Aetna Medicare Advantage Review For 2024


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Jessica Lester Editor
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Our Verdict

Aetna Medicare Advantage offers a wide range of Medicare health care plans and a variety of additional benefits aimed toward further convenience.

Key Features

  • Includes health maintenance organization (HMO) plans, preferred provider organization (PPO) plans, dual eligible special needs plans (D-SNPs) and HMO point of service (HMO-POS) plans
  • Additional benefits, such as a concierge service to help customers locate resources in their area
  • Expanded SNPs to help with personal expenses, such as groceries, are available for Medicare and Medicaid-eligible individuals

Aetna was founded in 1853 in Hartford, Connecticut. The company paid its first Medicare claim in 1966 and began offering HMO and PPO plans in the 1970s and 1980s. Aetna is a subsidiary of the CVS Health Corporation and serves about 39 million people currently.

In addition to Medicare Advantage plans, Aetna offers individual and family health, employer sponsored, dental, vision, supplemental, Medicaid and pharmacy insurance plans.

  • Many plans with $0 monthly premium and/or $0 annual deductible
  • Additional convenience benefits
  • More than 3.2 million Medicare Advantage plan beneficiaries
  • Location determines available plans
  • Ranking dropped to 3.5-star rating from the Centers for Medicare and Medicaid Services (CMS) in 2023 (received a 4.5-star rating in 2022)
  • Must also pay Plan B premiums

Aetna Medicare Advantage at a Glance

  • Plan options: Aetna offers four main types of Medicare Advantage plans: HMO, PPO, HMO-POS and D-SNP plans.
  • Provider network: Aetna allows you to search for providers in your area by ZIP code and coverage needs.
  • Average monthly premium: Many plans charge $0 for a monthly premium, though exact plans and costs depend on your location.

How Does Aetna Medicare Advantage Work?

Aetna’s four main types of Medicare Advantage plans include HMO, PPO, HMO-POS and D-SNP plans. Additional benefits of most these plans also include the following resources:

  • Resources for Living concierge to help you access local services
  • SilverSneakers fitness membership with access to more than 15,000 fitness locations
  • 24-hour nurse phone line
  • Prescription home delivery
  • Routine dental, vision and hearing benefits

Medicare Advantage HMO Plans. Most Aetna HMO plans require you to choose an in-network primary care physician (PCP). Specialists and hospitals you visit must also be in-network, although you may have access to limited out-of-network benefits. Hospital or specialist care likely requires a PCP referral.

Medicare Advantage HMO-POS Plans. If using an HMO-POS plan, you’ll likely be required to have an in-network PCP, visit in-network care providers and acquire specialist referrals, but this isn’t always the case. However, out-of-network visits will typically cost more. HMO-POS plans do allow you to visit out-of-network dentists.

Medicare Advantage PPO Plans. These plans don’t limit you to visit in-network providers, though out-of-network services may cost more. PPO plans don’t require a PCP or referrals for specialist or hospital care.

Aetna Dual Eligible Special Needs Plan. D-SNP plans may be available to individuals who are eligible for both Medicare and Medicaid. These plans offer extra resources, including a personal care team to coordinate visits to providers, ​develop a care plan with your doctor and help you understand other parts of your plan, such as medications.

Other D-SNP benefits may include: prescription drugs, an allowance for over-the-counter products, eyeglasses and hearing aids and routine dental services.

Aetna’s D-SNP plans are limited to individuals in Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Nebraska, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia and West Virginia, though not all counties are eligible.

How Much Do Aetna Medicare Advantage Plans Cost?

The costs of an Aetna Medicare Advantage plan varies depending on the county in which you live and your particular health needs. For most plans, you must also continue to pay your Medicare Part B premium, which costs $164.90 in 2023.

Monthly premiumAnnual deductibleOffice visitsAnnual maximum out-of-pocket cost
HMO$0$0$5 primary $40 specialist$7,550 in-network
HMO-POS$99$0$5 primary $40 specialist$7,550 in-network
PPO$0-$99$0-$1,000$0-$5 in-network primary $25-$50 out-of-network primary $35-45 in-network specialist $55-60 out-of-network specialist$5,000-$7,550 in-network $6,000-$11,300 out-of-network
Dual Eligible Special Needs Plan (D-SNP)$0$0$0$8,300 in-network

*Most prices are based on Kings County, New York, ZIP code 11201. HMO-POS prices are based on Hudson, New Jersey, ZIP code 07310.

The Fine Print

Aetna Medicare Advantage plans vary widely based on your ZIP code. To find the plan that best suits your health needs and budget and is readily available in your location, enter your ZIP code into the Aetna Medicare website.

What Experts Say About Aetna Medicare Advantage

While Aetna Medicare Advantage plans will vary based on location, experts say overall, the insurance is reliable. “The Aetna Medicare Advantage HMO in Florida is a strong plan with regard to the depth and breadth of the doctor and facilities network, low cost co-pays and generous supplemental benefits,” says Elisa Karen Ball, a Medicare insurance specialist licensed in Florida who is also an Aetna Medicare Advantage plan beneficiary.

Ball notes, however, that those enrolled in an Aetna Medicare Advantage plan should check that all the information on the website is up to date to avoid unnecessary costs. Outdated information can lead to appointments with physicians who seem to be in-network, but are not, resulting in “a much higher co-pay or charge.” Should you choose to enroll, speak with your health care provider to ensure your plan is accepted.

Confused About Medicare Advantage Insurance Options?

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On Medicare Enrollment's Website

HealthCompare Insurance Services does not offer every plan available in your area. Currently it represents 18 organizations, which offers 52,101 products in your area. Please contact, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

HealthCompare Insurance Services represents Medicare Advantage HMO, PPO, and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. 

Frequently Asked Questions (FAQs)

Is Aetna Medicare Advantage the same as Medicare?

Yes, Aetna’s Medicare Advantage plans are offered under Medicare Part C, which allows private organizations like Aetna to offer Medicare health plan options.

Aetna Medicare Advantage plans provide the coverage of Medicare Parts A (hospital insurance and skilled nursing facility care) and B (medical insurance for doctors and outpatient care, physical and occupational therapy and home health care).

Is Aetna Medicare considered an Advantage plan?

Yes. Aetna Medicare falls under the Medicare Advantage program (Medicare Part C).

What are the downsides of a Medicare Advantage plan?

Along with the costs of an Aetna Medicare Advantage plan, you still have to pay the premium for Medicare Plan B in most cases. The Part B premium amount is $164.90 in 2023.



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