|Medicare rating: 3.5 stars||A.M. Best financial strength rating: A||Better Business Bureau (BBB) rating: A+||National Committee for Quality Assurance (NCQA) rating: 2.5 to 4.5 stars||Consumer Affairs rating: 3 stars||J.D. Power ranking: 7th out of 10|
Quick Aetna Medicare Prescription Drug Plans (PDPs) review: Aetna offers prescription drug coverage through three stand-alone Part D PDPs and as a bundled service in their Medicare Advantage preferred provider organization (PPO) and health maintenance organization (HMO) plans. CVS Health Corporation acquired Aetna in 2018, and the company’s PDPs are available in 22 states. All of Aetna’s PDPs have a Medicare star quality rating of 3.5 out of five stars.
CVS/Aetna’s SilverScript Smart RX plan has the lowest average monthly premium in 2022, and CVS is one of four main providers of stand-alone Part D prescription drug plans in the United States. Monthly premium prices vary depending on where you live and the type of plan you choose. You can find plans and U.S. Centers for Medicare & Medicaid Services (CMS) quality rating information by searching Medicare.gov.
If you have Original Medicare Part A and/or B or a Private Fee-for-Service (PFFS) Medicare Advantage Plan, you can purchase one of Aetna’s stand-alone Part D plans. If you have an Aetna PPO or HMO Medicare Advantage Plan, your plan should include drug coverage.
Pros and Cons of Aetna Medicare Part D Plans
|What we like about Aetna Medicare Part D Plans:||The drawbacks of Aetna Medicare Part D Plans:|
What Do Aetna Medicare Part D Plans Cover?
Aetna’s Medicare Part D plans are regulated by CMS and must cover a wide range of prescription drugs that people with Medicare take. Plans include a coverage gap that begins when you and your plan have spent a certain amount ($4,430 in 2022) on prescription drugs and ends when you’ve spent $7,050 and entered the catastrophic coverage period. You then will pay a small coinsurance percentage or copayment amount for drugs you need until the end of the year. When you are in the coverage gap, you will pay up to 25% of drug costs.
Aetna has a formulary (list of drugs) and separates drugs into tiers that correspond to costs. Lower tiers include generic, lower-cost medications, and higher tiers include higher-cost, brand name, or specialty drugs.
Your share of costs for each prescription drug may change depending on which pharmacy you choose, the tier of the drug, and when you enter each coverage phase. You must meet your annual deductible before your plan pays unless you choose a plan that covers tiers 1 and 2 without the deductible requirement. Generic drugs and those obtained from in-network, preferred pharmacies are the least expensive.
Aetna’s SilverScript Plus plan is the only one that participates in the Senior Savings Program for select insulins to keep your costs below $35 per month.
What Are Aetna's Medicare Part D Plan Options?
Aetna offers three different Part D Plan options:
- A basic plan (SilverScript Smart RX) with the lowest monthly premiums and no deductible for drugs in tier 1. It may be best for you if you don’t need prescription drugs but need prescription drug coverage to avoid paying late penalties
- A medium-range plan (SilverScript Choice) with a zero deductible for drugs in tiers 1 and 2. A good choice if you qualify for Extra Help.
- A more comprehensive plan (SilverScript Plus) with the highest monthly premium and a zero deductible. This is the only plan that offers the Senior Savings Model for insulin and includes tier 1 and 2 gap coverage and extras such as prescription vitamins and erectile dysfunction drugs.
All three of Aetna’s plans include a zero deductible and minimal copay for tier 1 generic drugs from a preferred pharmacy (Walmart, Costco, King Soopers, Safeway, and CVS). Initial coverage limits and annual out-of-pocket threshold amounts are the same for all three plans. These types of plans and coverage limits are similar to other carriers of Part D prescription drug coverage. The differences lie in the monthly premiums, formularies, and preferred pharmacies.
Monthly premium costs vary, depending on your state and county. Compare costs for the three 2022 plans in Larimer County, Colorado:
|Plan name||Monthly premium||Annual deductible||Initial Coverage Limit||Annual out-of-pocket threshold amount|
|SilverScript Smart RX (PDP)||$7.60||$480 (tiers 2, 3, 4, 5)||$4,430||$7,050|
|SilverScript Choice (PDP)||$35.40||$480 (tiers 3, 4, 5)||$4,430||$7,050|
|SilverScript Plus (PDP)||$85.30||$0||$4,430||$7,050|
Aetna Medicare Part D Plans Reviews and Ratings
The CMS is the only rating entity that provides a separate rating for Aetna’s Medicare Part D plans. A.M. Best rates CVS Health corporation as a whole. The BBB rates Aetna, Inc., and Consumer Affairs rates CVS Pharmacy. NCQA and J.D. Power don’t rank Aetna’s Part D plans separately but provide insight into Aetna’s Medicare Advantage Plans.
|Medicare rating: 3.5 stars||Aetna’s Medicare Part D plans have an overall quality rating of 3.5 out of 5 stars from the CMS.|
|A.M. Best financial strength rating: A||A.M. Best sets credit ratings for insurers. In December 2021, A.M. Best affirmed its A (Excellent) Financial Strength Rating (FSR) for CVS Health Corporation’s Aetna subsidiaries. An A rating indicates CVS/Aetna has an excellent ability to meet financial obligations.|
|BBB Rating: A+||Aetna, Inc has an A+ rating from the BBB. The company has processed 711 complaints in the last three years, but that includes all of its products and services ― not just stand-alone Part D prescription drug plans. Aetna is not accredited by the BBB.|
|NCQA rating: 2.5 to 4.5 stars||According to the NCQA, satisfaction ratings for Medicare Advantage plans issued by all Aetna divisions range from 2.5 to 4.5 stars. Accredited plans have the highest performance ratings. Most rated plans are HMOs and PPOs which offer drug coverage. There are no NCQA ratings for Aetna/CVS stand-alone prescription drug plans.|
|Consumer Affairs rating: 3||CVS is the parent company of Aetna and is one of the preferred pharmacies with Aetna Part D plans. Consumer Affairs gave CVS Pharmacy a 3 out of 5-star rating based on 483 ratings. Reviews vary widely depending on individual experiences with customer service agents and wait times at local pharmacies.|
|J.D. Power ranking: seventh out of 10||In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Aetna scored 795 points out of 1,000 and came in seventh out of the top 10 Medicare Advantage providers.|
Learn More From Our Sources
- Aetna | Part D Prescription Drug Plans | Last accessed October 2022
- Aetna | Our History | Last accessed October 2022
- A.M. Best | Financial Strength Rating for CVS Health Corporation | Last accessed October 2022
- Better Business Bureau | Aetna Inc. | Last accessed October 2022
- Consumer Affairs | CVS Pharmacy | Last accessed October 2022
- J.D. Power | 2021 Medicare Advantage Study | Last accessed October 2022
- Medicare | How To Get Prescription Drug Coverage | Last accessed October 2022
- Medicare | How Do Medicare Advantage Plans Work? | Last accessed October 2022
- NCQA | NCQA Health Insurance Plan Ratings 2021 – Report Cards | Last accessed October 2022