Blue Cross Blue Shield (BCBS) is the only carrier between these two with ACA marketplace coverage in 2026, available in 36 states. Aetna exited the ACA market as of January 1, 2026. We reviewed BCBS across plan types, quality scores and denial rates to give you a direct read on what you're getting. The insurer 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: June 5, 2026
Advertising & Editorial Disclosure
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 Medicare Supplement plans in 44 states. Blue Cross Blue Shield covers 37 states. Both price most plans using Attained Age pricing, which means premiums rise as you get older. Aetna is cheaper on every plan both carriers sell, at both age 65 and 75. By age 75, Aetna's Plan G costs $56 per month less than BCBS, $672 per year.
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; Blue Cross Blue Shield operates in 31. In our analysis of CMS plan data, Aetna leads on $0 premium plan availability and out-of-pocket cost limits, while BCBS leads on HMO-POS quality ratings. Aetna's overall CMS star rating averages 3.88 vs. BCBS's 3.79.
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% |
Which Is the Right Option for You?
Aetna and Blue Cross Blue Shield serve different coverage needs depending on what you're shopping for. BCBS is the only option for ACA marketplace plans, since Aetna exited that market in 2026, though its premiums run $31 to $126 per month above national averages depending on plan type. For Medicare Supplement, Aetna is cheaper on every comparable plan, with the Plan G savings reaching $672 per year by age 75. BCBS is the right choice for Plans K, L and M, the cost-sharing plans Aetna doesn't sell in any state.
For Medicare Advantage, Aetna leads on $0 premium availability, out-of-pocket cost limits and HMO and PPO star ratings. BCBS has an edge on HMO-POS quality scores and adds PFFS plans to its lineup. Choose BCBS for ACA coverage or Medicare Supplement Plans K, L or M. Choose Aetna for Medicare Advantage or most other Medigap plans.
Frequently Asked Questions
The answers below cover the most common questions about Aetna and Blue Cross Blue Shield, organized by coverage type.
Is Aetna or Blue Cross Blue Shield better for Medicare?
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.
Does Aetna offer ACA marketplace plans in 2026?
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.
Which carrier has lower out-of-pocket maximums for Medicare Advantage?
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. On PPO plans the gap is larger: $5,168 with Aetna versus $6,289 with BCBS. For HMO-POS plans, BCBS is lower at $5,500 versus Aetna's $5,643.
Does Blue Cross Blue Shield offer Medicare Supplement Plans K and L?
Yes. BCBS offers Plans K, L and M, cost-sharing plans that Aetna doesn't sell in any state. Plan K starts at $107 per month for a 65-year-old and requires you to cover 50% of most Medicare-covered costs until you hit the annual out-of-pocket limit.
Related Pages
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he produces original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.
He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.
Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.
Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). His career began in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.
Sources
- CMS.gov. "What are you looking for today?." Accessed June 22, 2026.
- Medicare.gov. "Welcome to Medicare." Accessed June 22, 2026.