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Aetna vs. Anthem: Medicare Advantage Comparison
Aetna offers Medicare Advantage plans in more states and enjoys higher ratings than Anthem.
Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 18 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Aetna Medicare Advantage offers a strong menu of benefits with widely available plans and member experience ratings that are above the industry average. Aetna’s star ratings from the Centers for Medicare & Medicaid Services (CMS) are just below average for major providers.
Anthem-branded Medicare Advantage plans are available in only 14 states, and the company’s average star ratings and member experience scores from CMS fall below average. Anthem also offers 4-star plans in only three states.
Here’s a look at how Aetna and Anthem compare.
Aetna Medicare Advantage
Aetna
3.98
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Aetna Medicare Advantage plans are widely available and offer a variety of extra benefits. Member experience scores are also high, although star ratings fall just below the industry average.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.79 (Above average)
Pros
In addition to dental, vision and hearing, many plans offer perks like an over-the-counter allowance, meal delivery and in-home health visits.
More than 8 in 10 Medicare-eligible beneficiaries have access to a $0-premium Aetna plan.
Available in 46 states and Washington, D.C.
Cons
Customer satisfaction lands below industry average in some major Medicare markets.
States available
46 states and Washington, D.C.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.79 (Above average)
Pros
In addition to dental, vision and hearing, many plans offer perks like an over-the-counter allowance, meal delivery and in-home health visits.
More than 8 in 10 Medicare-eligible beneficiaries have access to a $0-premium Aetna plan.
Available in 46 states and Washington, D.C.
Cons
Customer satisfaction lands below industry average in some major Medicare markets.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Anthem's plans offer a range of benefits and flexible care, but plans are available in only 14 states and receive below-average star ratings.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Low (49% or less)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.89 (Below average)
Pros
Most plans cover prescription drugs and offer some coverage for dental, hearing and vision care.
Anthem's "Essential Extras" benefits let members choose extra plan benefits that meet their needs, such as $500/year toward assistive devices or $150/quarter toward household utilities.
Cons
Available in only 14 states.
Below-average overall star rating and member experience scores from CMS.
4-star rated plans available in only three states.
States available
14 states
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Low (49% or less)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.89 (Below average)
Pros
Most plans cover prescription drugs and offer some coverage for dental, hearing and vision care.
Anthem's "Essential Extras" benefits let members choose extra plan benefits that meet their needs, such as $500/year toward assistive devices or $150/quarter toward household utilities.
Cons
Available in only 14 states.
Below-average overall star rating and member experience scores from CMS.
4-star rated plans available in only three states.
Other factors to consider
Provider size
Part of the Blue Cross Blue Shield collective, which is the 3rd-largest provider of Medicare Advantage plans.
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).
