Pros Explained
- Offers very low Part D premiums: Aetna’s SilverScript SmartSaver plan is an ultra-low-cost prescription drug plan, with an average monthly premium of only $11.19.
- Medicare Advantage plans offer additional coverage during the gap: Some Aetna plans offer $0 copays on generic drugs in the Medicare donut hole.
- Most Medicare Advantage plans come with many extra benefits: These include fitness benefits, over-the-counter benefits, meals-from-home after a hospital or nursing facility stay, telehealth benefits, and ER and urgent care coverage worldwide.
Cons Explained
- Below-average J.D. Power rating for Medicare Advantage plans in some regions: In a study measuring customer satisfaction, Aetna ranked below average in New York, Pennsylvania, and Texas.
- Higher than average Medigap Plan G premium: Of the providers we reviewed, Aetna charged the most on average for the popular Medicare Supplement Plan G.
Third-Party Ratings
Aetna’s customer satisfaction rankings are favorable but still not as high as some competitors. We looked at star ratings from the National Committee for Quality Assurance (NCQA), a nonprofit organization that evaluates plan quality and customer experience on a 5-star scale. Aetna earned 3.8 stars. It also garnered a Medicare star rating of 3.6 stars for its Medicare Advantage plans, while its Medicare Part D prescription drug plans earned a 3.5.
Aetna had a mixed performance in the 2023 J.D. Power U.S. Medicare Advantage Study, which surveyed customers about their satisfaction with providers. For example, the company scored second-to-last in New York while scoring third-highest in Florida and Pennsylvania.
Policies Available
Medicare Advantage (Part C) Plans
Medicare Advantage plans include Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Most Medicare Advantage plans from Aetna also include prescription drug coverage with mail delivery, dental, vision, and hearing coverage, and other benefits.
Aetna offers the following plan types:
- HMO plans, which require you to use only doctors and facilities that are in-network for non-emergencies
- HMO-POS plans, which may allow you to see out-of-network providers for more money
- PPO plans, which don’t require you to have a primary care doctor or get referrals to see a specialist and allow you to see out-of-network doctors for an added cost
- Dual Eligible Special Needs Plans (D-SNP), which are available to people who qualify for both Medicare and Medicaid—but Aetna only offers them in Virginia and New Jersey
Some plans offer $0 copays for Tier 1 and Tier 2 generic medications during the coverage gap. And some plans also offer $0 in-network physician and lab copays. Aetna was our top pick for additional drug coverage during the gap among the best Medicare Advantage providers.
Part D Prescription Drug Plans
Aetna won our attention for providing the most value among the best Medicare Part D providers. Aetna offers three prescription drug plans, designed to provide drug coverage for people with Medicare Part A and/or Part B or certain Medicare Advantage plans that don’t include drug coverage. The best plan for you will depend on the medications you take.
Here are the three plans:
- SilverScript SmartSaver: Offers ultra-low premiums (but not the lowest copays), making it ideal for people who don’t take prescriptions or only take a few generics
- SilverScript Choice: A higher premium and lower copays for people taking more medications
- SilverScript Plus: A higher premium but a $0 deductible, low copays in the initial coverage phase, and $0 copays for some medications during the coverage gap
Medicare Supplement Plans (Medigap)
More than 1.4 million customers use Aetna’s Medigap policies. Medigap policies are intended to help pay copays and coinsurance and cover deductibles. Private insurers sell these plans, but coverage is standardized regardless of the insurer. In most states, plans are identified by letters.
Aetna offers plans A, B, C, F, G, high-deductible F and G, and N. We found some of Aetna’s Medicare Supplement plans to be among the priciest available. Therefore, you won’t find the company on our Best Medicare Supplement Insurance Companies list.
Cost
Overall, the costs of Aetna’s Medicare Advantage plans are slightly better than average. Here are the Aetna prices we found:
- Average MA premium for plans with drug coverage is $16.73 in 2024
- Average drug deductible:$107.43
- Average out-of-pocket expenditure: $5,566.89.
Of the largest Medicare Advantage providers we surveyed, Aetna had a fairly low premium, but the deductible and average out-of-pocket expenditure were about average.
Customer Service
Aetna maintains extended customer service hours from 8 a.m. to 8 p.m. Eastern time on weekdays. For Medicare Advantage and prescription drug plans, call 1-855-335-1407. For Medicare Supplement plans, call 1-800-358-8749. You can also request a call through an online form. Once you're a member, you can chat with the company online through your online account. But Aetna doesn’t offer weekend hours like some other Medicare providers.
How We Review Medicare Advantage Providers
To identify which Medicare insurance companies to review, we analyzed business and market insight databases including Statistia, Plunkett, and Gale. We also considered user-generated data from Google to determine public interest and trends in Medicare plans.
We collected data from third-party rating agencies like the credit rating agency AM Best and the National Committee for Quality Assurance (NCQA), an independent organization that rates health insurance plans on quality and customer satisfaction. We also gathered data from government websites and databases provided by the Centers for Medicare and Medicaid Services (CMS) such as CMS.gov and Healthcare.gov, and directly from companies via websites, media contacts, and existing partnerships. The data collection process spanned Sept. 15 to Sept. 29, 2023.
We then developed a quantitative model that scores each Medicare Advantage provider based on four major categories and 22 criteria that are crucial in evaluating the company's offerings and benefits.
We weighted the four categories as follows for this article:
- Plan features: 35%
- Plan quality and customer satisfaction: 30%
- Cost: 20%
- Availability: 15%
Read our full methodology for reviewing Medicare insurance providers.
