurance, and specialist services with a $0 to $40 copay and no coinsurance. While some chiropractic services are covered, routine chiropractic care and other chiropractic services are not covered. Therapy, mental health, and podiatry services range from a $25 to $40 copay with no coinsurance, while telehealth options require a $0 to $40 copay and 20% coinsurance.
Preventive Services See details
Aetna Medicare Advantra Signature (PPO) partially covers preventive services, offering no copay and no coinsurance for annual physical exams, glaucoma screenings, and diabetes training, while kidney disease education requires no copay but a 20% coinsurance. Several sub-services are not covered under this plan, including personal emergency response systems, medical nutrition therapy, weight management programs, and in-home safety assessments.
Hearing Services See details
Hearing services covered by Aetna Medicare Advantra Signature (PPO) include Medicare-covered exams for a $40 copay and no coinsurance, plus annual routine exams and fitting evaluations with no copay, no coinsurance, and no deductible. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription aids are not covered.
Vision Services See details
Vision Services are covered by Aetna Medicare Advantra Signature (PPO) with no deductibles and no coinsurance for all services. Routine eye exams and eyewear have no copay, though Medicare-covered exams have a copay of $0 to $40, with a $100 annual limit on eyewear.
Dental Services See details
Dental services are partially covered by Aetna Medicare Advantra Signature (PPO), with preventive care like oral exams, cleanings, and X-rays offered with no copay and no coinsurance, while Medicare-covered dental requires a $40 copay and no coinsurance. Comprehensive services such as restorative care, endodontics, periodontics, prosthodontics, and oral surgery are covered with no copay and 20% to 50% coinsurance up to a $500 annual maximum, but fluoride, implants, orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Advantra Signature (PPO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs have no copay and a 0% to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Advantra Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Advantra Signature (PPO) covers medical equipment with no copays, though prior authorization is required. Coinsurance ranges from 0% to 20% for durable medical equipment, medical supplies, and diabetic supplies, while prosthetic devices and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Aetna Medicare Advantra Signature (PPO) covers diagnostic procedures, tests, and lab services with no copay and no coinsurance. Diagnostic radiological services also feature no copay, while outpatient X-rays require a $30 copay and therapeutic radiological services require a 20% coinsurance, with prior authorization required for all services.
Home Health Services See details
Aetna Medicare Advantra Signature (PPO) covers home health services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Advantra Signature (PPO) with no copay and no coinsurance. While some services are covered, standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Advantra Signature (PPO) with no coinsurance, requiring prior authorization and no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 copay per day for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Advantra Signature (PPO), which provides a chronic illness meal benefit, annual wellness exams and screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. However, acupuncture, over-the-counter (OTC) items, and dual-eligible SNP services are not covered under this plan.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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