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Aetna Medicare Signature Extra (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature Extra (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 Extra (PPO) in 2026, please refer to our full plan details page.
Aetna Medicare Signature Extra (PPO) is a PPO plan offered by CVS Health Corporation available for enrollment in 2025 to people living in IL Northern. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that Aetna Medicare Signature Extra (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 Extra (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 Extra (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 Extra (PPO) plan features an annual prescription drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members pay no copay when using a preferred pharmacy or preferred mail-order service. If using a standard pharmacy or standard mail-order service, copays start at $2 for Tier 1 and $12 for Tier 2 for a one-month supply. For brand-name and specialty medications, cost-sharing shifts to coinsurance regardless of the pharmacy network. Tier 3 preferred brands require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. Specialty drugs are limited to a one-month supply under this plan.
Additional Benefits
The Aetna Medicare Signature Extra (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, routine preventive screenings, and home health services. For specialized care, members will pay a $40 copay with no coinsurance for specialist visits and urgent care, while emergency room visits carry a $130 copay that is waived if admitted. Inpatient hospital stays require no coinsurance but do feature a daily copay of $325 for the first eight days of acute care. Routine hearing and vision services are covered with no deductible, no coinsurance, and no copay for annual routine exams, alongside allowances of up to $500 per ear for hearing aids and $150 annually for eyewear. Dental care is also highly accessible, offering preventive services with no copay and comprehensive dental coverage up to a $2,000 annual limit with 20% to 50% coinsurance. Additionally, diagnostic laboratory services and home infusion bundled services are provided with no copay, while durable medical equipment requires no copay and a coinsurance ranging up to 20%.
Inpatient Hospital See details
Inpatient hospital care is partially covered by Aetna Medicare Signature Extra (PPO) with no coinsurance, requiring a $325 daily copay for days 1-8 of acute stays and a $300 daily copay for days 1-7 of psychiatric stays, followed by no copay for subsequent days. Prior authorization is required, and non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services are covered by Aetna Medicare Signature Extra (PPO) with no coinsurance across all categories. Ambulatory surgical and blood services feature no copay, while outpatient hospital services require a $0 to $325 copay, observation services cost a $325 copay per stay, and substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Partial hospitalization is covered by Aetna Medicare Signature Extra (PPO) with a copay of either $70.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature Extra (PPO) covers ground ambulance services with a $330 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required. While transportation services are technically covered, transportation to plan-approved or any health-related locations is not covered in practice.
Emergency Services See details
Aetna Medicare Signature Extra (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services carry a $40 copay with no coinsurance, and worldwide emergency services are covered up to $250,000 with no coinsurance and copays ranging from $130 to $330.
Primary Care See details
Aetna Medicare Signature Extra (PPO) provides primary care physician services with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, mental health, psychiatric, and opioid treatment services have a $40 copay and no coinsurance. Telehealth benefits are covered with a $0 to $40 copay and 20% coinsurance, though chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive Services are partially covered by Aetna Medicare Signature Extra (PPO), offering an annual physical, health education, and select screenings with no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, but several supplemental benefits—including in-home safety assessments, personal emergency response systems, and medical nutrition therapy—are not covered.
Hearing Services See details
Aetna Medicare Signature Extra (PPO) covers hearing services with no deductible, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with no copay or coinsurance up to $500 per ear annually, though OTC, inner ear, outer ear, and over-the-ear hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature Extra (PPO) covers vision services with no deductibles and no coinsurance, featuring routine eye exams and eyewear with no copay. Routine exams are covered up to a $50 yearly limit, eyewear has a combined annual limit of $150, and Medicare-covered exams have a copay of $0 to $40.
Dental Services See details
Aetna Medicare Signature Extra (PPO) provides partially covered dental services, featuring Medicare-covered dental for a $40 copay and no coinsurance, alongside preventive care with no copay and no coinsurance. Comprehensive services are covered with no copay and 20% to 50% coinsurance up to a $2,000 annual limit, 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 under the Aetna Medicare Signature Extra (PPO) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a coinsurance ranging from no coinsurance to 20%, while 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 Extra (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature Extra (PPO) with no copay and prior authorization required. Coinsurance ranges from no coinsurance to 20% for durable medical equipment (DME), 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 Signature Extra (PPO) covers diagnostic and radiological services, subject to prior authorization. Diagnostic services require no coinsurance, offering lab services with no copay and diagnostic procedures with copays ranging from $0 to $100. Radiological services feature no copays for outpatient X-rays and diagnostic radiology, while therapeutic radiology requires a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature Extra (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are provided by Aetna Medicare Signature Extra (PPO) with no coinsurance, though only some services are covered. Specifically, Cardiac Rehabilitation (with a $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
Skilled Nursing Facility (SNF) services are covered by Aetna Medicare Signature Extra (PPO) 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, and while a prior 3-day hospital stay is not necessary, additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Aetna Medicare Signature Extra (PPO) partially covers other services, offering 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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