Aetna Medicare Advantage 2023 Review

Aetna Medicare Advantage is a low-cost option with strong benefits but average reviews for member satisfaction.

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Aetna is the fourth-largest provider of Medicare Advantage plans in 2022

. A CVS Health company since 2018, Aetna offers a strong array of benefits, with most Aetna Medicare Advantage plans including dental, vision and hearing coverage, and many plans offering additional (and valuable) perks. The plans are also largely low cost, with an estimated 84% of Medicare beneficiaries having access to a $0 premium Aetna plan.

Although the company's offerings are notable, Aetna Medicare Advantage plans score in the “average” range for member satisfaction and quality of care. Here’s what you should know about Aetna Medicare Advantage.

Aetna Medicare Advantage pros and cons

Aetna’s offerings have advantages and disadvantages.

Pros

  • Multiple benefits offerings: In addition to dental, vision and hearing, Aetna Medicare beneficiaries in many plans have access to benefits such as an over-the-counter allowance, meal delivery services and in-home health visits.

  • Strong $0 premium offerings: In 2023, Aetna estimates that 84% of Medicare-eligible beneficiaries in the U.S. have access to a $0-monthly-premium Aetna Medicare Advantage plan.

  • Broad availability: Aetna offers Medicare Advantage plans in 46 states and Washington, D.C., as well as stand-alone drug plans in all 50 states plus Washington, D.C.

  • Drug savings: All Aetna Medicare Advantage prescription drug plans come with a $0 deductible for all Tier 1 drugs, and nearly all offer a $0 copay on Tier 1 drugs. Aetna’s most popular formulary is also moving almost 300 drugs to lower-cost tiers.

Cons

  • Average star ratings: The Centers for Medicare & Medicaid Services gives Aetna’s 2023 Medicare Advantage plans an average weighted rating of 3.67 out of 5 stars. (The national average for all providers is 4.15.)

  • Mediocre member love: When it comes to member satisfaction, J.D. Power found that Aetna Medicare Advantage scored 796 points out of 1,000, below the industry average of 809. That places it sixth overall out of nine Medicare Advantage companies ranked.

Available Medicare Advantage plans

Aetna offers several kinds of Medicare Advantage plans, and they vary in structure, costs and benefits. Most plans offer dental, vision and hearing benefits as well as fitness benefits through SilverSneakers.

In general, Aetna offers Medicare Advantage prescription drug plans, or MAPDs, as well as stand-alone prescription drug plans and Medicare Advantage plans without drug coverage. The company has expanded its Medicare Advantage plan for veterans — Aetna Medicare Eagle — to 42 states in 2023. The plan is designed to complement the health care coverage veterans receive from the VA.

Aetna is also introducing the Aetna Medicare Longevity Plan in Pennsylvania in 2023. This is an Institutional Special Needs Plan, which is meant for members who live in nursing homes.

Plan availability may vary by county. Other plan offerings may include the following types:

A health maintenance organization, or HMO, generally requires that you use a specific network of doctors and hospitals. You may need a referral from your primary doctor to see a specialist, and out-of-network benefits are usually limited.

HMO point-of-service plans give you a bit more flexibility than traditional HMO plans. While you do have a primary doctor and you may still need a referral, you have more freedom to see out-of-network providers, although you’ll pay more for out-of-network care.

Preferred provider organization, or PPO, plans provide the most freedom, allowing you to see any provider that accepts the insurance. You may not need to choose a primary doctor, and you don’t need referrals to see specialists. You can seek out-of-network care, although it may cost more than seeing an in-network doctor.

If you have Medicare and Medicaid and live in one of the 30 states where Aetna offers this, you may be eligible for a Dual-Eligible Special Needs Plan, or D-SNP. These plans combine hospital, doctor and drug coverage with additional benefits such as a care coordinator to help you manage medical visits, a social worker to connect you with local and state programs and a member advocate to help you access your state benefits.

Additional benefits

Aetna Medicare Advantage offers most members access to routine vision, dental and hearing coverage. Some of its plans offer added benefits, many of which aren’t available in other Medicare Advantage plans. Here are a few standouts:

  • Fitness benefits: Many plans include SilverSneakers, which gives you access to participating gyms, community centers, online fitness classes, healthy living discounts and a fitness app, among other things.

  • In-home health visits: Some beneficiaries can request an in-person home health visit or telehealth call as an added convenience.

  • Concierge services for local resources: Aetna’s Resources for Living program can help beneficiaries find the support they need, whether that’s assistance at home, caregiver resources or help finding local activities.

  • Over-the-counter benefit: Some plans include an OTC benefit that allows you to pick up certain items, like vitamins and cold medications, from participating drugstores (or online) at no extra cost.

  • Meals at home: After you have a hospital stay, some plans offer to bring healthy meals to you to help you recuperate.

  • Telehealth: All 2023 plans offer virtual visits for primary care, urgent care and specialty care as well as mental health services. Telehealth is also available for physical, occupational and speech therapy, substance abuse treatment, kidney disease education and diabetes self-management training services.

Limited-area extras

Aetna Medicare Advantage also offers some benefit programs that are available for only a few plans in select locations, including the following:

  • Companionship benefit: In some D-SNP plans, Aetna pairs members with a companion who can help them run errands or keep them company for up to 10 hours per month.

  • Extra Benefits Card: Some members will have access to a preloaded debit card that can be used for over-the-counter items, healthy foods, utilities or transportation.

  • Memory Fitness: Some members will have access to a library of brain games and exercises as well as information on brain health.

  • Fresh Food Boxes: Certain members will be eligible to get a box of fresh fruits and vegetables at regular intervals, such as biweekly or monthly.

  • Fall prevention: In some Medicare Advantage plans, some members are eligible for a yearly allowance they can use for safety items that may decrease the risk of injuries from falls.

Customer service

Aetna Medicare Advantage members can contact their plan’s customer service in several ways:

Aetna Medicare Advantage service area

Aetna offers Medicare Advantage prescription drug plans in 46 states and Washington, D.C., including 2,014 counties

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Aetna expanded its Dual-Eligible Special Needs Plan to 30 states, and the Aetna Medicare Eagle plans — veteran-specific Medicare Advantage offerings — are available in 42 states.

Aetna is the third-largest for-profit Medicare Advantage provider, with more than 3.2 million Medicare beneficiaries enrolled in Aetna Medicare Advantage plans as of October 2022. The company added 323,000 members for the 2022 plan year, according to a report from health care analytics firm The Chartis Group

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Costs

Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs. One of the costs to consider is the plan’s premium, and Aetna has expanded its offering of $0 premium plans: Nearly three-quarters (74%) of plans in 2023 have no premium, and the company estimates that 84% of Medicare-eligible beneficiaries have access to a $0-monthly-premium Aetna Medicare Advantage plan.

For 2023 Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $7 to $198

Centers for Medicare & Medicaid Services. 2023 MA Landscape Source File (v 09 06 2022) (ZIP). Accessed Oct 19, 2022.
. For special needs plans, or SNPs, monthly premiums range from $8.50 to $41.00.

Even as a Medicare Advantage user, you’ll still be responsible for paying your Medicare Part B premium, which is $170.10 per month in 2022 ($164.90 in 2023), although some plans cover part or all of this cost.

Other out-of-pocket costs to consider include:

  • Whether the plan covers any part of your monthly Medicare Part B premium.

  • The plan’s yearly deductibles and any other deductibles, such as a drug deductible.

  • Copayments and/or coinsurance for each visit or service. For instance, there may be a $10 copay for seeing your primary doctor and a $45 copay for seeing a specialist.

  • The plan’s in-network and out-of-network out-of-pocket maximums.

  • Whether your medical providers are in-network or out-of-network, or how often you may go out-of-network for care.

  • Whether you require extra benefits, and whether the plan charges for them.

To get a sense of costs, use Medicare’s plan finding tool to compare information among available plans in your area. You can select by insurance carrier to see only Aetna plans or compare across carriers. You can also shop directly from Aetna’s website by entering your ZIP code.

Medicare star ratings

Average star rating, weighted by enrollment: 3.67

If you want Medicare’s take on Aetna’s plans, look no further than the Centers for Medicare & Medicaid Services' own star ratings, which rank each plan from best (5 stars) to worst (1 star). The agency bases these ratings on plans’ quality of care and measurements of customer satisfaction, and ratings may change from year to year.

All Medicare Advantage plans are evaluated on health plan measures, and Medicare Advantage plans that include prescription drug coverage are also evaluated on drug plan measures. Based on the most recent year of data and weighted by enrollment, Aetna’s 2023 Medicare Advantage plans get an average rating of 3.67 stars

Centers for Medicare & Medicaid Services. 2023 Star Ratings Data Table (ZIP). Accessed Oct 19, 2022.
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For comparison, the average star rating for plans from all providers for 2023 is 4.15

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet (PDF). Accessed Oct 19, 2022.
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Of Aetna members who are in contracts with a Medicare star rating, 85% are in contracts rated 4.0 or above as of September 2022

Centers for Medicare & Medicaid Services. Monthly Enrollment by Contract, 2022-09. Accessed Oct 19, 2022.
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To get an overall star rating, the CMS ranks contracts on 40 plan factors. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.) Here’s where Aetna plans really delivered, with average scores of 4.5 (out of 5) and above:

  • Care for older adults — medication review.

  • Medication reconciliation post-discharge.

  • Plan makes timely decisions about appeals.

  • Reviewing appeals decisions.

  • Health plan: Call center — foreign language interpreter and TTY availability.

  • Drug plan: Call center — foreign language interpreter and TTY availability.

  • Medicare Plan Finder price accuracy.

In several categories, Aetna contracts averaged a sub-3.0 score. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)

  • Monitoring physical activity.

  • Special needs plan care management.

  • Improving bladder control.

  • Rating of health plan.

  • Health plan: Members choosing to leave the plan.

  • Health plan quality improvement.

  • Drug plan: Members choosing to leave the plan.

  • Drug plan quality improvement.

  • Rating of drug plan.

  • Getting needed prescription drugs.

  • Medication adherence for diabetes medications.

  • Statin use for persons with diabetes.

You can find a plan’s rating with Medicare's plan finding tool.

Third-party ratings

A few companies weigh in on health plans or on the strength of the company in question, and we’ve included three here:

AM Best Financial Strength Rating: A (Excellent)

AM Best is a credit rating agency that specializes in the insurance industry. In December 2021, AM Best affirmed its Financial Strength Rating of A (Excellent) for Aetna Life Insurance Co. and the other operating entities of Aetna that are wholly owned subsidiaries of CVS Health. AM Best also affirmed its A (Excellent) FSR rating of Texas Health Aetna, as well as Allina Health and Aetna Insurance Co., which are joint ventures with subsidiaries of Aetna Inc

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An A rating in this category indicates that AM Best believes Aetna has an excellent ability to meet its ongoing insurance obligations.

J.D. Power Ranking: 6th out of 9

In its 2022 Medicare Advantage Study — the eighth it has done — J.D. Power measured member satisfaction with Medicare Advantage plans based on six factors: coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. On these measures, Aetna scored 796 points out of 1,000 and came in sixth out of the top nine Medicare Advantage providers

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NCQA Score Range: 2.5 to 4.0 out of 5

The National Committee for Quality Assurance rates health insurance plans on a 5-point scale (with 5 being best) based on quality of care, patient satisfaction and health plans’ efforts to keep improving.

In its September 2022 ratings of Aetna plans, the NCQA awarded ratings between 2.5 and 4.0, with the majority receiving ratings of 3.5 or 4.0. Four plans received a rating of 2.5: Aetna Better Health Premier Plan MMAI, Aetna Better Health of Texas, Aetna Better Health Inc. in Louisiana and Aetna Health Inc. in Georgia

NCQA. Health Plans. Accessed Oct 19, 2022.
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Compare Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

About Aetna

Aetna was founded in 1853 in Hartford, Connecticut, and the insurer became a subsidiary of CVS Health Corp. in 2018. The company’s headquarters are in Hartford.

Aetna’s health insurance offerings include medical, dental and pharmacy plans. Aetna offers individual and group health insurance, including Medicare Advantage plans, Medicare prescription drug plans and Medicare Supplement Insurance. As of October 2022, Aetna covers 10.6 million Medicare members in the U.S., including more than 3.2 million in Aetna Medicare Advantage plans and 6.1 million in stand-alone Medicare prescription drug plans.

CVS Health posted total revenues of $292.1 billion in 2021.

Read the NerdWallet reviews of these other Aetna Medicare offerings:

Find the right Medicare Advantage plan

It’s important to do your research before selecting a Medicare Advantage plan for yourself. Here are some questions to consider asking:

  • What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?

  • Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.

  • Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?

  • Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?

  • Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?

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