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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 Eastern 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 generic and Tier 2 generic medications, you will pay no copay when using a preferred pharmacy or preferred mail-order service. If you choose a standard pharmacy or standard mail-order service, copays range from $2 to $6 for Tier 1 and $12 to $36 for Tier 2 depending on the prescription supply. For higher-tier drugs, costs transition to coinsurance percentages across all pharmacy and mail-order options. 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. Understanding these tier structures can help you estimate your out-of-pocket prescription costs with this Aetna Medicare Signature plan.
Additional Benefits
The Aetna Medicare Signature (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, including no copay for primary care visits and routine home health services. For hospital stays, members pay a $495 daily copay for the first five days of inpatient care and no copay for additional days, with no coinsurance required. Emergency room visits carry a $130 copay, while urgent care services require a $50 copay. This plan also features strong supplemental benefits, offering no copay or coinsurance for routine dental, vision, and hearing exams, alongside a $100 annual allowance for prescription eyewear. Routine hearing aid fittings are covered with no copay, while prescription hearing aids carry copays ranging from no copay up to $1,700. Additionally, most medical equipment and diabetic supplies are provided with no copay, though coinsurance up to 25% may apply.
Inpatient Hospital See details
Aetna Medicare Signature (HMO-POS) covers inpatient acute hospital stays with no coinsurance and a $495 daily copay for days 1 through 5, followed by no copay for unlimited additional days. Inpatient psychiatric care is also covered with no coinsurance and a $480 daily copay for days 1 through 4, then no copay for days 5 through 90. Prior authorization is required for these services, while upgrades and non-Medicare-covered stays are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO-POS) covers outpatient services with no coinsurance, featuring copays of $0 to $350 for outpatient hospital services, $495 per stay for observation services, and $50 for substance abuse sessions. Ambulatory surgical center services and outpatient blood services are covered with no copay and no coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the Aetna Medicare Signature (HMO-POS) plan with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required for these covered services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO-POS) covers ground ambulance services with a $290 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, both requiring prior authorization. For transportation, some services are covered but trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
Emergency services are covered by Aetna Medicare Signature (HMO-POS) with a $130 copay (waived if admitted within 24 hours) and no coinsurance, while urgently needed services require a $50 copay and no coinsurance. Worldwide emergency and urgent care are also covered with no coinsurance up to a $250,000 limit, carrying a $130 copay for emergency or urgent services and a $290 copay for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO-POS) offers primary care physician services with no copay and no coinsurance, while specialist visits and telehealth services require copays up to $50 and up to 20% coinsurance. Physical, occupational, and mental health therapies have a $50 copay with no coinsurance, while chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (HMO-POS), with most options like annual physicals, health education, and fitness benefits requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while services like in-home safety assessments, personal emergency response systems, weight management, and medical nutrition therapy are not covered. Wigs for chemotherapy-related hair loss are also covered up to $400 annually with no copay and no coinsurance.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (HMO-POS), with Medicare-covered exams requiring a $50 copay and no coinsurance, while routine exams and hearing aid fittings are offered once annually with no copay and no coinsurance. Prescription hearing aids are covered up to twice per year with no coinsurance and a copay ranging from $0 to $1,700, but OTC, inner ear, outer ear, and over the ear models are not covered.
Vision Services See details
Vision services are covered by Aetna Medicare Signature (HMO-POS) with no coinsurance, featuring no copay for yearly routine eye exams and a copay of $0 to $50 for Medicare-covered exams. Prescription eyewear, including lenses, frames, and contacts, is also covered with no copay up to a $100 annual maximum limit.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO-POS), with most preventive and comprehensive services requiring no copay and no coinsurance up to a $500 yearly maximum. Medicare-covered dental benefits are available for a $50 copay and no coinsurance, but maxillofacial prosthetics, implant services, and orthodontics 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 is required. Medicare Part B insulin drugs are covered with a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry no copay and a 0% to 20% coinsurance.
Dialysis Services See details
The Aetna Medicare Signature (HMO-POS) plan covers Dialysis Services 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, prosthetics, and diabetic supplies, with no copays. Coinsurance ranges from no coinsurance up to 25% depending on the equipment, and prior authorization is required.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Aetna Medicare Signature (HMO-POS), featuring no coinsurance for diagnostic services, no copay for lab services, and a $0 to $50 copay for diagnostic tests. Radiological services require prior authorization, with outpatient X-rays carrying a $10 copay and coinsurance, diagnostic radiology starting at no copay, and therapeutic radiology requiring a copay and a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered under the Aetna Medicare Signature (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are offered with no coinsurance under Aetna Medicare Signature (HMO-POS), meaning some services are covered, though standard cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($25 copay) are not covered.
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 to 20 and a $218 daily copay for days 21 to 100. Prior authorization is required, and additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other services are partially covered by Aetna Medicare Signature (HMO-POS) with no copay and no coinsurance, including chronic illness meal benefits, annual wellness exams, screening mammography, additional gFOBT and FIT tests, and up to $20 every three months for over-the-counter items. Acupuncture is not covered under this plan.
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