Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

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UPDATED: Sep 14, 2020

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Aetna Medicare

Financial Strength

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Aetna is one of the biggest names in health insurance across the U.S. As of 2017 statistics, Aetna stood as the third largest health insurance company, behind only United Health Group and Anthem based on revenue and enrolled members. Aetna provides individual health insurance, group coverage, and Medicare plans to more than 23 million people across the country.

Table of Contents

About Aetna

Aetna originally started out as a fire insurance company founded in 1819 in Hartford, Connecticut. In 1853, the company shifted course, incorporating as Aetna Life Insurance Company. Diversification began in 1891 with the addition of accident insurance, leading the way for Aetna’s entry into the health insurance market in 1899.

Aetna expanded into the global insurance market in 1960 when they purchased a Canadian life insurance company. The company’s diverse interests took a turn in 1996, when Aetna sold off all of its property and casualty insurance, focusing in on the health insurance market; that focus was enhanced by a merger with U.S. Healthcare. By 2000, Aetna was known as solely a health insurance company and was on its way to becoming a giant.

The company has been serving the Medicare market since 1966. They were quick to enter the Medicare Advantage market under the Affordable Care Act. A proposed merger with Humana that would have made the combined company a force to be reckoned with in the Medicare industry was killed in the courts in 2017. The merger did not stop Aetna from adding 250,000 Medicare members in the first quarter of 2018 alone and moving up the list of biggest Medicare providers in the country.

Aetna’s new proposed merger with CVS, which at the time of this review appears poised to go through, will still have an impact on Medicare, according to a Kaiser Foundation study. Either way, Aetna will remain one of the biggest names in Medicare.
Aetna Medicare plans are available in most states, although not all. Plans are sold directly through the company website.

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Aetna Medicare Plans

Not surprisingly, Aetna has a full range of Medicare products available: Advantage, Part D, and Supplement. Plan availability varies from state to state; we used a Southern California zip code as our sample for the purpose of this review.

Medicare Advantage Plans

Aetna offers three Advantage plans in our sample area, all of which include prescription drug coverage. There are two HMO plans, both of which are zero-premium, and one PPO plan. All of the plans have a $0 deductible.

Medicare Select is the first HMO plan. It has $0 copays for either office visits or specialists and a $260 per day copay for the first five days of a hospital stay ($0 thereafter). Hearing, vision, and dental are not included in this plan, but they can be added for a monthly premium.

Like all of the plans, Select includes prescription drug coverage. Tier 1 drugs have a $0 copay, Tier 2 a $5 c pay. Tiers 3 and 4 have a $42 and $100 copay respectively, while Tier 5 is covered with a 33% coinsurance.

Medicare Prime is also an HMO plan and is again a $0 premium plan. This plan has similar copay amounts, with no charge for office visits or specialists, but has a lower out of pocket maximum. It also has a $0 copay for hospital stays. Fees under the plan are lower in many areas, although prescription drug coverage is the same as the Select plan.

Unlike Select, Prime does include limited coverage for hearing, dental, and vision. There is no premium for these services.

Medicare Choice is the only PPO plan among the Advantage offerings. Because of the much wider selection of providers offered by a PPO, this plan does have a monthly premium. Primary care visits have a $10 copay, and specialist visits have a $40 copay. Hospital stays have a $225 copay for the first five days, $0 thereafter.

Prescription coverage on this plan is the same as that offered on the HMO plans. This plan includes a prescription eyewear benefit, but dental and hearing coverage are optional and can be added for an additional premium.

Medicare Part D (Prescription Drug) Plans

In our sample area, there are three Part D plans available. All of the plans have $0 deductibles for Tier 1 & 2 drugs.

Select, the lowest priced plan, has a $405 deductible for Tiers 3, 4, and 5. Copays start at $0 for Tier 1 and $3 for Tier 2, going up from there. There is a $5,000 out of pocket maximum with this plan.

Saver has a $375 deductible on Tiers 3, 4, and 5. The Tier 1 copay is $1, Tier 2 is $2, and increase from there, although most copays are lower than with the Select plan. Again, out of pocket maximum is $5,000.

The final plan, First Health Part D Value Plus, has no deductible at any level. Again, Tier 1 and 2 drugs have copays of $1, and $2 respectively, but the other copays are more in line with the higher rates on the Select plan. Again, the out of pocket limit is $5,000 with this plan.

All of these plans can be purchased to compliment a regular Medicare plan, but not one of Aetna’s Advantage plans. All Advantage plans already include Part D.

Medicare Supplement

In our sample area, Aetna offers several of the standardized Medicare Supplement plan options.

Like all companies, they start at the base level Plan A, which covers coinsurance amounts for medical, hospital, and hospice, along with the first three pints of blood each year.

Additional plans available are B, F, G, and N. F, which offers the most comprehensive coverage of all the standard plans, is available as a high deductible plan in some areas.


As noted, the two HMO Medicare plans from Aetna are $0 premium – this means you do not pay an additional amount beyond your regular Medicare premium. The PPO plan has a monthly premium of $79.

While Select includes dental, vision, and hearing at no cost, adding them to the other plans has an additional premium.

For Prime there are several options:

  • Dental alone, $11/month
  • Dental plus eyewear, $18/month
  • Dental plus eyewear and hearing, $22/month

For Choice (which includes eyewear already), there are two options:

  • Dental only, $23/month
  • Dental plus hearing aids, $26/month

Part D plan rates for our sample area are:

  • Select, $19.70/month
  • Saver, $31.60/month
  • Value Plus, $56.30/month

The Aetna site does not offer rates for Supplement plans at this time.

Overall, Aetna’s Medicare plans are well priced for the coverage they provide. The company seems to have made adjustments to rates since the last time we reviewed them; all rates appear to be a flat monthly amount, which makes shopping for Medicare insurance a lot easier.

Ratings and Consumer Reviews

Both of Aetna’s HMO plans have a 3.5-star rating from Medicare, and the PPO plan has a 3-star rating. This indicates that Aetna definitely has some room for improvement.

The National Committee for Quality Assurance rates Aetna solidly across all states for Medicare, with a 4.5 rating across the board. Although the underlying ratings in each state vary, there is not one state where they offer coverage that ranked any lower. That is a very positive sign for Aetna.

The Better Business Bureau (BBB) gives Aetna, Inc. an A+ rating. There is a total of 568 complaints on file in the past three years. Given that those complaints cover all of Aetna’s approximately 23 million customers in all areas of health insurance, that is a really low complaint volume. Only 177 of those complaints were closed in the past 12 months.

Consumer Affairs has 789 reviews of Aetna, with an overall 1.5-star rating. That rating is based only on the 106 ratings submitted in the past year. Bearing in mind again the size of this company, and the fact that these ratings apply to all of the company’s business and not only Medicare, those numbers are again quite low.

We would like to see Aetna’s Medicare star rating come up a bit, and it will be important to watch how things change if and when the current merger with CVS is completed.

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The Bottom Line

Much like the last time we reviewed this company, Aetna is on the verge of a major change. When the acquisition by pharmacy giant CVS is complete, there may be some changes to the way Medicare plans are handled. As of the time of this review, however, Aetna has some good plans at good prices and appears to have a pretty good reputation as well. Those in the market for Medicare coverage will find their approach straightforward and their options affordable and easy to choose from.

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