Aetna Medicare Advantage 2023 Review

Aetna is the fourth-largest provider of Medicare Advantage plans^[0]

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.

Aetna 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^[0]

For comparison, the average star rating for plans from all providers for 2023 is 4.15^[0]

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^[0]

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

What does Aetna Medicare Advantage cost?

Costs for Medicare Advantage plans will depend on your plan, geographic location and health needs.

Premiums

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^[0]

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

Copays, coinsurance and deductibles

Requirements for copays, coinsurance and deductibles vary depending on your plan, location and the services you use. 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.

Here are examples of Aetna Medicare Advantage costs for the most popular plans in a mid-range city:

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.

Aetna Medicare Advantage plan types

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 also introduced 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:

Aetna 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^[0]

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^[0]

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^[0]

Aetna Medicare Advantage service area

Aetna offers Medicare Advantage prescription drug plans in 46 states and Washington, D.C., including 2,014 counties^[0]

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 287,000 members for the 2023 plan year, according to a report from health care analytics firm The Chartis Group^[0]

Read the NerdWallet reviews of these other Aetna Medicare offerings:

• Aetna Medicare Supplement Insurance (Medigap).

• Aetna Medicare Part D prescription drug plans.

Aetna customer service

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

• Call the main national service number, available from 8 a.m. to 8 p.m. local time daily, at 855-335-1407 (TTY: 711).

• Find the specific phone number for their plan.

• Request a call.

• Send an email.

• Join an online or in-person member seminar.