A non-government entity
Aetna Medicare Signature (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Aetna Medicare Signature (HMO). 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) in 2026, please refer to our full plan details page.
Aetna Medicare Signature (HMO) is a HMO plan offered by CVS Health Corporation available for enrollment in 2026 to people living in Northern and Southern Utah. 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) 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).
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), 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 $5000.00 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) plan features an annual drug deductible of $615. For Tier 1 preferred generics and Tier 2 generics, members enjoy no copay when using a preferred pharmacy or preferred mail-order service for up to a three-month supply. If you choose a standard pharmacy or standard mail order, Tier 1 drugs carry a low copay starting at $2, while Tier 2 drugs start at a $12 copay for a one-month supply. For higher-tier medications, costs transition to coinsurance across all pharmacy and mail-order channels. Tier 3 preferred brand drugs require a 24% coinsurance, while Tier 4 non-preferred drugs and Tier 5 specialty medications incur a 25% coinsurance. Additionally, Tier 5 specialty drugs are limited to a one-month supply.
Additional Benefits
The Aetna Medicare Signature (HMO) plan offers robust coverage with no copay for primary care visits, home health services, and most preventive care. Inpatient hospital stays require a copay of $430 per day for the first seven days of acute stays, while specialist visits and urgent care require a $45 copay. Emergency room visits carry a $130 copay, which is waived if you are admitted to the hospital within 24 hours. Routine dental, vision, and hearing exams are covered with no copay, helping members save on everyday wellness needs. The plan also features allowances for essential devices, including up to $1,000 per ear annually for prescription hearing aids and a $100 annual limit for eyewear. Additionally, diagnostic lab services and home infusion therapies are available with no copay, though some specialized services may require coinsurance or prior authorization.
Inpatient Hospital See details
Aetna Medicare Signature (HMO) covers inpatient hospital care with no coinsurance, requiring a copay of $430 per day for days 1-7 of acute stays and $370 per day for days 1-5 of psychiatric stays, with no copay for subsequent days. Unlimited additional acute stay days are covered at no copay, though upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Aetna Medicare Signature (HMO) outpatient services are covered with no coinsurance, featuring copays ranging from $0 to $425 for outpatient hospital services and a $430 copay per stay for observation services. Ambulatory surgical center and outpatient blood services have no copay and no coinsurance, while outpatient substance abuse sessions require a $40 copay with no coinsurance.
Partial Hospitalization See details
Aetna Medicare Signature (HMO) covers partial hospitalization benefits with a copay of $55.00 or $145.00 and no coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Aetna Medicare Signature (HMO) covers ground ambulance services with a $350 copay and no coinsurance, and air ambulance services with a 20% coinsurance and no copay, with prior authorization required for both. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency services under the Aetna Medicare Signature (HMO) plan are covered with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $45 copay and no coinsurance, while worldwide emergency services are covered up to a $250,000 maximum with no coinsurance and copays of $130 for emergency or urgent care and $350 for emergency transportation.
Primary Care See details
Aetna Medicare Signature (HMO) covers primary care visits with no copay and no coinsurance, and specialist visits for a $45 copay and no coinsurance. Physical, occupational, speech, mental health, and psychiatric therapies are covered with a $40 copay and no coinsurance, while podiatry and chiropractic services are not covered.
Preventive Services See details
Preventive services covered by Aetna Medicare Signature (HMO) are partially covered, with most services—including annual physical exams, glaucoma screenings, and diabetes training—requiring no copay and no coinsurance. Kidney disease education is covered with no copay and a 20% coinsurance, while sub-services such as in-home safety assessments, personal emergency response systems, medical nutrition therapy, and weight management are not covered.
Hearing Services See details
Aetna Medicare Signature (HMO) covers routine hearing exams and fitting evaluations with no copays, no coinsurance, and no deductible. While some prescription hearing aid services are covered up to $1,000 per ear annually with no copay or coinsurance, inner ear, outer ear, over-the-ear, and OTC hearing aids are not covered.
Vision Services See details
Aetna Medicare Signature (HMO) covers vision services with no copay, no coinsurance, and no deductible for both eye exams and eyewear. Covered services include one routine eye exam per year and up to a $100 annual combined maximum benefit for contact lenses, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by Aetna Medicare Signature (HMO), with preventive care like cleanings, exams, and x-rays available for no copay and no coinsurance. Medicare-covered dental services require a $45 copay and no coinsurance, while other covered treatments like endodontics and restorative services have no copay and 20% to 50% coinsurance up to a $1,000 annual maximum, though fluoride, implants, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by Aetna Medicare Signature (HMO) 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 require no copay and a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Aetna Medicare Signature (HMO) plan with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Aetna Medicare Signature (HMO) covers medical equipment, including durable medical equipment, prosthetics, medical supplies, and diabetic services, with prior authorization required. These covered benefits feature no copay, with coinsurance ranging from no coinsurance up to 20% depending on the specific item.
Diagnostic and Radiological Services See details
Aetna Medicare Signature (HMO) covers diagnostic and radiological services with prior authorization required, featuring no coinsurance for diagnostic services. Members will pay no copay for lab services, a $0 to $10 copay for diagnostic procedures, a $10 copay for outpatient X-rays, and a minimum 20% coinsurance for therapeutic radiological services.
Home Health Services See details
Home health services are covered by Aetna Medicare Signature (HMO) 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) with no coinsurance, but only some services are covered since cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered. Copayments for these excluded rehabilitation services range from $15 to $20.
Skilled Nursing Facility (SNF) See details
Aetna Medicare Signature (HMO) 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, and while a prior three-day inpatient hospital stay is not required, additional days beyond the standard 100-day Medicare benefit are not covered.
Other Services See details
Other services under the Aetna Medicare Signature (HMO) are partially covered with no copay and no coinsurance, including over-the-counter items up to fifteen dollars every three months, an annual wellness exam, screening mammography, and additional colorectal screenings. Acupuncture, meal benefits, and dual eligible SNP services are not covered under this plan.
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