Aetna vs. Cigna (2026 Comparison)

Cigna sells ACA marketplace plans in 11 states, offering both HMO and EPO options. Aetna exited the individual health insurance market, and no longer has ACA plans.

• HMO plans require you to choose a primary care physician who coordinates your care and provides referrals to specialists.
• EPO plans offer more flexibility, allowing you to see specialists without referrals, though you'll still need to stay in-network for coverage.

Cigna’s average monthly premiums are higher than the national average, with silver-tier HMO plans for 40-year-olds costing $756 per month compared to $678 nationally. The provider’s EPO plans are closer to the benchmark at $753 compared to the national average of $731.

Cigna has a Qualified Rating System (QRS) score of 73.71 out of 100 for its ACA plans, with particularly strong member experience ratings at 93.59. However, the insurer scores lower in Medicare care coordination (71.73) and plan administration (80.29). Cigna also denies about 23% of claims. While it’s possible to appeal claim denials, they can be time-consuming and don’t guarantee approval.

Aetna is cheaper than Cigna for most popular Medicare Supplement plans, particularly Plan G, the most commonly purchased option. At age 65, beneficiaries pay an average of $144 per month with Aetna compared to $162 with Cigna. This $18 monthly gap widens to $34 by age 75, with premiums of $169 versus $203, resulting in $408 in annual savings with Aetna.

Cigna is less expensive for Plan B at both ages, though this plan is less popular. Both insurers use attained-age pricing in most states, so premiums increase as you get older regardless of when you enroll. Actual rates vary by location, gender, and household discount eligibility, making it important to compare quotes from both companies in your area before choosing a plan.

Cigna has more $0 premium plans than Aetna across HMO plans at 85 percent versus 76 percent and PPO plans at 83 percent versus 56 percent. This makes it easier to find coverage without monthly payments. Average HMO premiums remain low for both insurers at about $7 to $8 per month. PPO pricing differs sharply, with Cigna averaging about $1 per month compared to $88 for Aetna.

Aetna has lower maximum out of pocket (MOOP) limits for both plan types. HMO plans average $5,020 with Aetna vs. $5,585 with Cigna, while PPO plans average $5,168 vs. $6,578. This difference could save more than $1,000 in a high cost year. When choosing between these insurers, compare total costs including premiums, deductibles, and out of pocket maximums since the lowest premium does not always deliver the best overall value.

CMS star ratings measure Medicare Advantage plan quality on a 1 to 5 scale, based on factors such as preventive care, chronic condition management, customer service, and member satisfaction. Aetna earns higher average ratings for HMO plans at 4.14 compared to 3.77 and PPO plans at 4.05 compared to 3.01, suggesting stronger performance in care coordination and network quality.

Cigna scores higher for HMO POS plans with an average rating of 3.96 against Aetna’s rating of 3.41, which may appeal to members who want some flexibility to see out of network providers. Plans rated 4 stars or higher qualify for special enrollment periods and often include added benefits, making Aetna HMO and PPO plans a strong choice for beneficiaries who prioritize plan quality.