Aetna Medicare Plans Review

Fact Checked
Expert reviewed by: Tammy Burns, insurance and healthcare consultant
Updated: October 10, 2021

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Tammy Burns
Medicare advisor and nursing consultant
Tammy Burns
Medicare advisor and nursing consultant

Tammy Burns is an experienced health insurance advisor specializing in  Medicare and senior health issues, including Medicare Advantage Plans and prescription drug plans, as well as ACA certified for health insurance and other ancillary, life and annuity products.

Aetna Medicare plans give seniors access to a large network of medical professionals with $0 premiums and affordable copays.

Established in 1853, Aetna is one of the nation’s oldest insurance companies, and it’s processed Medicare claims since 1966. Today, Aetna is owned by CVS Health, and it insures more than 39 million individuals, including 9.2 million Medicare beneficiaries. The company offers an impressive selection of Medicare Advantage Plans in 46 states and the District of Columbia. These plans provide medical care and a variety of extra benefits and give excellent value.

The company also manages stand-alone prescription drug plans and sells Medigap supplemental insurance. If you’re enrolling in Medicare for the first time or want to change coverage, learn more about some of the Aetna Medicare plans that may be available in your area.

Pros and Cons of Aetna Medicare Plans

What we like about Aetna Medicare plans: The drawbacks of Aetna Medicare plans:
  • Coverage available in 46 states
  • Average CMS satisfaction rating of 4 stars
  • Wide selection of HMO and PPO plans
  • Variable quality ratings
  • Concerns about coverage value
  • Frequent changes to drug formularies

What do Aetna Medicare Plans Cover?

Also called Medicare Part C, Medicare Advantage Plans combine Part A and B benefits with various extra services. Most Aetna Medicare Advantage Plans include prescription drug coverage as well as vision, dental, hearing, and wellness benefits, such as free gym memberships. Plans may also give you access to medical transportation and certain over-the-counter medications to promote your health and well-being.

If you have certain chronic medical conditions, such as cancer or Alzheimer’s, you may qualify for a Medicare Advantage Special Needs Plan that serves a specific population group. With Medicare Advantage, you continue to pay your Original Medicare premiums. In many cases, there’s no additional cost.

The company’s Medigap plans work with your Original Medicare Parts A and B. You can use this supplemental insurance to help pay for copays and deductibles. Aetna’s Part D, or prescription drug coverage, is another add-on plan for seniors with Original Medicare, specifically designed to help pay for prescription medication.

Aetna Medicare Plan Options

Aetna offers a wide selection of HMO and PPO Medicare Advantage Plans. Coverage options vary by county, but if you live in a major city, you can typically choose between four to 10 plans. HMOs have lower copays and out-of-pocket expenses since most services are delivered by a network of contracted providers. You must select a primary care physician, and pre-authorizations are generally required for specialist visits. PPOs give you the freedom to visit in- or out-of-network providers, although copays and coinsurance rates are lower when you choose a preferred provider.

Aetna has various Part D and Medigap plan selections specific to your state of residence. Learn more about some of the Aetna Medicare plan options that may be available to you.

Compare some of your Aetna Medicare options before making a decision:

Plan Name Monthly premium Annual deductible Office visits Telehealth Emergency room Annual maximum out-of-pocket cost
Aetna Medicare Premier Plus Plan (PPO) $0 $0 $0 in-network/$55 out-of-network for primary care

$35 in-network/$60 out-of-network for specialists

Same cost as in-person visits for primary or urgent care $90 $6,700
Aetna Medicare Premier Plan (PPO) $0 $0 $0 in-network/$55 out-of-network for primary care

$40 in-network/$60 out-of-network for specialists

Same cost as in-person visits for primary or urgent care $90 $7,500
Aetna Medicare Value Plus Plan (HMO) $20 $0 $0 primary care/$25 specialists Same cost as in-person visits for primary or urgent care $90 $6,700
Aetna Medigap Plan A Varies by gender and age, ($1,048 annually for a 65 year-old female) $203 Part B and $1,484 Part A pays 20% n/a pays 20% $203 Part B and $1,484 Part A
  SmartRx $7.30 $445 n/a n/a n/a $6,550

*Based on pricing in Nashville, Tennessee

Aetna Medicare Plans Reviews and Ratings

Aetna has a longstanding reputation in the insurance industry. Its Medicare plans typically receive favorable reviews, and the company has an overall quality rating of 4 stars from the Centers for Medicare & Medicaid Services.

Aetna has an A+ rating from the Better Business Bureau. Although the carrier has had more than 200 complaints in the past year, very few issues were related to its Medicare coverage or Advantage Plans.

According to the National Committee for Quality Assurance, satisfaction ratings for Medicare plans issued by all Aetna divisions range from 2.5 to 4.5 stars, with more than 40 plans receiving high-performance ratings.

Consumer Affairs gave Aetna a similarly high rating of 4 stars with more than 1,000 consumer reviews. Beneficiaries appreciate the carrier’s low rates, large provider network, and long-term care services for aging in place.

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