A Guide to Aetna Medicare Advantage Plans in 2025

Aetna Medicare Advantage Pros and Cons

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

Aetna PPO Pricing

The listed numbers are quotes from Aetna as of March 2025. You’ll want to contact Aetna to get a verified quote for your needs, however.

Current Medicare Advantage Plans

Aetna currently offers six 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.

Aetna Medicare Advantage Institutional Special Needs (I-SNP)

This plan applies to people who have lived, or plan to live, in an “institution” for 90 days or longer. These institutions include, according to the Centers for Medicare & Medicaid Services:

• Long-term care skilled nursing facility (LTC SNF)
• Long-term care nursing facility (LTC NF)
• Skilled nursing facility or nursing facility (SNF/NF)
• Intermediate care facility for people with intellectual disabilities (ICF/IDD)
• Inpatient psychiatric facility

Aetna Medicare Advantage Chronic Condition Special Needs (C-SNP)

Finally, those with eligible chronic conditions can get a C-SNP from Aetna. These chronic conditions include:

• Autoimmune disorders like rheumatoid arthritis and polymyositis
• Cancer
• Cardiovascular disorders such as coronary artery disease and cardiac arrhythmias
• Chronic alcohol/drug dependence
• Chronic and disabling mental health conditions like bipolar or paranoid disorder
• Chronic heart failure
• Chronic lung disorders like asthma and emphysema
• Dementia
• Diabetes
• End-stage liver disease
• End-stage renal disease that requires dialysis
• HIV/AIDS
• Neurological disorders like epilepsy or multiple sclerosis
• Severe hematologic disorders like sickle-cell disease and hemophilia
• Stroke

Additional Benefits

Aetna Medicare Advantage plans cover everything that Original Medicare covers, in addition to other health-related benefits.

Dental Benefits

Only 64 percent of U.S. adults 65 and older had visited the dentist in the past 12 months, according to 2022 data from the CDC’s National Center for Health Statistics. However, for those with dental insurance, that number was closer to 70 percent. It’s necessary to visit the dentist on an annual basis. Unchecked gum disease and inflammation can increase the risk of dementia, heart disease, lung disease, strokes, and blood vessel blockage, based on an article by Harvard Medical School.

Many of Aetna’s Medicare Advantage plans include dental coverage. While covered services depend on the type of plan, you could receive:

• Bridges
• Cleanings
• Crown
• Dentures
• Fillings
• Implants
• Oral exams
• Root canal treatments
• X-rays

Vision Benefits

Specific Aetna plans offer coverage for routine vision care. These benefits include:

• Annual eye exams
• Prescription lenses
• Contacts

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. Hearing aids are 100 percent covered, with the exception of FIDE plans (dual special needs.)

Over-the-Counter Benefits

Aetna has many plans that provide over-the-counter benefits, an allowance that you can use to buy products like:

• Allergy medicine
• Cold medicine
• Dental care supplies
• Ear care products
• Eye care products
• First aid/medical supplies
• Flu medicine
• Pain relievers
• Sunscreen

You’ll buy these products through a catalog, which you’ll receive in the mail. You also can use the benefit in CVS locations, online, or over the phone.

Prescription Home Delivery

With CVS Caremark, you can have your prescriptions delivered to your home for free.

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, and SilverSneakers On-Demand. You can also take group fitness classes via SilverSneakers FLEX, which provides access to over 15,000 participating locations and classes at all levels (which are taught by professionals.) Note that this benefit isn’t available to those with I-SNP plans.

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.

Durable Medical Equipment

You can use your policy to pay for durable medical equipment (DME), such as wheelchairs, hospital beds, pumps, diabetic supplies, oxygen equipment, and more. However, you’ll need prior authorization before you buy electric scooters, lower limb prosthetics, or motorized wheelchairs. Your request could take up to two weeks.

Care Management

Aetna’s care management 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 to get advanced care, and connect you to community resources.

Customer Service

Here are three ways to contact Aetna’s customer service:

• Phone: Call the number on your ID card.
• Message: Log into your account on the Aetna website and send a message.
• Contact form: If you’re not registered on the member website, fill out the contact form.

Aetna Medicare Advantage Service Area

Aetna Medicare Advantage plans are available in every state plus Washington, D.C., except:

• Alaska
• Hawaii
• Idaho
• Minnesota
• Montana
• New Mexico
• North Dakota
• Vermont

Even within states where Aetna offers Medicare Advantage plans, it may not be available in your county.

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: AM Best issued a Financial Strength Rating of A (excellent), meaning Aetna is able to easily meet their ongoing insurance obligations.
• Moody’s: Unfortunately, as of the most recent December 2024 update, Moody’s has downgraded Aetna’s rating from an Aa3 to a Baa3. The reason for this downgrade is partially due to the Medicare Advantage program, as costs have increased. Still, the company outlook is stable; Aetna has adjusted prices to compensate for these increased costs, which unfortunately could mean higher premiums and out-of-pocket costs.
• S&P Global: Aetna has an A- rating from S&P Global.

Bottom Line

Aetna offers numerous benefits that are sure to enhance your health and wellness, and with most plans, you won’t have to pay a premium or deductible. That being said, some out-of-pocket costs can be high, so make sure to choose a plan you would actually be able to afford if you have a health problem. To learn more about our favorite Medicare Advantage providers, read our additional guides:

• AARP Medicare Advantage
• Anthem Medicare Advantage
• Blue Cross Blue Shield Medicare Advantage
• Cigna Medicare Advantage
• Humana Medicare Advantage
• Kaiser Medicare Advantage
• UnitedHealthcare Medicare Advantage