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Aetna Medicare Signature (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Aetna Medicare Signature (HMO-POS) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO-POS) is a HMO-POS plan offered by CVS Health Corporation available for enrollment in 2025 to people living in Central Massachusetts. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature (HMO-POS) 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 (HMO-POS).
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 (HMO-POS), 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 Maximum Out-Of-Pocket cost of $6750.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
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 (HMO-POS) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using preferred pharmacies or preferred mail-order services. If you use standard pharmacies or standard mail-order services, Tier 1 copays start at $2 and Tier 2 copays start at $12 for a one-month supply. For higher-tier medications, coverage transitions to coinsurance across all pharmacy and mail-order options. Tier 3 preferred brand drugs require a 24% coinsurance for all supply durations. Tier 4 non-preferred drugs and Tier 5 specialty drugs both carry a 25% coinsurance, with specialty tier coverage limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers robust medical coverage featuring no copay and no coinsurance for primary care visits and most preventive services. Specialist visits range from no copay to a $45 copay, while emergency room services require a $130 copay which is waived if you are admitted. For inpatient hospital stays, members pay a $395 daily copay for days one through six, with no copay for subsequent days. Additionally, the plan provides dental, vision, and hearing benefits to help reduce out-of-pocket costs. Dental services feature no copay and no coinsurance for preventive care up to a $1,000 annual maximum, while routine vision exams range from no copay to a $45 copay with no copay for eyewear up to a $150 annual limit. Routine hearing exams also feature no copay, and home health services are fully covered with no copay or coinsurance.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature (HMO-POS), requiring prior authorization and featuring no coinsurance for covered stays. Acute hospital stays require a $395 daily copay for days 1 to 6 (with no copay for day 7 and beyond), while psychiatric stays require a $385 daily copay for days 1 to 5 (with no copay for days 6 to 90); however, upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services at no copay. Outpatient hospital services have a copay ranging from $0 to $395, observation services require a $395 copay per stay, and outpatient substance abuse sessions carry a $45 copay, with prior authorization required for some services.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature (HMO-POS) with a copay of either $70.00 or $145.00 and no coinsurance, depending on the service. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by Aetna Medicare Signature (HMO-POS), with ground ambulance services requiring a $315 copay (no coinsurance) and air ambulance services requiring a 20% coinsurance (no copay), both of which require prior authorization. Transportation services to plan-approved or health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (HMO-POS) with a $130 copay and no coinsurance, with the copay waived if admitted to the hospital within 24 hours, while urgently needed services require a $45 copay and no coinsurance. Worldwide emergency and urgent services are also covered up to a $250,000 maximum benefit with a $130 copay ($315 for worldwide emergency transportation) and no coinsurance.
Primary Care See details
Aetna Medicare Signature (HMO-POS) covers primary care visits with no copay and no coinsurance, specialist visits with a $0 to $45 copay and no coinsurance, and physical, occupational, speech, and mental health therapies with a $45 copay and no coinsurance. Telehealth services require a $0 to $45 copay and 20% coinsurance, podiatry is not covered, and while some chiropractic services are covered, routine and other chiropractic services are not.
Preventive Services See details
Aetna Medicare Signature (HMO-POS) partially covers preventive services, with most covered benefits like annual exams and screenings costing no copay and no coinsurance, while kidney disease education has no copay and a 20% coinsurance. Sub-services that are not covered under this plan include 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, palliative care, in-home support, caregiver support, enhanced disease management, telemonitoring, home safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (HMO-POS) covers Medicare-covered hearing exams for a $45 copay and no coinsurance, while annual routine hearing exams and fitting evaluations have no 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 aids per year, though OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no deductibles and no coinsurance, featuring a $0 to $45 copay for eye exams and no copay for eyewear. This plan includes one routine eye exam every year and a $150 annual maximum limit for contact lenses, eyeglasses, frames, and upgrades.
Dental Services See details
Aetna Medicare Signature (HMO-POS) offers partially covered dental services with a $1,000 annual maximum, featuring no copay and no coinsurance for preventive and most comprehensive services. Medicare-covered dental services require a $45 copay and no coinsurance, while orthodontics, implant services, and maxillofacial prosthetics are not covered.
Home Infusion bundled Services See details
Aetna Medicare Signature (HMO-POS) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin has a $35 copay and no coinsurance, while chemotherapy and other Part B drugs carry no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO-POS) covers medical equipment, including durable medical equipment (DME), prosthetics, and diabetic supplies, with prior authorization required. Covered items feature no copay, with coinsurance ranging from no coinsurance to 25% for DME and medical supplies, no coinsurance to 20% for diabetic supplies, and 25% coinsurance for prosthetic devices.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS) with prior authorization required. Diagnostic services feature no coinsurance, with no copay for lab services and a $0 to $45 copay for tests, while radiological services require a $20 copay for X-rays, copays starting at $0 for diagnostic radiology, and a minimum 20% coinsurance for therapeutic radiology.
Home Health Services See details
Home Health Services are covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, but some services are covered while standard Cardiac Rehabilitation, Intensive Cardiac Rehabilitation, Pulmonary Rehabilitation, and Supervised Exercise Therapy (SET) for symptomatic Peripheral Artery Disease (PAD) services are not covered and require copayments ranging from $15 to $25.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO-POS) 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 inpatient hospital stay is not required for admission, and additional days beyond the standard 100 days are not covered.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance for covered benefits, which include chronic illness meal benefits, annual wellness exams, and a $25 quarterly over-the-counter reimbursement. Acupuncture is not covered under this plan.
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