Aetna vs. Blue Cross Blue Shield (2026 Comparison)

Blue Cross Blue Shield sells ACA marketplace health insurance plans in 36 states. Aetna no longer offers ACA plans in the U.S.

BCBS States

Alabama, Alaska, Arizona, Arkansas, California, Delaware, Florida, Idaho, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wyoming

BCBS Plan Types

• HMO: Requires a primary care physician and specialist referrals. Coverage limited to in-network providers except in emergencies.
• POS: Requires a primary care physician for referrals but allows out-of-network visits at higher cost.
• EPO: Covers in-network providers only, no referrals needed for specialists. More flexibility than an HMO, less than a PPO.
• PPO: No primary care physician or referrals required. Covers in-network and out-of-network care; in-network costs less.

Aetna and Blue Cross Blue Shield are widely available across the U.S., with Aetna offered in 44 states and BCBS in 37. Aetna provides Plans A, B, F, G, and N in most states, covering the core Medigap options, with some states like Vermont and New Jersey having additional Plans C and D. Blue Cross Blue Shield generally has a broader range of options, including Plans K, L, M, and occasionally C and D. Ultimately, Aetna’s offerings are more consistent across states, while Blue Cross Blue Shield varies more by state but often includes expanded plan choices.

Aetna has Medicare Advantage plans in 44 states with HMO, HMO-POS and PPO options, while Blue Cross Blue Shield operates in 31 states and adds PFFS plans to its lineup. Aetna provides broader geographic coverage, operating in states like Colorado, Connecticut, Iowa and Kentucky where BCBS doesn't offer Medicare Advantage, though BCBS reaches Idaho, Montana and New Mexico where Aetna isn't available.

• Aetna Availability: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin
• BCBS Availability: Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Idaho, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Washington, West Virginia