Blue Cross Blue Shield (BCBS) has ACA marketplace coverage in 36 states. Aetna stopped selling ACA plans as of January 1, 2026. BCBS sells four plan types, giving you flexibility in how you access care. It earns an average Quality Rating System (QRS) score of 77.72 out of 100 and denies about 19% of claims on average.
Aetna vs. Blue Cross Blue Shield (2026 Comparison)
Updated: May 8, 2026
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Aetna vs. Blue Cross Blue Shield: ACA Health Insurance
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% |
Aetna vs. Blue Cross Blue Shield: Medicare Supplement
Aetna sells plans in 44 states for Medicare Supplement; Blue Cross Blue Shield covers 37 states. On plan variety, BCBS offers all 10 standardized plan types while Aetna offers seven, with availability varying by state. Both carriers sell high-deductible versions of Plans F and G, which come with lower monthly premiums but 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 vs. Blue Cross Blue Shield: Medicare Advantage
Aetna sells Medicare Advantage plans in 44 states against BCBS's 31. Both cover similar plan types; BCBS adds PFFS options for members who want to see any Medicare-accepting provider. Aetna edges ahead on quality with a 3.88 average CMS star rating versus BCBS's 3.79, and includes enhanced drug coverage as standard where BCBS alternates between basic and enhanced. On cost, 62% of Aetna plans carry $0 monthly premiums compared to 41% for BCBS.
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% |
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.
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About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has analyzed the insurance market for almost a decade, first with LendingTree and now with MoneyGeek, conducting original research on hundreds of insurance companies and millions of insurance rates for insurance shoppers.
He writes about economics and insurance on MoneyGeek, breaking down complex topics so people can have confidence in their purchase. Like all MoneyGeek analysts, Mark collects and analyzes independent cost and consumer experience data on insurance companies to provide objective recommendations in our content that are independent of any of MoneyGeek's insurance company partnerships.
His insights on products ranging from car, home and renters insurance to health and life insurance have been featured in The Washington Post, The New York Times and NPR, among others.
Mark holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He started his career working in financial risk management at State Street before transitioning to the analysis of the personal insurance market. He's also a five-time Jeopardy champion!