Aetna Medicare Advantage Review (2026): Cost, Pros & Cons

Aetna delivers three Medicare Advantage plan types to fit different healthcare preferences and budgets, including:

• HMO: HMO plans require you to choose a primary care physician who coordinates your care and manages referrals to specialists. You’ll need to use in-network doctors and hospitals except for emergency or urgent care, but these plans have lower premiums and out-of-pocket costs.
• HMO-POS: HMO-POS plans combine the structure of an HMO with limited out-of-network coverage. You'll still need a primary care physician and referrals for in-network specialists, but you can see out-of-network providers for certain services at higher costs.
• PPO: PPO plans give the most flexibility without requiring a primary care physician or referrals to see specialists. You can visit any doctor or hospital, though staying in-network costs less, and out-of-network care is covered at higher rates.

All Aetna Medicare Advantage plans include enhanced prescription drug benefits rather than basic Part D coverage. Enhanced benefits mean lower copays for common medications and broader formulary coverage compared to basic plans.

Aetna offers Medicare Advantage plans in 43 states and Washington, D.C., with plan availability varying by location. The insurer has different combinations of HMO, HMO-POS and PPO plans depending on your state, with some areas providing more plan choices than others.

Aetna's Medicare Advantage plans have an average CMS Star Rating of 3.88 across all states and plan types, slightly above the national average of 3.81. CMS star ratings measure plan quality based on customer satisfaction, care coordination and health outcomes, with higher scores indicating better performance.

Aetna's HMO and PPO plans perform especially well, with both scoring above their respective national averages. HMO plans earn 4.14 stars compared to the 3.86 national average, while PPO plans score 4.05 stars versus 3.63 nationally. HMO-POS plans score below the national average at 3.41 stars, compared to 4.01 nationally, though these plans represent a smaller portion of Aetna's options.

Aetna's Medicare Advantage plans cost an average of $48.59 per month across all plan types and states. About 62% of Aetna plans charge no monthly premium, making them affordable for people on fixed incomes.

Aetna’s HMO plans have the lowest average premiums at $7 per month, which is $19 below the national average, though most plans carry no monthly premium. These plans have an average maximum out-of-pocket limit of $5,020, about $113 higher than the national average. HMO-POS plans average $6 per month, $41 below the national average, with 66 percent available at no premium. However, they have higher out-of-pocket limits, averaging $5,643, or $572 above the national average.

PPO plans are more expensive, averaging $88 per month, which is $44 above the national average, and about 56 percent of plans have no monthly premium. The higher cost reflects greater flexibility for out-of-network care. In return, PPO plans give the strongest financial protection, with an average maximum out-of-pocket limit of $5,168, or $1,099 below the national average, helping balance the higher monthly premiums.

Aetna Medicare Advantage plans have added benefits that go beyond what Original Medicare provides. You’ll get extras like preventive services, fitness programs, wellness resources, and easier access to clinical support. Not all benefits are available on every plan or in every location, so be sure to read plan documents to confirm access.

• Dental, vision and hearing coverage: Many plans include routine dental cleanings, exams and X-rays at no additional cost. Vision benefits cover annual eye exams, and some plans have allowances for eyeglasses or contact lenses. Hearing benefits include annual hearing exams and coverage for hearing aids and fittings.
• SilverSneakers fitness membership: Get access to thousands of participating gyms and fitness centers nationwide at no additional cost. The program includes in-person group fitness classes, online workout sessions, the SilverSneakers GO mobile app and at-home workout kits for people who can't visit fitness locations.
• Over-the-counter allowance: Plans have a quarterly allowance for approved health and wellness products including pain relievers, cold and allergy medications, first aid supplies and dental care items.
• 24-Hour nurse line: Registered nurses are available around the clock to answer health questions, help determine appropriate care settings and provide information about symptoms and treatments. The service is available at no additional cost but doesn't replace medical advice from your doctor.
• Telehealth services: Most plans cover virtual appointments with primary care physicians and specialists at the same cost as in-person office visits. You can connect with providers via phone or video for follow-up appointments, prescription refills and mental health services.
• CVS Health product discount: You’ll get 20% off select CVS Health brand products both in-store and online.

Aetna offers multiple Medicare Advantage plan types to fit different healthcare needs and budgets. Use the table below to filter plans by state and compare HMO, HMO-POS and PPO options to find coverage that works for you.

We rate the best health insurance providers based on premiums, out-of-pocket expenses, customer experience, claims denial rates and plan selection.

MoneyGeek weights health insurance provider scores as follows:

• Affordability (60%): When scoring providers on affordability, we considered monthly premiums, deductibles, and maximum out-of-pocket (MOOP) costs. We weighted these factors as follows within the affordability score: monthly premiums (66.67%), deductible (16.67%), MOOP (16.67%).
• Customer Experience (30%): Centers for Medicare & Medicaid Services (CMS)’s Quality Rating System (QRS) overall rating for health-insurance plans. This is a 5-star rating system used to help consumers compare health plans on the Health Insurance Marketplace. Ratings are calculated based on three main categories: Medical Care, Member Experience, and Plan Administration. Providers with the highest overall rating get the highest score
• Denial Rate (10%): Denial rate is the percentage of submitted claims or applications that are rejected instead of approved. Providers with the lowest denial rate get the highest score.

Data sources

Health insurance plan and provider data was updated with the Centers for Medicare & Medicaid Services (CMS) exchange data released in October 2025 for the 2026 enrollment period as well as manual collection of health plan data from state insurance marketplaces for 22 states.

Sample consumer profile

We collected data on all available health plans for consumers ages 18, 26, 40, 50 and 60. Monthly premiums are based on a 40-year-old buyer unless otherwise noted, such as the category for seniors. We analyzed plans for each cited metal tier, which include Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.