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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 2025 to people living in IL Chicago. This plan received an overall rating of 3.5 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) prescription drug coverage includes an annual drug deductible of $615. For Tier 1 preferred generic and Tier 2 generic medications, you will pay no copay when filling prescriptions through 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, cost-sharing is based on coinsurance rather than flat copays. Tier 3 preferred brand drugs require a 24% coinsurance across all pharmacy and mail-order options. Both Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance, with specialty medications limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (PPO) plan offers comprehensive medical coverage featuring predictable copayments and no coinsurance for many key services. Members pay no copay for primary care visits, routine annual physicals, and home health services, while specialist visits require a $45 copay. Inpatient hospital stays feature no coinsurance but require a daily copay of $435 for the first seven days of acute stays, after which there is no copay. For everyday health needs, the plan provides preventive dental, routine hearing, and annual vision exams with no copay. Comprehensive dental services are covered up to a $2,250 annual limit with a 20% to 50% coinsurance, and vision hardware is supported by a $100 annual allowance. Additionally, emergency care is available with a $130 copay, while urgent care visits require a $30 copay, both with no coinsurance.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) covers inpatient hospital services with no coinsurance, requiring a daily copay of $435 for days 1-7 of acute stays (no copay for days 8 and beyond) and $325 for days 1-7 of psychiatric stays (no copay for days 8-90). This benefit is partially covered, as hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered, and prior authorization is required.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, featuring a $0 to $435 copay for outpatient hospital services and a $435 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 Signature (PPO) covers partial hospitalization services with a copay of either $65.00 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 $300 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. 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 urgent care with a $30 copay, both with no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $250,000 maximum benefit with no coinsurance and copays ranging from $130 to $300.
Primary Care See details
Aetna Medicare Signature (PPO) offers primary care physician services with no copay and no coinsurance, while specialist, occupational therapy, and physical therapy visits require a $45 copay and no coinsurance. Mental health, psychiatric, and opioid treatment services have a $40 copay and no coinsurance, telehealth is available with a $0 to $45 copay and 20% coinsurance, and chiropractic and podiatry services are not covered.
Preventive Services See details
Aetna Medicare Signature (PPO) partially covers preventive services, offering annual physical exams, health education, and screenings with no copay and no coinsurance, while kidney disease education requires a 20% coinsurance and no copay. However, several services are not covered under this benefit, including 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 safety modifications, and counseling.
Hearing Services See details
Aetna Medicare Signature (PPO) partially covers hearing services, featuring routine hearing exams and fitting evaluations with no copay and no coinsurance, and Medicare-covered exams for a $45 copay and no coinsurance. Prescription hearing aids are covered up to a $500 annual limit with no copay or coinsurance, though OTC hearing aids and inner ear, outer ear, or over-the-ear prescription models are not covered.
Vision Services See details
Aetna Medicare Signature (PPO) vision services are covered with no deductible and no coinsurance, featuring eye exam copays ranging from $0 to $45 and no copay for eyewear. Benefits include one routine eye exam per year with no copay up to a $50 maximum limit, and a combined $100 annual allowance with no copay for contacts, eyeglasses, frames, lenses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (PPO), featuring no copay and no coinsurance for preventive care like exams and cleanings, and a $45 copay with no coinsurance for Medicare-covered dental. Comprehensive dental benefits have no copay and 20% to 50% coinsurance up to a $2,250 annual limit, but other diagnostic services, fluoride, other preventive services, maxillofacial prosthetics, implants, 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 chemotherapy and other drugs have 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 Signature (PPO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical Equipment is covered under the Aetna Medicare Signature (PPO) with no copay, though prior authorization is required. Durable medical equipment, medical supplies, and diabetic supplies feature a coinsurance ranging from no coinsurance to 20%, while prosthetic devices and diabetic therapeutic shoes or inserts require a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under the Aetna Medicare Signature (PPO) plan, with diagnostic lab services requiring no copay or coinsurance, and other diagnostic procedures carrying a copay between $0 and $100 with no coinsurance. Radiological services require prior authorization and feature a $15 copay for X-rays, diagnostic radiology starting at no copay, and therapeutic radiology with a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Signature (PPO) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under Aetna Medicare Signature (PPO) with no coinsurance, though copayments do apply. Patients will pay a $20 copay for standard and intensive cardiac rehabilitation, a $15 copay for pulmonary rehabilitation, and a $25 copay for supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a daily copayment of $10 for days 1 through 20 and $218 for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard Medicare-covered limits are not covered.
Other Services See details
Aetna Medicare Signature (PPO) partially covers other services, providing coverage for an annual wellness exam, screening mammography, and additional gFOBT and FIT with no copay and no coinsurance. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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