Aetna Medicare Advantage 2024: Pros, Cons, Costs, Benefits

Aetna Medicare Advantage pros and cons

Our full review

Aetna Medicare Advantage plans are largely low-cost, with an estimated 84% of Medicare beneficiaries having access to a $0-premium plan. And they score above average for member experience ratings with the Centers for Medicare & Medicaid Services (CMS), including health care quality and customer service^[0]

Here’s what you should know about Aetna Medicare Advantage, which is the fourth-largest provider of Medicare Advantage plans^[0]

What is the star rating for Aetna Medicare Advantage?

Average star rating, weighted by enrollment: 4.14

Aetna Medicare Advantage plans are rated slightly above the industry average, receiving an average rating of 4.14 stars out of 5 from CMS for 2024, weighted by enrollment. For comparison, the average weighted star rating for all plans is 4.04^[0]

Of Aetna members who are in contracts with a Medicare star rating, 87% are in contracts rated 4 stars or above as of March 2024^[0]

CMS maintains its own database of 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.

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

What does Aetna Medicare Advantage cost?

About 7 in 10 Aetna plans in 2024 have no premium^[0]

Some Medicare Advantage plans cover part or all of your Part B premium^[0]

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 three 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.

What additional benefits does Aetna Medicare offer?

Aetna Medicare Advantage offers all 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: In addition to the SilverSneakers program, some plans may offer a fitness reimbursement allowance that members can put toward activities (like pickleball) or fitness supplies, including athletic shoes. 

• Medicare Payment Card: On some plans, members will get a quarterly allowance they can put toward things like medical expenses for in-network services or certain over-the-counter wellness items. 

• Expanded $0 copays: Many Aetna plans offer a $0 copay for labs and for visits to your primary care physician. In 2024, all plans will offer a $0 copay for preventive and diagnostic colonoscopies, so long as they’re with in-network providers. 

• MinuteClinic access: Since Aetna is a CVS Health company, members in plans that don’t require a primary care physician (PCP) can visit any MinuteClinic location for medical needs and pay the same copay they would pay to see their PCP. 

• 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.

• Meals at home: After a hospital stay, some plans offer to bring healthy (fresh) meals to your door to help you recuperate.

Aetna Medicare Advantage plan types

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

In general, Aetna offers Medicare Advantage prescription drug plans (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 43 states in 2024. The plan is designed to complement the health care coverage veterans receive from the VA.

Aetna also introduced Aetna Medicare SmartFit plans, which offer a fitness reimbursement benefit of $600 to $1,200 per year.

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 March 2024, 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, which is a joint venture 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

In its 2023 Medicare Advantage Study — the ninth it’s done so far — J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the five biggest Medicare markets, and here’s how Aetna ranked out of all major providers in the locations it offers plans^[0]

• Florida: 3rd out of 6. 

• New York: 7th out of 8.

• Pennsylvania: 3rd out of 7. 

• Texas: 5th out of 6. 

NCQA Score Range: 2.5 to 4.5 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 2023 ratings of Aetna plans, the NCQA awarded ratings between 2.5 and 4.5, with the majority receiving ratings of 3.5 or 4.0. Two plans received a rating of 2.5: 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.

Aetna expanded its Institutional Special Needs Plans (I-SNPs) into Ohio and New York and widened availability in Pennsylvania, and Aetna Medicare Eagle plans — veteran-specific Medicare Advantage offerings — are available in 43 states.

Aetna is the third-largest for-profit Medicare Advantage provider, with more than 3.8 million Medicare beneficiaries enrolled in Aetna Medicare Advantage plans. The company added 544,000 members for the 2024 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 Medicare Advantage customer service

Aetna Medicare Advantage members can contact customer service in a few ways:

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

• Find the specific phone number for your plan.

• Request a call.

• Send an email.

What’s the difference between Medicare and Aetna Medicare Advantage?

Original Medicare is health insurance provided by the federal government — specifically, Medicare Part A and Part B. Medicare Advantage is a bundled alternative to Original Medicare, provided by private insurance companies like Aetna, that includes Medicare Part A, Part B and usually Medicare Part D.

Because Medicare Advantage is provided by private insurers, you typically must get medical care from providers within that insurer’s network.

Does Aetna Medicare Advantage have OTC benefits?

Most Aetna Medicare Advantage plans include an over-the-counter benefit that gives members a certain amount of money throughout the year to spend on over-the-counter health and wellness products. OTC benefits may vary by plan, and not all plans include them.