Aetna Medicare Advantage Plan Review
Editor's Rating
Aetna is one of the country's largest providers of Medicare Advantage plans. Aetna Medicare Advantage plans are fairly cheap, and many people have access to a plan with a $0 monthly premium.
Aetna's Advantage plans come with several perks, like prescription delivery and care management. But the company isn't well rated by the Centers for Medicare & Medicaid Services (CMS) and has below-average customer satisfaction according to J.D. Power.
Pros
Cons
Is Aetna Medicare Advantage good insurance?
Aetna's Medicare Advantage plans are good, but the company's service isn't the best.
Medicare Advantage plans are available in most states, average rates are low and most people have access to at least one plan that costs $0 per month.
But Aetna, which was purchased by CVS Health in 2017, does not have a highly rated patient experience. CMS star ratings are designed to help consumers judge a plan's quality, so a below-average rating might mean you can find a higher-quality plan elsewhere. Aetna's CMS star rating is below average, especially for its Special Needs Plans (SNPs). Additionally, J.D. Power's annual Medicare Advantage study found the company's service to be worse than the industry average.
Plan options and types
The main difference between Aetna Medicare Advantage plans is the provider networks. Aetna offers HMO, HMO-POS and PPO plans.
- HMO plans require you to have a primary care physician and use in-network doctors except in emergencies. You may also need a referral to see a specialist.
- HMO-POS plans still have a provider network, but you can get out-of-network care at a higher cost. Like HMOs, HMO-POS plans require a primary care physician and may require referrals to see specialists.
- PPO plans don't require you to have a primary care physician and you don't need a referral to see a specialist. You can seek care outside of the network of preferred providers, but it will still likely be a higher cost.
Each network type comes with its own pros and cons. For example, Aetna's HMO plans tend to cost less but limit your options for care to in-network facilities. PPO plans, on the other hand, allow you to seek out-of-network care, although you'll likely pay a higher monthly rate for the flexibility.
You can purchase an Aetna Medicare Advantage plan with or without drug coverage. Additionally, most plans include vision, dental and hearing benefits. The specifics of your coverage, including your deductible, out-of-pocket maximum and rate will depend on the plan you choose.
Aetna also offers two different SNPs depending on where you live. Finally, Aetna offers the Medicare Eagle plan for veterans.
Aetna Medicare Value Plus PPO vs. Aetna Medicare Select HMO
Some of Aetna's more popular PPO and HMO options have a $0 health deductible and a $0 copay for in-network primary care doctors. Additionally, both offer vision, dental and hearing benefits as well as a wellness program.
Aetna Medicare Value Plus | Aetna Medicare Select | |
|---|---|---|
| Network type | PPO | HMO |
| Monthly premium | $28 | $0 |
| Drug deductible | $505 | $0 |
| Out-of-pocket maximum | $8,300 | $3,900 |
| Specialist copay | $15 | $45 |
Keep in mind that you may have to pay more for care that isn't in-network or from a preferred provider.
Cost of Aetna Medicare Advantage plans
Aetna Medicare Advantage plans with prescription drug coverage cost an average of $19 per month.
Aetna's Medicare Advantage plans tend to be very affordable. The plans cost an average of just $19 per month when prescription drug coverage is included, which is the second-cheapest monthly rate when compared to the other four largest Medicare Advantage companies. Aetna also estimates that 84% of Medicare-eligible enrollees have access to one of its $0 premium plans.
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You'll also have your Medicare Part A and B premiums to pay. Part A is generally $0 per month for most people, and Part B costs $164.90 per month in 2023.
Medicare Advantage company | Monthly cost for Part C |
|---|---|
| UnitedHealthcare | $18 |
| Aetna | $19 |
| Humana | $32 |
| Blue Cross Blue Shield | $42 |
| Kaiser Permanente | $48 |
Where can I buy Aetna Medicare Advantage plans?
Aetna Medicare Advantage plans are available in nearly every state.
Aetna Medicare Advantage plans with prescription drug coverage are available everywhere but Alaska, Hawaii, Montana and Vermont. Aetna's Medicare Eagle option for veterans is available in 42 states. Only eight states and Washington D.C. don't have access to these plans:
- Alaska
- Arkansas
- Hawaii
- Maryland
- Montana
- North Dakota
- Rhode Island
- Vermont
- Washington, D.C.
Aetna's Dual-Eligible Special Needs Plan (D-SNP) is available in 30 states. The company expanded its availability to South Carolina, South Dakota and Utah in 2023, and it added PPO plans in Georgia and South Dakota. Coverage is not available in the following 20 states and Washington, D.C.
- Alaska
- Arizona
- Hawaii
- Idaho
- Illinois
- Maryland
- Massachusetts
- Minnesota
- Montana
- New Hampshire
- New Mexico
- North Dakota
- Oklahoma
- Oregon
- Rhode Island
- Tennessee
- Vermont
- Washington
- Washington, D.C.
- Wisconsin
- Wyoming
For those who need specific coverage for long-term care situations, Aetna introduced the Aetna Medicare Longevity Plan, which is an Institutional Special Needs Plan (I-SNP). Coverage is currently only available in Pennsylvania.
Aetna benefits and features
Aetna offers benefits and numerous resources with most Medicare Advantage plans.
- 24/7 nurse line: If you have questions about your health, you can call and speak to a registered nurse any time of day and any day of the week. Aetna's nurse line phone number is 800-556-1555.
- Care management: Aetna offers several tools to manage health care needs, ranging from helping you prepare for doctor appointments to providing help with managing medical conditions. For example, the National Medical Excellence program provides case managers who can help guide you through the organ or stem-cell transplant process.
- Healthy Home Visit: If it's difficult or inconvenient for you to leave your home for a doctor appointment, Aetna offers home visits that can help you get care. Aetna reports that over 95% of members are satisfied with their home visits. You may also be able to schedule a virtual visit with your primary care physician, an urgent care facility or a mental health professional.
- Prescription home delivery: If you have a prescription that you fill often, you may want to consider the CVS Caremark Mail Service Pharmacy, which allows you to fill up to a 100-day prescription when you have an Aetna Medicare Advantage plan with prescription drug coverage.
- Resources For Living: This gives you access to a consultant to help you navigate your health care needs or the needs of a loved one. Resources For Living can help you with meal services, home modifications, finding support groups or fitness classes, securing backup caregiver support and more. The program is a part of all Aetna Medicare Advantage plans.
- SilverSneakers: Most Aetna Medicare Advantage plans come with free access to SilverSneakers, which offers virtual and in-person fitness classes geared toward those 65 and older.
Additionally, most Aetna Medicare Advantage plans also include vision, dental and hearing care.
Customer reviews and complaints
Overall, Aetna has mediocre service and quality reviews.
- Medicare star ratings: Aetna's overall Medicare Advantage plan star rating is 3.6 out of a possible 5.0, which is lower than the national plan average of 3.9. Aetna might be a good fit if you want a company with language interpreters and assistance for those with hearing loss, due to high scores in those areas. If you're looking for a D-SNP or new I-SNP plan, Aetna might not be the best choice due to a very low score for SNP Care Management.
- J.D. Power: Aetna scored well below the industry average for customer satisfaction in J.D. Power's 2022 U.S. Medicare Advantage Study. J.D. Power analyzed six different categories of satisfaction during the study, including coverage and member benefits, average rates and customer interaction.
- National Association of Insurance Commissioners (NAIC): One of the largest companies in the Aetna group received 15% fewer complaints than expected for an average company its size. However, the NAIC complaint index gives a view of the company's service as a whole, not service for Medicare Advantage specifically.
Frequently asked questions
Is Aetna Medicare good?
Overall, yes, Aetna Medicare plans offer good coverage. The company's average rates are low and it offers several different provider networks and benefits to its members. Aetna also sells Part D drug plans and Medicare Supplement plans in addition to its Medicare Advantage plans. But remember that Aetna's Medicare Advantage plans aren't highly rated. If service is your main concern, you may want to compare a few different companies.
Is Aetna Medicare the same as Original Medicare?
No. Original Medicare refers to Parts A and B, which are sold by the federal government. Aetna sells Medicare Advantage plans, also called Medicare Part C, which are bundled Medicare insurance plans that combine hospital coverage, outpatient coverage and, frequently, drug coverage into one plan. Medicare Advantage coverage is at least as good as buying Parts A and B separately, and you may get additional benefits like vision, dental and hearing coverage.
How do I choose an Aetna Medicare Advantage provider network?
If you have preferred doctors, hospitals or other medical care facilities, you may first want to check to see if those locations are in-network for Aetna's various plan types. Otherwise, you might want to compare the benefits and drawbacks of each plan type. Aetna offers HMO-POS, HMO and PPO Medicare Advantage plans. The HMO plans tend to offer cheaper coverage but require you to seek care within a specified network. PPO plans allow you to get care anywhere, although the preferred providers will be cheaper.
Methodology
Medicare Advantage rates are from Medicare.gov and the Centers for Medicare & Medicaid Services (CMS). Rates are for Medicare Advantage plans that include prescription drug coverage. Special Needs Plans, Part-B-only plans, sanctioned plans, PACE plans, prepayment plans (HCPPs), Medicare savings account (MSA) plans, Medicare-Medicaid plans and employer-sponsored plans are not included in our analysis.
Information about the largest Medicare Advantage companies is from a Kaiser Family Foundation analysis of CMS Medicare Advantage enrollment files. To choose Aetna Medicare Advantage plans to compare, we used enrollment statistics from the Monthly Enrollment by Contract/Plan/State/County data provided by CMS for April 2023. Information about the plans was sourced from Medicare.gov using plans in Atlanta, Georgia. Specific plan details may vary by state and ZIP code.
Medicare Advantage star ratings were sourced from the public use files provided by CMS. The ratings include all 2022 Aetna Medicare Advantage plans, including plans sold by CVS Health and Allina Health.
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