Aetna vs. Blue Cross Blue Shield (2026 Comparison)

Aetna vs. Blue Cross Blue Shield: ACA Health Insurance

Blue Cross Blue Shield (BCBS) has ACA marketplace coverage in 36 states, while Aetna stopped selling ACA plans as of January 1, 2026. BCBS sells four plan types, giving you flexibility in how you access care. The insurer earns an average Quality Rating System (QRS) score of 77.72 out of 100 and reports an average claims denial rate of 19%.


Availability	N/A	36 States
Plan Types	N/A	HMO, POS, EPO, PPO
Avg. QRS Score	N/A	77.72
Avg. Denial Rate	N/A	19%

Blue Cross Blue Shield sells ACA marketplace health insurance plans in 36 states, but Aetna does not have ACA plans anywhere in the U.S. anymore.

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 plans require you to choose a primary care physician and get referrals to see specialists, with coverage limited to in-network providers except for emergencies.
- POS plans mix HMO and PPO features by requiring a primary care physician for referrals but allowing you to see out-of-network doctors at a higher cost.
- EPO plans only cover in-network providers without referrals to see specialists, giving you more freedom than an HMO but less flexibility than a PPO.
- PPO plans let you see any doctor or specialist without referrals and covers both in-network and out-of-network care, though you'll pay less when you stay in-network.
HMO
N/A
$762
$678
POS
N/A
$756
$725
EPO
N/A
$857
$731
PPO
N/A
$899
$803
Blue Cross Blue Shield’s ACA premiums are higher than national averages across all plan types, with monthly costs running $30 to $125 above typical marketplace rates depending on plan type. On average, BCBS HMO plans cost $762 per month compared to the $678 national rates, while POS plans cost $756 versus $725 nationally. The gap is larger for EPO and PPO plans at $857 and $899, respectively.
Overall QRS Score
N/A
77.72
Medical Care QRS Score
N/A
73.96
Member Experience QRS Score
N/A
95.91
Plan Administration QRS Score
N/A
81.36
Avg. Denial Rate
N/A
19%
Blue Cross Blue Shield earns an overall Quality Rating System (QRS) score of 77.72 out of 100, with member experience as its highest-rated category at 95.91. The insurer scores 73.96 for medical care quality and 81.36 for plan administration, indicating solid but not exceptional performance in these areas. BCBS denies about 19% of claims on average, meaning roughly one in five claims may require an appeal or lead to out-of-pocket costs. The strong member experience score shows effective customer service and communication, while the company has room for improvement in care coordination and health outcomes.


HMO	N/A	$762	$678
POS	N/A	$756	$725
EPO	N/A	$857	$731
PPO	N/A	$899	$803


Overall QRS Score	N/A	77.72
Medical Care QRS Score	N/A	73.96
Member Experience QRS Score	N/A	95.91
Plan Administration QRS Score	N/A	81.36
Avg. Denial Rate	N/A	19%

Aetna vs. Blue Cross Blue Shield: Medicare Supplement

Both Aetna and Blue Cross Blue Shield have Medicare Supplement coverage across much of the country, with Aetna available in 44 states and BCBS in 37. BCBS has a wider selection with all 10 standard plan types compared to Aetna’s seven options, though availability varies by location. Both insurers also offer high-deductible versions of Plans F and G, which reduce monthly premiums in exchange for higher upfront costs before coverage begins.


Availability	44 States	37 States
Plan Types	A, B, C, D, F, G, N	A, B, C, D, F, G, K, L, M, N
High-Deductible F and G	Yes	Yes
Dominant Pricing Style	Attained Age	Attained Age

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.


Alabama	A, B, F, G, N	A
Alaska	A, F, G, N	A, C, G, N
Arizona	A, B, F, G, N	A, C, D, F, G, N
Arkansas	A, F, G, N	A, C, F, G, N
California	A, B, F, G, N	A, F, G, N
Colorado	A, B, F, G, N	N/A
Connecticut	N/A	N/A
Delaware	A, B, F, G, N	A, B, C, D, F, G, N
Florida	A, B, F, G, N	A, B, C, D, F, G, K, L, M, N
Georgia	A, F, G, N	N/A
Hawaii	N/A	N/A
Idaho	A, B, F, G, N	A, C, F, G, K, N
Illinois	N/A	N/A
Indiana	A, B, F, G, N	N/A
Iowa	A, B, F, G, N	A, D, F, G, N
Kansas	A, B, F, G, N	A, F, G, K, L, N
Kentucky	A, B, F, G, N	N/A
Louisiana	A, B, F, G, N	A, B, F, G, N
Maine	N/A	N/A
Maryland	A, B, F, G, N	A, B, F, G, L, M, N
Massachusetts	N/A	Meets state standards
Michigan	A, B, F, G, N	A, D, F, G, N
Minnesota	Meets state standards	Meets state standards
Mississippi	A, B, F, G, N	A, B, C, D, F, G
Missouri	A, B, F, G, N	N/A
Montana	A, B, F, G, N	A, F, G, N
Nebraska	A, B, F, G, N	A, B, C, F, G, L, N
Nevada	A, B, F, G, N	N/A
New Hampshire	A, B, F, G, N	N/A
New Jersey	A, B, C, D, F, G, N	A, C, D, F, G, K, N
New Mexico	A, F, G, N	A, F, G, N
New York	N/A	N/A
North Carolina	A, B, F, G, N	A, G, K, N
North Dakota	A, B, F, G, N	A, C, F, G, L, N
Ohio	A, B, F, G	N/A
Oklahoma	A, B, F, G, N	A, F, G, N
Oregon	A, B, F, G, N	A, C, F, G, K, N
Pennsylvania	A, B, F, G, N	A, B, F, G, N
Rhode Island	A, F, G, N	A, F, G, N
South Carolina	A, B, F, G, N	A, B, C, D, F, G, K, L, N
South Dakota	A, B, F, G, N	A, D, F, G, N
Tennessee	A, B, F, G, N	A, C, D, F, G, N
Texas	A, B, F, G, N	A, F, G, N
Utah	A, B, F, G, N	A, C, F, G, K, N
Vermont	A, B, C, D, F, N	C, D, F, G, N
Virginia	A, B, F, G, N	A, B, F, G, L, M, N
Washington	N/A	A, C, F, G, K, N
West Virginia	A, B, F, G, N	A, C, D, F, G, N
Wisconsin	Medigap Basic Plan	Medigap Basic Plan
Wyoming	A, B, F, G, N	A, G, K, N


A	$206	$279	$242	$360
B	$244	$287	$286	$368
C	$276	$285	$325	$369
D	$217	$283	$250	$372
F	$185	$215	$215	$285
G	$144	$170	$169	$225
K	N/A	$107	N/A	$131
L	N/A	$206	N/A	$273
M	N/A	$307	N/A	$400
N	$172	$204	$206	$274

Aetna has lower Medicare Supplement premiums than Blue Cross Blue Shield across comparable plans and age groups. For example, a 65-year-old pays $144 per month for Aetna’s Plan G versus $170 with BCBS, while a 75-year-old pays $169 with Aetna compared to $225 with BCBS, saving roughly $672 annually. BCBS does provide cost-sharing Plans K, L, and M that Aetna does not, with Plan K starting at $107 per month for a 65-year-old, making it the most affordable option for those comfortable covering 50% of most costs until the annual limit.

Aetna vs. Blue Cross Blue Shield: Medicare Advantage

Aetna sells Medicare Advantage plans in 44 states, with much wider availability than Blue Cross Blue Shield’s 31-state footprint. Both provide similar plan types, though BCBS adds PFFS options that let members see any Medicare-accepting provider. Aetna has a slight quality advantage with an average CMS star rating of 3.88 versus 3.79 and includes enhanced drug coverage as standard, while BCBS varies between basic and enhanced prescription benefits. Affordability also sets Aetna apart, with 62% of its having $0 monthly premiums compared to 41% for BCBS, making it a stronger choice for seniors seeking to minimize costs beyond Part B.


Availability	44 States	31 States
Plan Types	HMO, HMO-POS, PPO	HMO, HMO-POS, PPO, PFFS
Avg. CMS Star Rating	3.88	3.79
Drug Benefits	Enhanced	Basic, Enhanced
% $0 Premium Plans	62%	41%

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


HMO	76%	55%	$7	$31	$5,020	$5,292
HMO-POS	66%	26%	$6	$64	$5,643	$5,500
PPO	56%	38%	$88	$67	$5,168	$6,289
PFFS	N/A	0%	N/A	$57	N/A	$7,500

Aetna delivers better value in most cases, with 76% of HMO plans charging nothing beyond the Part B premium compared with 55% of BCBS HMO plans, and an even larger gap for HMO-POS plans at 66% versus 26%. BCBS generally has higher average premiums for HMO and HMO-POS plans, though it’s cheaper than Aetna for PPO plans. Aetna’s plans also feature lower maximum out-of-pocket costs for both HMO and PPO options, making them a stronger choice to minimize both monthly premiums and potential annual expenses.

HMO
4.14
3.73
HMO-POS
3.41
4.09
PPO
4.05
3.76
PFFS
N/A
3.5
Aetna and Blue Cross Blue Shield show strengths in different Medicare Advantage plan types based on CMS Star Ratings. Aetna leads in HMO and PPO plans, earning average ratings of 4.14 and 4.05 compared with BCBS’s 3.73 and 3.76. Blue Cross Blue Shield, however, performs better in HMO-POS plans with a rating of 4.09 vs. Aetna’s 3.41. BCBS also has PFFS plans with an average rating of 3.5, while Aetna does not provide this plan type. Aetna tends to score higher in more traditional plan types, while BCBS shows an edge in HMO-POS and niche offerings.


HMO	4.14	3.73
HMO-POS	3.41	4.09
PPO	4.05	3.76
PFFS	N/A	3.5

Bottom Line

Aetna and Blue Cross Blue Shield meet different needs depending on the coverage you’re looking for. BCBS is the only option for ACA marketplace plans since Aetna exited that market in 2026, though premiums tend to run above the national average. For Medicare Supplement coverage, Aetna has lower premiums on popular plans like G and N, while BCBS has greater plan variety with cost-sharing options like Plan K. Aetna also leads in Medicare Advantage with wider availability, more $0 premium plans, and lower out-of-pocket maximums.

BCBS is a strong choice for ACA coverage or Medicare Supplement Plans K, L, or M, but Aetna gives better value for Medicare Advantage and most other Medigap plans.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.

Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!

He writes about economics and insurance, breaking down complex topics so people know what they're buying.

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Aetna vs. Blue Cross Blue Shield (2026 Comparison)

Aetna vs. Blue Cross Blue Shield: ACA Health Insurance

Plan & State Availability

Pricing

Customer Experience

Aetna vs. Blue Cross Blue Shield: Medicare Supplement

Plan & State Availability

Pricing

Aetna vs. Blue Cross Blue Shield: Medicare Advantage

Plan & State Availability

Pricing

CMS Star Ratings

Bottom Line

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