Aetna vs. Blue Cross Blue Shield (2026 Comparison)

For Medicare, Aetna costs less on every shared plan and scores higher on Medicare Advantage. For ACA plans in 2026, BCBS is the only option. Aetna exited the market in January.

Find the right health insurance for you.

Written by Mark Fitzpatrick

Updated: September 8, 2026

Advertising & Editorial Disclosure

Which Is the Right Option for You?

Aetna is the stronger choice for Medicare in 2026. For Medicare Supplement, it's cheaper on every plan both carriers sell: Plan G runs $144 a month with Aetna versus $170 with BCBS for a 65-year-old. For Medicare Advantage, Aetna averages a higher CMS star rating (3.88 vs. 3.79 out of 5.0) and 62% of its plans carry no premium, versus 41% for BCBS.
BCBS is the only ACA option in 2026. Aetna left the ACA market on January 1. Choose BCBS also if you want Medicare Supplement Plans K, L or M (cost-sharing plans Aetna doesn't sell anywhere).

Aetna vs. Blue Cross Blue Shield: ACA Health Insurance

Aetna left the ACA individual market on January 1, 2026. BCBS is the only carrier in this comparison with ACA plans, available in 36 states across all four plan types. The pricing and quality data below are from MoneyGeek's 2026 analysis of ACA marketplace plan files. Shoppers in states without BCBS coverage have no option from either carrier and should compare plans on HealthCare.gov.


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. Aetna doesn't offer ACA plans 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 (Health Maintenance Organization): You'll need a primary care physician to get referrals for specialists, and coverage stays within the network except in emergencies.

POS (Point of Service): A primary care physician coordinates care and writes referrals. Out-of-network care is available at higher cost.

EPO (Exclusive Provider Organization): No referrals needed to see a specialist. Coverage is limited to in-network providers. An EPO allows more flexibility than an HMO but without out-of-network access.

PPO (Preferred Provider Organization): No primary care physician or referrals required. You can see in-network and out-of-network providers, where in-network visits cost less.
HMO
N/A
$762
$678
POS
N/A
$756
$725
EPO
N/A
$857
$731
PPO
N/A
$899
$803
BCBS premiums are above national averages across all four plan types. The PPO at $899 per month is the only BCBS ACA plan with partial out-of-network coverage. Neither the PPO nor the EPO requires a referral, and the PPO adds out-of-network access. That flexibility costs $137 more per month than the HMO.

BCBS covers only 36 states, so shoppers in states without BCBS ACA coverage can compare other marketplace carriers on HealthCare.gov.
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%
The Quality Rating System (QRS) is the Centers for Medicare & Medicaid Services' annual measure of ACA plan performance, scored out of 100 across three categories: medical care, plan administration and member experience. BCBS's strongest category is member experience at 95.91. Its weakest is medical care at 73.96, a 22-point gap. The QRS scores these separately: member experience captures whether enrollees are satisfied with the insurer; medical care reflects how well the plan delivers preventive and chronic disease care.

BCBS scores 81.36 on plan administration and denies 19% of claims at first submission. You can appeal a denied claim, but the process takes time. Check your plan's coverage rules before scheduling care to avoid a dispute after the fact.


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

Aetna is cheaper on every plan both carriers sell, at both age 65 and 75. Both price most plans using Attained Age pricing, which means premiums rise as you get older. Aetna sells Medicare Supplement plans in 44 states, whereas Blue Cross Blue Shield covers 37 states.


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 sells Medicare Supplement plans in 44 states, generally offering Plans A, B, F, G and N, with Plans C and D available in some states like Vermont and New Jersey. BCBS covers 37 states and adds Plans K, L and M to its lineup. Availability varies by state. Aetna's plan lineup is consistent across state lines. BCBS adds Plans K, L and M where it operates, three options Aetna doesn't sell in any state.


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

Premium figures are drawn from MoneyGeek's 2026 analysis of Medicare Supplement plan data across both carriers, based on rates for a 65-year-old and 75-year-old nonsmoker.


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

A 65-year-old pays $26 per month less for Plan G with Aetna ($144 vs. $170). By 75, that gap grows to $56 per month ($169 vs. $225).

Shoppers who became Medicare-eligible after 2020 can't enroll in Plan C or Plan F. In that group, Plan G covers the most, including the Part A deductible (the amount you pay for a hospital stay before Medicare begins covering costs), without requiring you to share a portion of every covered expense. It's the strongest option for that eligibility tier.

BCBS does have three plans Aetna doesn't: Plans K, L and M. Plan K is the cheapest at $107 per month for a 65-year-old and requires you to cover 50% of most Medicare-covered costs until you reach the annual out-of-pocket limit. Plan M and Plan L are cost-sharing plans as well, each with different out-of-pocket structures. BCBS Plan G costs $312 more than Aetna at 65. By 75, that yearly difference reaches $672.

Aetna doesn't sell Plans K, L or M in any state. Those three plans trade lower premiums for higher out-of-pocket exposure. Plan K requires you to cover 50% of most Medicare-covered costs until you reach the annual out-of-pocket limit. Choose BCBS if you want a cost-sharing plan (Plans K, L or M) or if Aetna doesn't operate in your state.
If Aetna operates in your state, get its Plan G quote first. Plan G costs $312 less per year with Aetna at 65. By 75, that difference reaches $672 per year. Plan G costs $312 less per year with Aetna at 65, by 75 that gap grows to $672 annually. BCBS is the right call when you want Plans K, L or M, cost-sharing plans Aetna doesn't sell in any state.

Aetna vs. Blue Cross Blue Shield: Medicare Advantage

Aetna has Medicare Advantage plans in 44 states; BCBS operates in 31. In our 2026 CMS plan analysis, Aetna leads on $0-premium availability and HMO and PPO out-of-pocket cost limits. Aetna's average CMS star rating is 3.88 out of 5.0, versus BCBS's 3.79. BCBS has an edge only on HMO-POS plans (a plan type that combines HMO network rules with the option to see out-of-network providers at higher cost), where it averages a 4.09 star rating versus Aetna's 3.41 and has the lower annual out-of-pocket cap ($5,500 versus $5,643).


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 across HMO, HMO-POS and PPO plan types. BCBS operates in 31 states and adds PFFS to its lineup. Aetna covers Colorado, Connecticut, Iowa and Kentucky where BCBS has no Medicare Advantage presence. BCBS reaches Idaho, Montana and New Mexico where Aetna doesn't operate.

BCBS is a network of independent regional companies, not a single national insurer. The CMS star ratings and QRS scores are national averages. Check CMS Plan Finder to see ratings for the specific BCBS plan in your ZIP code.

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

Pricing and star rating data below come from MoneyGeek's review of 2026 CMS Medicare Advantage plan files across both carriers' active service areas.

Aetna's annual out-of-pocket maximums are lower than BCBS's for HMO and PPO plans. The PPO difference is the one that matters most for high-care-use years: $5,168 with Aetna versus $6,289 with BCBS, a $1,121 difference at the cap.

For HMO-POS plans, this flips. BCBS caps annual costs at $5,500 versus Aetna's $5,643. The $143 difference is small as network availability in your county and drug coverage are bigger factors for HMO-POS shoppers.

On $0-premium plans, Aetna leads by 21 percentage points: 62% of its plans carry no monthly premium, vs. 41% for BCBS. A $0 premium doesn't mean $0 cost. You still pay out-of-pocket when you use care, but it lowers the baseline for enrollees who expect light use in a given year.

HMO
4.14
3.73
HMO-POS
3.41
4.09
PPO
4.05
3.76
PFFS
N/A
3.5
Aetna's HMO and PPO ratings are above those of BCBS. But for HMO-POS, Aetna scores lower. HMO-POS plans require a carrier to process both referral-required and open-access claims under one structure. BCBS handles that split more consistently.

The HMO-POS star rating matters because plans rated below 4.0 stars (like Aetna at 3.41) don't qualify for the Star Rating Special Enrollment Period. That window is from December 8 through November 30 and lets members switch to a higher-rated plan.
Aetna's HMO-POS star rating of 3.41 is its lowest across all three plan types and falls 0.68 points below BCBS's 4.09 on the same plan type. Shoppers who want an HMO-POS plan and need a quality rating above 4.0 stars should choose BCBS.

Aetna also doesn't offer PFFS plans, so don't get it the ability to see any Medicare-accepting provider without a network requirement matters to you.
Most Medicare Advantage shoppers who can access Aetna in their county will get better value there. Aetna's $0-premium share is 62% versus BCBS's 41%. Its out-of-pocket maximums are lower on HMO plans ($5,020 vs. $5,292) and PPO plans ($5,168 vs. $6,289).

Aetna also leads BCBS on HMO and PPO star ratings: 4.14 versus 3.73 and 4.05 versus 3.76.

Choose BCBS for Medicare Advantage if you want an HMO-POS plan (4.09 stars versus Aetna's 3.41) or if Aetna doesn't operate in your county.


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

Frequently Asked Questions

For Medicare Supplement, Aetna is cheaper on every plan both carriers sell. A 65-year-old pays $26 per month less for Plan G with Aetna ($144 vs. $170), and by 75, that gap reaches $56 per month. For Medicare Advantage, Aetna posts the stronger numbers on $0 premium availability and CMS star ratings for HMO and PPO plans. BCBS has an edge if you specifically want an HMO-POS plan, where it averages a 4.09 star rating versus Aetna's 3.41.

No. Aetna exited the ACA marketplace as of January 1, 2026. Blue Cross Blue Shield is the only option between these two carriers for ACA coverage and sells plans in 36 states.

ACA open enrollment on HealthCare.gov runs November 1 through January 15. Enroll by December 15 for coverage starting January 1. Outside open enrollment, a qualifying life event such as job loss, marriage or a move opens a 60-day special enrollment window. State-based exchanges set their own dates; check your state's marketplace to confirm.

The Annual Enrollment Period for Medicare Advantage runs October 15 through December 7. Coverage changes take effect January 1. Plans rated 4.0 stars or above qualify for a Star Rating Special Enrollment Period between December 8 and November 30, which means Aetna's HMO and PPO plans on this page qualify. Its HMO-POS plans don't.

Aetna's out-of-pocket maximums are lower than BCBS's for HMO and PPO plans. Aetna's HMO plans cap annual costs at $5,020 versus $5,292 for BCBS. PPO plans costs $5,168 with Aetna versus $6,289 with BCBS. For HMO-POS plans, BCBS is lower at $5,500 versus Aetna's $5,643.

Yes. BCBS offers Plans K, L and M in the states it covers. Aetna doesn't sell any of the three. Plan K has the lowest premium on this page at $107 per month for a 65-year-old and carries higher cost-sharing requirements than Plans G or N.

About Mark Fitzpatrick

Mark Fitzpatrick is a licensed Property and Casualty (P&C) Insurance Producer in Connecticut and MoneyGeek's resident expert in insurance and economics. In nearly a decade covering the insurance market at LendingTree and MoneyGeek, he's analyzed hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

His work has appeared in The Washington Post, The New York Times and NPR. He draws on independent cost and consumer experience data, and no insurance company partnerships affect his recommendations.

Mark studied at Boston College and later earned a master's in economics and international relations from Johns Hopkins University. He worked in financial risk management at State Street before joining MoneyGeek. He's also a five-time “Jeopardy!” champion.

Read Full Bio »

Sources

CMS.gov. "What are you looking for today?." Accessed September 20, 2026.
Medicare.gov. "Welcome to Medicare." Accessed September 20, 2026.

Aetna vs. Blue Cross Blue Shield (2026 Comparison)

Which Is the Right Option for You?

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

When to Avoid Aetna Medicare Supplement Plans

When to Avoid BCBS Medicare Supplement Plans

Aetna vs. Blue Cross Blue Shield: Medicare Advantage

Plan & State Availability

Pricing

CMS Star Ratings

When to Avoid Aetna Medicare Advantage Plans

When to Avoid BCBS Medicare Advantage Plans

Frequently Asked Questions

Is Aetna or Blue Cross Blue Shield better for Medicare?

Does Aetna offer ACA marketplace plans in 2026?

When can I sign up for a BCBS ACA Plan?

When can I enroll in a Medicare Advantage Plan?

Which carrier has lower out-of-pocket maximums for Medicare Advantage?

Does Blue Cross Blue Shield offer Medicare Supplement Plans K and L?

Related Pages

About Mark Fitzpatrick