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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 2026 to people living in IL Northern and 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 plan has an annual drug deductible of $615. You will pay no copay for Tier 1 preferred generics and Tier 2 generics when using preferred pharmacies or preferred mail order services. Standard pharmacies and standard mail order options charge a copay starting at $2 for Tier 1 and $12 for Tier 2 one-month supplies. Brand-name and specialty medications are subject to coinsurance rather than flat copays under this plan. Tier 3 preferred brands require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty drugs require a 25% coinsurance. These coinsurance rates remain the same across both preferred and standard pharmacy and mail order channels.
Additional Benefits
The Aetna Medicare Signature (PPO) plan provides robust medical coverage featuring fixed copayments and no coinsurance for many core services. Primary care doctor visits require a $10 copay, specialists require a $60 copay, and emergency room visits carry a $130 copay which is waived upon hospital admission. Inpatient acute hospital stays require a $425 daily copay for days one through seven, while outpatient hospital services range from no copay up to a $425 copay. Routine preventive care, annual physicals, and home health services are fully covered with no copay and no coinsurance. You will also pay no copay for routine dental cleanings, annual hearing exams, and routine eye exams, though allowance limits apply, including up to $100 annually for eyewear and $500 per ear for prescription hearing aids. Additionally, skilled nursing facility stays are highly accessible with no copay required for the first 20 days of care.
Inpatient Hospital See details
Aetna Medicare Signature (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1-7 of acute stays and a $325 daily copay for days 1-7 of psychiatric stays, with no copay thereafter. Upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (PPO) covers outpatient services with no coinsurance, including ambulatory surgical center and blood services with no copay. Outpatient hospital services require a copay of $0 to $425, observation services cost a $425 copay per stay, and outpatient substance abuse sessions have a $40 copay.
Partial Hospitalization See details
Aetna Medicare Signature (PPO) covers partial hospitalization services with no coinsurance, subject to prior authorization. Depending on the care received, you will pay a copay of either $65.00 or $145.00.
Ambulance and Transportation Services See details
Aetna Medicare Signature (PPO) covers ambulance services with prior authorization, requiring a $300 copay and no coinsurance for ground transport, and a 20% coinsurance with no copay for air transport. These ambulance costs are not waived if you are admitted to the hospital, and additional transportation services are not covered.
Emergency Services See details
Aetna Medicare Signature (PPO) covers emergency services with a $130 copay, which is waived if admitted to the hospital within 24 hours, and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent care are also covered up to a $250,000 maximum with a $130 copay, while worldwide emergency transportation has a $300 copay, all with no coinsurance.
Primary Care See details
Aetna Medicare Signature (PPO) covers primary care doctor visits for a $10 copay and specialists for a $60 copay, with no coinsurance for either. Physical and occupational therapy require a $45 copay with no coinsurance, whereas podiatry is not covered, and though some chiropractic services are covered, routine and other chiropractic services are not. Telehealth benefits are available with a 20% coinsurance and a copay ranging from no copay to $60, while mental health services require a $40 copay and no coinsurance.
Preventive Services See details
Preventive services are partially covered by Aetna Medicare Signature (PPO), with no copay and no coinsurance for annual physical exams, screenings, and supplemental benefits, though kidney disease education requires no copay and a 20% coinsurance. Sub-services that are not covered under this plan include in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission 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 devices, and counseling.
Hearing Services See details
Hearing services are partially covered by Aetna Medicare Signature (PPO), which features Medicare-covered exams for a $60 copay and annual routine exams and fitting evaluations with no copay, all with no deductible and no coinsurance. Prescription hearing aids are covered up to $500 per ear annually with no copay and no coinsurance, but 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 (PPO) with no deductibles and no coinsurance, offering eye exam copays ranging from $0 to $60 and no copay for eyewear. This includes one routine eye exam per year (up to a $50 limit) and follow-up diabetic eye exams with no copay, alongside a $100 annual combined maximum for eyewear such as contacts and eyeglasses.
Dental Services See details
Aetna Medicare Signature (PPO) offers partially covered dental services, featuring a $60 copay and no coinsurance for Medicare-covered dental care, which requires prior authorization. Routine preventive services like exams, cleanings, and X-rays are covered with no copay and no coinsurance, while fluoride, restorative, endodontic, periodontic, prosthodontic, implant, oral surgery, and orthodontic services 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 benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while chemotherapy, radiation, and other Part B drugs carry a coinsurance of 0% to 20%.
Dialysis Services See details
Dialysis Services are covered by Aetna Medicare Signature (PPO) with no copay and a 20% coinsurance, although prior authorization is required.
Medical Equipment See details
Medical equipment is covered by Aetna Medicare Signature (PPO) with no copays for durable medical equipment, prosthetics, and diabetic shoes, though coinsurance ranges from no coinsurance up to 20% depending on the item. Prior authorization is required for most of these services, and diabetic supplies may be limited to specific manufacturers.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic procedures and tests have no coinsurance and a $0 to $100 copay, lab and diagnostic radiological services have no copay, outpatient X-rays require a $50 copay, and therapeutic radiological services have a minimum 20% coinsurance.
Home Health Services See details
Home health services are covered by the Aetna Medicare Signature (PPO) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered with no coinsurance under the Aetna Medicare Signature (PPO), though in practice only some services are covered. Specifically, 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
Skilled Nursing Facility (SNF) services are partially covered by Aetna Medicare Signature (PPO) with no coinsurance, as additional days beyond the standard Medicare-covered limit are not covered. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with no prior three-day hospital stay required.
Other Services See details
Other Services are partially covered by Aetna Medicare Signature (PPO), featuring no copay and no coinsurance for annual wellness exams, screening mammographies, and additional gFOBT and FIT tests. Acupuncture, over-the-counter (OTC) items, and meal benefits are not covered.
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