Offered in 49 states, Aetna Medicare Advantage plans are a great option for those looking to save on health care costs. Not only do many of their plans require no monthly premium payments, but they also offer additional benefits for vision, hearing, dental, and over-the-counter medications.
FYI: To learn more about our favorite Medicare insurance, read our guide to this year’s best Medicare Advantage.
Aetna Medicare Advantage Pros and Cons
Pros
- $0 premium offerings: Many Aetna Medicare Advantage plans offer $0 premiums, and the majority of them cost less than $30 per month.
- Ample additional benefits: While the benefits will vary by your location, Aetna Medicare Advantage plans offer prescription drug coverage, Rx mail order benefits, dental, vision, hearing, fitness memberships, and meals-at-home programs.
- Nationwide availability: Aetna Medicare Advantage plans are available in 49 states, and their Part D drug plans are available in all 50.
- In-person clinic access: Because Aetna is a CVS Health company, you can visit walk-in or MinuteClinics. The copay is the same as a regular visit to a primary care physician (PCP), but the facility has to be in PPO and HMO plans that don’t require a PCP visit.
Cons
- Limited plan types: Plan types are limited to HMO, PPO, and special needs (DSNP). PFFS or MSA’s aren’t offered.
- Frequent changes to drug formularies: Medicare Part D is updated throughout the year. Changes can include which drugs are covered, new drugs added, what drugs are moved to a different cost-sharing tier, if prior authorization is required, step therapy restrictions, if quantity limits are added, and what drugs are removed from the market.
Our Top-Rated Carriers
Aetna Medicare Advantage plans are not offered everywhere. If you live outside of their regions, then we'd recommend checking out plans from our top-rated carriers.
Aetna Medicare Advantage Costs
While the exact costs of Aetna’s Medicare Advantage plans will vary by age and state, here’s what a person might expect to pay.
Aetna HMO Pricing*
| Location | Monthly Premium** | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $0-$19.30 | $0 | $2,000-$7,550 |
| Florida | $0-$25.20 | $0 | $3,000-$3,450 |
| New York | $0 | $0 | $7,550 |
| Texas | $0 | $0 | $3,900-$7,550 |
Aetna PPO Pricing*
| Plan | Monthly Premium** | Deductible | Maximum Annual Out of Pocket |
|---|---|---|---|
| California | $90 | $0 | $6,700 |
| Florida | $0 | $0 | $6,700 |
| New York | $0-$25 | $0 | $7,550 |
| Texas | $0-$10 | $0 | $5,000-$7,550 |
*The listed numbers represent an estimated quote; however, you’ll want to contact Aetna to get a verified quote for your needs.
**Remember that with a Medicare Advantage plan, you’ll still need to pay Medicare Part B premiums.
Current Medicare Advantage Plans
Aetna currently offers four different types of Medicare Advantage plans.
Aetna Medicare Advantage HMO
HMOs require you to have a primary care provider who will assist in coordinating care. Most of Aetna’s HMO plans require you to use in-network providers (except for emergencies) as well as receive a referral to see a specialist. Overall, many of these plans have pharmacy and extra benefits.
Aetna Medicare Advantage HMO-POS plans
Select Aetna HMO-POS plans give you the flexibility to see providers outside of a specific network; however, they’re more expensive. They provide pharmacy, dental, vision, and hearing in addition to over-the-counter benefits and home-delivered meals after hospital discharge. Aetna requires you to have a PCP for these plans and others may require that you obtain a referral to see a specialist.
Aetna Medicare Advantage PPO
PPOs are a great choice because they offer more flexibility in terms of seeing out-of-network providers (compared to other Medicare Advantage plans). Keep in mind that these providers may cost more. Aetna’s PPO plans usually don’t require you to have a PCP, and you don’t need a referral to see a specialist. Moreover, these plans have supplemental benefits that you receive when in an HMO-POS plan.
Aetna Medicare Advantage Dual Special Needs (D-SNP)
If you have both Medicare and Medicaid, then you’re eligible for a D-SNP. You’ll receive Medicare Advantage benefits in addition to benefits your private insurer may choose to include. Aetna’s D-SNPs have a dedicated care team to support you if you have a chronic disease or special healthcare needs. You can also use programs that help with non-medical expenses like housing, utilities, transportation, and food.
Additional Benefits
Aetna Medicare Advantage plans cover everything covered by Original Medicare. They also provide some additional health-related benefits.
Dental Benefits
Many of Aetna's Medicare Advantage plans include dental coverage. For those that don’t, you might have the option of paying extra for them, which would be done via an optional supplemental benefit.
While covered services depend on the type of plan, you could receive:
- Oral exams
- Cleanings
- X-rays
- Fillings
- Root canal treatments
- Dentures
- Crown, implants, and bridges
Vision Benefits
Specific Aetna plans offer coverage for routine vision care. These benefits include:
- Annual eye exams
- Prescription lenses (bifocal, trifocal, single vision, or standard/premium progressive)
- Contacts (conventional or disposable)
Hearing Benefits
Most of Aetna’s Medicare Advantage plans have hearing aid coverage through a network provider. Benefits include one annual routine exam and hearing aid fitting that’s 100 percent covered.
Over-the-Counter Benefits
Aetna has many plans that provide over-the-counter benefits so you can receive items like cold medicine at no extra cost.
Meal Programs
Once discharged from the hospital or skilled nursing facility, you’re eligible to receive meals at home while you recover. This is included in most of Aetna’s Medicare Advantage plans.
24-Hour Nurse Line
If you have a question or concern, such as how to manage your chronic condition or if you need to go to urgent care, you’re eligible to contact Aetna’s 24-hour nurse line.
Prescription Home Delivery
With CVS Caremark, you can have your prescriptions delivered to your home for free. Depending on the plan, you may be eligible to receive up to a 90-day supply rather than a 30-day. You can also refill prescriptions once every three months and reorder online, by phone, or mail.
Fitness Memberships
Aetna’s Medicare Advantage plans often cover fitness memberships at no added cost. Through SilverSneakers, you’ll receive the SilverSneakers GO app, SilverSneakers LIVE, SilverSneakers On-Demand, group fitness classes via SilverSneakers FLEX, access to over 17,000 participating locations, and classes at all levels (which are instructed by professionals).
Telehealth Benefits
You’ll have access to in-network primary care physicians, physician specialty care, urgent care clinics, mental health support, and prescription refills. Out-of-network telehealth visits are only covered if you’re enrolled in a Medicare Advantage ESA or PPO plan through your employer.
Companionship Benefits
Aetna’s Compassionate Care Program provides free services and support to you and your family who have a serious illness. You’ll be assigned a Case Manager to help coordinate care, make it easier for advanced care, and connect you to community resources.
Utility Card
Aetna has partnered with PayFlex to provide you with a Medicare Payment debit card to help make copayments for in-network primary and specialty care as well as other medical/diagnostic services. If qualified, you’ll receive $100 per quarter with a $400 year maximum. Keep in mind this is only offered with select Medicare Advantage plans in Pennsylvania and Minnesota.
Fall Prevention
If you’re a low-income house, you may be eligible to receive fall prevention benefits. These are mostly offered via D-SNPs.
Healthy Foods Debit Card
If you have a D-SNP, you can obtain a healthy foods debit card each month. You can only use these at approved stores.
Customer Service
If you need to contact Aetna’s customer service, you can do so via phone at 1-800-US-AETNA (1-800-872-3862) between 8AM-6PM (ET). You can also reach their team via mail or on Twitter at @Aetna or @AtenaHelp.
Aetna Medicare Advantage Service Area
Aetna Medicare Advantage plans are offered in:
- Alabama
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Washington, D.C.
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Kansas
- Kentucky
- Louisiana
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Aetna Financial Strength
When shopping for health insurance, it’s important to choose a plan that has great financial strength. Here is what Aetna Medicare Advantage is rated:
- AM Best: Issued a Financial Strength Rating of A (excellent), meaning Aetna is able to easily meet its ongoing insurance obligations
- NCQA: Using its five-point scale, Aetna’s scores varied by state, ranging between a 2.5-4.5
To learn more about our favorite Medicare Advantage providers, read our additional guides:
Frequently Asked Questions
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Which Medicare Advantage plans does Aetna offer?
Aetna offers HMO, PPO, and D-SNP Medicare Advantage plans.
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How many states have Aetna Medicare Advantage plans?
Aetna offers Medicare Advantage plans in 49 states.
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What does Aetna Medicare Advantage cover?
Aetna Medicare Advantage covers dental, vision, hearing, fitness, telehealth, care management assistance, mail prescriptions, over-the-counter prescriptions, and other supplemental benefits.
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Which is better: Aetna Medigap or Medicare Advantage?
Aetna Medigap is a good option if you’re searching for special coverage, as it covers costs that aren’t by Original Medicare (Parts A and B). It can also help lower your yearly out-of-pocket expenses. Take into account that if you choose to switch plans, you must switch to Original Medicare.
Aetna Medicare Advantage provides supplemental benefits like meal programs, over-the-counter prescriptions, telehealth visits, fitness memberships, prescription drugs, as well as dental, vision, and hearing. It’s also available in 49 states whereas Medigap may not be. Aetna’s Medicare Advantage is also offered in different types, like HMO, PPO, and D-SNP.
