Aetna Medicare Signature Plans 2027: PPO and HMO Options, States and Benefits

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 11, 2026

Aetna Medicare Signature is Aetna’s largest family of Medicare Advantage plans. You’ll see it as Aetna Medicare Signature (PPO), Signature (HMO), Signature (HMO-POS), Signature Extra, Signature Plus, Signature Giveback and several new versions for 2027.

CMS’s 2027 plan data lists 214 individual Aetna Medicare Signature plans in 39 states and 1,667 counties, down from 225 plans in 2026. That’s about one in three of Aetna’s individual Medicare Advantage plans. Annual Enrollment runs October 15 to December 7, 2026, for coverage that starts January 1, 2027.

Signature plans are sold in 39 states for 2027. These are the 15 states with the largest Signature footprint:

Source: CMS 2027 Plan Benefit Package and plan service area data, individual (non-employer) plans.

Signature plans are also sold in parts of Oklahoma, Iowa, Indiana, New York, Georgia, Nebraska, Wisconsin, Florida, North Dakota, South Carolina, New Jersey, Minnesota, California, West Virginia, Colorado, South Dakota, Maine, Connecticut, Massachusetts, Washington, Utah, Rhode Island, Arizona and Nevada. In Minnesota they’re sold as Allina Health Aetna Medicare Signature. Not every plan is sold in every county, so check by ZIP code.

Comparing CMS’s 2026 and 2027 plan data, the Signature lineup changed in a few ways:

• Slightly fewer plans. 214 individual Signature plans for 2027, down from 225.
• Fewer PPOs. Signature PPO plans drop from 126 to 115, and HMO-POS plans from 47 to 42. Signature HMO plans rise from 52 to 57.
• New Signature Classic plans in Missouri, Kansas, Iowa, Nebraska, Arkansas, North Dakota and South Dakota, including Classic Extra, Classic Plus and Classic Giveback versions.
• New Signature Legacy plans in Florida and California, plus new Extra Plus and Extra Care versions in some states.

Aetna overall is exiting 123 counties for 2027, leaving Maryland and New Hampshire, and cutting 20 PPO plans. If you’re in a Signature plan now, read your Annual Notice of Change to see whether your plan continues, changes names or is replaced. See our guide to Aetna Medicare Advantage plans for the full picture.

Of the 214 Signature plans for 2027, 115 are PPOs, 57 are HMOs and 42 are HMO-POS plans. Here’s what else CMS’s 2027 benefit data shows. Amounts and rules depend on the plan and county:

• An over-the-counter allowance on 104 of the 214 Signature plans, about half.
• A Part B premium giveback on 7 Signature Giveback plans, sold in parts of North Carolina, Pennsylvania, Louisiana, Arkansas, South Carolina and Alabama.
• Grocery help on 31 Signature plans, generally only for members with qualifying chronic conditions.
• Dental, vision and hearing benefits may be included, depending on the plan.

None of the Signature plans are special needs plans, so anyone with Medicare Parts A and B in the service area can join. Learn how Aetna Medicare Advantage PPO plans and Aetna Medicare Advantage HMO plans work. Check each plan’s 2027 Summary of Benefits for exact premiums and copays.

Star ratings are given to each Medicare contract, not to a plan name. Signature plans are spread across more than 30 Aetna contracts, so two Signature plans in different states can have different ratings. 84 of the 214 Signature plans are on Aetna’s national PPO contract, H5521.

Across all its Medicare Advantage plans, Aetna says more than 69% of its members are in plans rated 4 stars or higher for 2027, down from more than 81% for 2026. The national average rating for 2027 is 3.99. Look up the exact rating for any Signature plan in Medicare Plan Finder, or see every carrier in our 2027 Medicare Advantage star ratings.

Elite is a smaller Aetna plan family, with 42 plans in 15 states for 2027. In states like Georgia, Missouri, New York and Virginia, you may see both Signature and Elite plans in the same ZIP code.

The names don’t tell you which plan costs less or covers more. Compare the premium, the out-of-pocket maximum, drug costs and the provider network side by side. See our guide to Aetna Medicare Elite plans for the Elite lineup.

1. Confirm your county. Signature versions differ from state to state.
2. Check your doctors and hospitals. HMO plans generally require in-network care.
3. Run your prescriptions. Compare drug costs across Signature, Elite and other carriers.
4. Compare the out-of-pocket maximum. PPOs have an in-network limit and a combined limit.
5. Read your Annual Notice of Change. Some 2026 Signature PPOs are not continuing.
6. Mark the dates. Medicare Open Enrollment 2027 runs October 15 to December 7, 2026.