Aetna Medicare Advantage Reviews

Aetna is a major Medicare Advantage plan provider in 45 states and Washington, D.C. Their plans are known for their good member satisfaction and comprehensive coverage.
By . Last update: June 11, 2024

Many of the plans featured here are available through our partners who may compensate us for enrollments. This influences which Medicare plans we write about, but it does not influence our evaluations. Our opinions are our own. Member opinions and comments are their own and do not express the views of MedicareWire. How we make money.

Editor's Rating:   Add Your Own Review!
Aetna Medicare Advantage Reviews
The Aetna logo is a registered trademark of Aetna Inc.

Aetna offers a range of Medicare Advantage (Part C) plans that are designed to provide comprehensive healthcare coverage, including additional benefits beyond traditional Medicare. Their plans typically include coverage for prescription drugs, dental, vision, and hearing services, as well as fitness programs and wellness resources. Aetna’s plans are known for their flexibility and variety, catering to different health needs and preferences with competitive pricing and extensive provider networks.[1]

In this review, we’ll delve into Aetna’s top Medicare Advantage plans, detailing their coverage options, associated costs, and the network of doctors and hospitals available to members. Additionally, we will explore customer feedback to provide insight into the overall satisfaction and experience of Aetna’s plan members.

Table of Contents

Member Reviews for Aetna

The following Aetna reviews have been left by our members.

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

PROS

  1. Zero-Dollar Premiums: Aetna provides numerous $0-premium plans, making it a cost-effective option for many beneficiaries. Approximately 84% of Medicare-eligible individuals in the U.S. can access these plans in 2024​​​​.
  2. Comprehensive Coverage: Many Aetna Medicare Advantage plans offer additional benefits not covered by Original Medicare, such as dental, vision, hearing, and prescription drugs. Plans may also include over-the-counter allowances, meal delivery services, and in-home health visits​​​​.
  3. Cost Savings: Aetna plans often have lower out-of-pocket costs, including reduced copayments, coinsurance, and deductibles. Many plans feature a $0 deductible for Tier 1 and Tier 2 drugs, providing savings on prescriptions​​​​.
  4. Additional Perks: Aetna plans frequently include fitness memberships like SilverSneakers, 24/7 nurse lines, and prescription home delivery. Some plans also offer wellness programs, meal programs, and home health visits​​​​​​.
  5. Extensive Network: Beneficiaries have access to a large network of healthcare providers, allowing them to choose from a wide range of doctors, specialists, and hospitals​​​​.
  6. Care Coordination: Many Aetna plans offer care management and coordination services, which can help improve health outcomes and manage chronic conditions effectively​​​​.

CONS

  1. Network Restrictions: While Aetna has a broad network, some plans require beneficiaries to use in-network providers, limiting flexibility. HMO plans, in particular, often need primary care physician referrals for specialist visits​​​​.
  2. Prior Authorization Requirements: Certain treatments and services may need prior authorization, which can potentially delay care​​.
  3. Plan Limitations: Some benefits, such as dental and vision coverage, may have annual limits or restrictions, resulting in additional out-of-pocket expenses for beneficiaries​​​​.
  4. Geographic Limitations: Aetna's Medicare Advantage plans are available in 46 states and Washington, D.C., but not in every region, restricting options for beneficiaries in certain areas​​​​.
  5. Annual Changes: As with all Medicare Advantage plans, Aetna's offerings can change annually, including premiums, benefits, and provider networks​​​​.
  6. Variable Quality Ratings: Some Aetna plans receive lower ratings from the National Committee for Quality Assurance (NCQA), indicating variability in plan performance​​​​.
  7. Frequent Changes to Drug Formularies: Aetna's Medicare Part D plans may frequently update their drug formularies, affecting coverage and out-of-pocket costs for medications​​.
FEATURED PARTNER OFFER [i]
Compare Top Medicare Advantage Plans from Aetna
Aetna Medicare Advantage Reviews
  • Compare affordable Aetna plans online
  • Additional benefits may include dental, vision, hearing, lifestyle and transportation
  • Call to speak to a licensed insurance agent. TTY 711, Mon-Fri 8am-9pm, Sat 9pm-8pm EST
On Medicare Enrollment's Website

How Do Aetna Medicare Advantage Plans Work?

Aetna Medicare Advantage plan members get all their hospital coverage (Medicare Part A) and medical coverage (Medicare Part B) benefits through their plan. This covers screenings, preventive care, vaccinations, visits to doctors and specialists, hospital stays, skilled nursing, and hospice.

All Aetna Medicare Advantage plans include coverage for:

  • Inpatient hospital admissions.
  • Doctor and specialist care.
  • Preventive care, screenings, and vaccinations.
  • Diagnostic services, lab work, X-rays and other imaging.
  • Outpatient services.
  • Ambulance transportation for emergencies.
  • Durable medical supplies and equipment.

Medicare rules say that all Aetna plans must provide at least the same coverage and benefits as Original Medicare. But, each plan sets its own out-of-pocket costs.

Some Aetna plans offer additional benefits like routine dental, vision, hearing, and wellness programs, which are not usually covered by Original Medicare.

When you join a Aetna Medicare Advantage plan, you can manage all your healthcare needs under one plan. This often comes with lower out-of-pocket costs and extra benefits suited to your health and lifestyle.

However, it's important to note that lower costs aren't guaranteed. Costs depend on the specific plan and how much you use healthcare services. Also, the Aetna plan you choose may have access restrictions, such as needing referrals and prior authorization. Original Medicare does not have these restrictions.

Extra Benefits from Aetna

Aetna offers a wide range of extra benefits is their plans. Some of the most common additional benefits include:

  • Dental Benefits: Annual allowance for preventive and comprehensive services.
  • Vision Benefits: Routine eye exams and an annual eyewear allowance.
  • Hearing Benefits: Routine hearing exams and coverage for hearing aids and fittings.
  • Extra Benefits Card: Monthly allowance for approved foods, over-the-counter items, transportation, and more.
  • SilverSneakers®: Access to over 15,000 fitness facilities​​.
  • 24-Hour Nurse Line: Access to registered nurses for health-related questions​​.
  • Prescription Mail-Order Delivery: Convenient home delivery of certain medications​​.
  • Resources For Living®: Service to help members find local resources​.
  • Telehealth Services: Virtual healthcare services for routine care and consultations​​.
  • Over-the-Counter (OTC) Benefits: Monthly allowance for OTC products​​​​.
  • Home-Delivered Meals: Home-delivered meals following a hospital stay​​.
  • In-Home Support Services: Assistance with daily activities for those with chronic conditions or after hospitalization​​.

What Types of Plans Does Aetna Offer?

Not all Aetna plans are the same. And, Aetna may not offer all plan types where you live, so it pays to explore using our Medicare Advantage Plan Finder tool. Here are the plan types Aetna offers:[6]

HMO point-of-service plans are HMO plans that allow members to get some out-of-network services, but you’ll pay more for those services.

Medicare preferred provider organization (PPO) plans provide the most freedom, allowing you to see any provider that accepts the insurance. With a PPO plan, you generally do not need to choose a primary care doctor, and you don’t need referrals to see specialists. And you can seek out-of-network care, although it may cost more than seeing an in-network doctor.

Health maintenance organization (HMO) plans require that you use a specific network of doctors and hospitals. Also, with a Aetna HMO plan you may need a referral from your primary care doctor in order to see a specialist. Out-of-network benefits are usually very limited. However, in an emergency you are not limited to care from your local hospital of emergency room.

NOTE: Aetna may also offer Medicare Advantage Special Needs Plans (SNPs). Due to the highly specialized nature of D-SNP (dual eligible), C-SNP (chronic condition), and I-SNP (institutional) insurance plans, we review them separately.

How Much Do Aetna Plans Cost?

Aetna's plan costs vary based on several factors, including your chosen plan, where you live, your usage, and the plan's out-of-pocket costs. Our plan finder provides detailed information about out-of-pocket costs for all Aetna plans.

Generally, Aetna will charge you a monthly premium, which can vary based on the level of coverage and additional benefits included. You must also continue to pay your Part B premium. If you're a high-income earner, Medicare may add a Income Related Monthly Adjustment Amount (IRMAA) to your premium.[5]

Aetna’s monthly premiums are highly dependent on where you live. For instance, the average cost of a Medicare Advantage plan from Aetna in Florida is $0.00 per month, but in Ohio the average cost is $70.04 per month. These averages do not include Special Needs Plans.

Aetna's Premiums vs. Competitors

The following list shows Aetna's nationwide average monthly premium (excluding Special Needs Plans) vs. several competitors.

Aetna
$22.24
Humana
$5.51
Cigna
$17.39
Anthem
$10.11
AARP
$22.97

You also need to factor in copayments or coinsurance for healthcare services like doctor visits or hospital stays. The costs in each Aetna plan we reviewed varied depending on the level of coverage and the type of services received.

Some plans offer $0 premiums or minimal copayments for certain services, while others might have higher premiums with lower out-of-pocket expenses. Carefully reviewing the cost and coverage details of each plan is the only way to find the one that aligns best with your needs.[7]

We analyzed the following popular Aetna plans to give you an idea of what members pay to use healthcare services. This is just a sample, use our Medicare Advantage Plan Finder to see plans and costs where you live.

Important costs for plan ID H3931-092-0 reviewed in Maricopa County, AZ.
  • Monthly premium: $0
  • Out-of-pocket max: $2,500
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H3931-129-0 reviewed in Maricopa County, AZ.
  • Monthly premium: $0
  • Out-of-pocket max: $4,800
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None
Important costs for plan ID H5521-100-0 reviewed in Maricopa County, AZ.
  • Monthly premium: $0
  • Out-of-pocket max: $3,850
  • Primary Care: $$0
  • Specialist: $$0
  • Tier 1 Prescriptions: $5.00 copay, $0 deductible
  • Urgent Care: $$0
  • Emergency Room: $$0
  • Ground Ambulance: $$0
  • Inpatient Care:
  • Extra Benefits: None

Is Aetna a Good Medicare Advantage Plan?

Aetna is a prominent provider of Medicare Advantage plans, offering a range of options to meet diverse needs. The quality of Aetna's plans can depend on individual health needs, budget, and preferences. Here’s an evaluation of Aetna's plan quality using various consumer intelligence sources and review platforms.

J.D. Power Ranking

In its 2023 U.S. Medicare Advantage Study, J.D. Power evaluated member satisfaction with Medicare Advantage plans based on eight factors, including trust, customer service, and plan management. Here’s how Aetna ranked in the five largest Medicare Advantage markets[2]:

  • California: 5th out of 7.
  • Florida: 4th out of 6.
  • New York: 5th out of 8.
  • Pennsylvania: 4th out of 7.
  • Texas: 5th out of 6​​​​.

NCQA Health Plan Score

The National Committee for Quality Assurance (NCQA) rates health plans annually using a 5-point scale, focusing on quality of care, patient satisfaction, and efforts for continuous improvement. In 2023, Aetna's Medicare Advantage plans received scores ranging from 2.5 to 4.5 stars. Approximately 25% of Aetna plans achieved a rating of 4.0 stars or higher, with most plans falling between 3.0 and 4.0 stars​​​​.[4]

Better Business Bureau (BBB)

The Better Business Bureau (BBB) awards Aetna an A+ rating, the highest possible. This rating indicates Aetna's strong ability to resolve consumer complaints and maintain a positive track record​​.

Consumer Reviews

Consumer review platforms like ConsumerAffairs provide insights into member experiences with Aetna Medicare Advantage plans. Reviews are mixed; many members appreciate the comprehensive coverage and extra benefits, while others cite concerns about network limitations and customer service issues​​​​.

AM Best Financial Strength Rating

AM Best, a credit rating agency that specializes in the insurance industry, has assigned an A (Excellent) rating to Aetna’s parent company, CVS Health. This rating signifies Aetna’s strong financial ability to meet ongoing insurance obligations​​.[3]

Conclusion

Aetna's Medicare Advantage plans are generally well-regarded for their comprehensive coverage options and added benefits. However, individual experiences can vary. It's important for beneficiaries to evaluate their personal healthcare needs and preferences when considering these plans.

Aetna's Medicare Star Ratings

Aetna's average 5-star rating: 4.14*
*Our calculation is weighted by enrollments in public plans, excluding Special Needs Plans, with CMS star ratings across 38 contracts covering 3,964,180 members.

If you want the government’s take on the quality of Aetna’s Medicare Advantage plans, check out the Centers for Medicare and Medicaid Services' star ratings, which rank each plan from 1 (worst) to 5 (best) stars. The health agency assigns ratings based on quality of care and customer satisfaction measurements, and updates ratings every year.[9]

All Medicare Advantage plans are assessed using CMS's health plan criteria. Plans that come with prescription drug coverage are evaluated on additional drug plan metrics. Based on the latest year of data and adjusted for enrollment numbers, Aetna’s 2024 Medicare Advantage plans have an average rating of 4.14 stars.[9] [11]

Of all Aetna members who are in contracts with a Medicare star rating, 87% are in contracts rated 4 stars or above as of January 1, 2024.

You can find all plan ratings in your area using our Medicare Advantage Plan finder tool.

Plan Availability

Aetna's Medicare Advantage plans are available in 45 states and the District of Columbia, including:

AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, WA, WI, WV, and WY.

In total, Aetna offers Medicare Advantage plan in 0 out of 3,140 U.S. counties.[8]

Aetna's Top Plans

Here's a list of Aetna's most popular plans (by enrollments):[9][10]

Medicare Advantage Search and compare Medicare Advantage plans available in your area.

Find Plans in your area with your ZIP Code

Frequently Asked Questions

The following are the most frequently asked questions we found about Aetna's Medicare Advantage plans:

There is no debate when it comes to which plan offers better coverage. Original Medicare and a supplement plan offer the best coverage, but it costs more up-front. For a complete breakdown of the differences between Medicare Advantage plans and Medigap plans, read: Medicare Advantage vs Medigap: Which is Best for You?

MA Plan Pros

  1. The maximum out-of-pocket cost is $7,550 a year
  2. Many plans cost $0 extra a month
  3. Most plans include drug coverage
  4. Many include basic hearing, dental, and vision benefits
  5. May include gym discounts (Silver Sneakers)

MA Plan Cons
  1. Can only switch during Open Enrollment
  2. Not easy to compare because plans are not standardized
  3. No nationwide coverage (plans don't travel with you)
  4. Most are HMO plans that require referrals to see a specialist
  5. Plans can change health and drug coverage each year

Learn more in this article.

If you have ever had a Health Maintenance Organization (HMO) plan or a Preferred Provider Organization (PPO) plan through an employer or the Healthcare Exchange, you already have a pretty good idea about how Medicare Advantage plans work. For a more in-depth look, read How Does Medicare Advantage Work?

With a Medicare Advantage plan you pay most of your costs when you use healthcare services through deductibles, copayments and/or coinsurance. As a result, private health plans can be difficult to budget. Learn More...

Researching your health plan options is important. Here are some key questions to consider before choosing a Medicare Advantage plan as well as additional companies to read about:

Key Questions

All plans potentially have monthly premiums, deductibles, copayments, and/or coinsurance, including plans from Aetna. Are these costs within your budget?

  • Does the plan cover your prescriptions? Knowing how a plan covers them is important if you have regular prescriptions because costs and coverage vary widely from plan to plan.
  • Are your doctors in the plan’s network? If you have preferred providers, ensure they participate in the plan’s network.
  • Is routine dental, vision, and hearing covered? Traditional Medicare doesn’t cover these services. If you need it, be sure to explore plans that cover it.
  • What extras does the plan include? Plans may include many beneficial extras, like gym memberships (SilverSneakers), medical transportation, meal delivery, telehealth, and more.

If you have additional questions, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

About Aetna

XYZ about Aetna.

Company
Aetna Inc
Phone Number
855-335-1407
Website
https://www.aetnamedicare.com/
Facebook Page
https://www.facebook.com/aetna/
X (Twitter) Page
https://twitter.com/humanahelp

Citations

MedicareWire uses trustworthy sources to inform its work, including government websites, government data, actuarial service data, consumer intelligence websites, and peer-reviewed studies. All content is fact-checked for accuracy, timeliness, and relevance. We used the following information sources in this review: