Updated: June 29, 2026
Advertising & Editorial Disclosure
Aetna discontinued its ACA marketplace plans effective January 1, 2026. Cigna is now the only option between these two insurers for individual health coverage. It sells HMO and EPO plans across 11 states with an average Quality Rating System (QRS) score of 73.71.
MoneyGeek's comparison of the two carriers shows the ACA question is straightforward: Cigna is the only option and its 23% denial rate is the number worth examining.
Availability | N/A | 11 States |
Plan Types | N/A | HMO, EPO |
Avg. QRS Score | N/A | 73.71 |
Avg. Denial Rate | N/A | 23% |
Both Aetna and Cigna sell comprehensive Medicare Supplement coverage with the same core plan types, including high-deductible versions of Plan F and Plan G. Aetna is available in 44 states and Cigna in 43. Cigna has 86% of its plans at $0 premium versus Aetna's 62%. For Plan G, the plan most beneficiaries buy, Aetna is $18 per month cheaper at age 65 and $34 per month cheaper at age 75.
A 65-year-old who picks Aetna over Cigna for Plan G saves $216 per year at the start. By 75, the annual savings grows to $408 and both carriers are still raising premiums because both use attained-age pricing.
Availability | 44 States | 43 States |
Plan Types | A, B, C, D, F, G, N | A, B, C, D, F, G, N |
High-Deductible F and G | Yes | Yes |
Dominant Pricing Style | Attained Age | Attained Age |
Aetna operates Medicare Advantage plans in 43 states; Cigna operates in 29. Aetna's average CMS star rating of 3.88 is higher than Cigna's 3.66. For PPO plans, Aetna averages $88 per month while Cigna averages $1 per month. Cigna's lower premium comes with a higher out-of-pocket maximum: $6,578 versus Aetna's $5,168, a $1,410 difference.
In a worst-case year, total exposure is $6,590 with Cigna ($12 in annual premiums plus $6,578 at the out-of-pocket maximum) compared to $6,224 with Aetna ($1,056 in annual premiums plus $5,168 at the out-of-pocket maximum), a $366 difference in Aetna's favor.
Availability | 43 States | 29 States |
Plan Types | HMO, HMO-POS, PPO | HMO, HMO-POS, PPO |
Avg. CMS Star Rating | 3.88 | 3.66 |
Drug Benefits | Enhanced | Basic, Enhanced |
% $0 Premium Plans | 62% | 86% |
For ACA coverage, Cigna is your only option between these two carriers. Aetna exited the ACA market in 2026, so comparison shopping here starts with other insurers on HealthCare.gov.
For Medicare Supplement, Aetna is the better choice for most Plan G buyers. At $18 per month less at age 65 and $34 per month less at age 75, the savings are real with no difference in coverage, since Plan G benefits are standardized by federal law. Cigna is worth pricing if a $0-premium plan is the priority, as 86% of its plans carry no monthly premium versus Aetna's 62%.
For Medicare Advantage, the decision depends on expected plan use. Aetna's average HMO and PPO star ratings both clear the four-star threshold, which opens up additional benefits and special enrollment access. Cigna's average PPO premium of $1 a month is low, but its PPO out-of-pocket maximum of $6,578 is $1,410 above Aetna's $5,168. A beneficiary who gets that MOOP in a bad year pays $366 more in total annual costs with Cigna's PPO than with Aetna's, once premiums are included. Heavy plan users are better served by Aetna's higher star ratings. Beneficiaries in good health who want to keep the monthly bill low should price Cigna's $0-premium PPO options first.
It depends on the product. For Medicare Supplement Plan G, Aetna costs less in most states: $144 per month at age 65 versus Cigna's $162. For Medicare Advantage, Aetna's average HMO and PPO star ratings of 4.14 and 4.05 both clear the 4-star threshold for additional benefits; Cigna's do not. Cigna has more $0-premium Medicare Advantage options at 86% versus Aetna's 62%, so beneficiaries focused on minimizing monthly costs should price both.
Yes. Cigna sells ACA marketplace plans in 11 states: Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas and Virginia. Aetna exited the ACA market effective January 1, 2026. If you're outside Cigna's 11-state footprint, neither carrier is an option through the ACA marketplace.
Aetna. Its average HMO rating is 4.14 and its average PPO rating is 4.05, both above the 4-star threshold that qualifies plans for special enrollment periods and added benefits. Cigna's average HMO rating is 3.77 and its average PPO rating is 3.01. Cigna's HMO-POS plans score 3.96 against Aetna's 3.41 for that plan type.
Both carriers offer Plans A, B, C, D, F, G and N, plus high-deductible versions of Plan F and Plan G. Aetna is available in 44 states and Cigna in 43. Neither carrier is available in Illinois, Maine, Massachusetts, New York and Washington, where Medigap rules are state-administered. Plan G is the most widely available option from both carriers.
Aetna is cheaper for most plans, including Plan G. At age 65, Aetna's Plan G averages $144 per month versus Cigna's $162. Cigna is less expensive for Plan B. Both carriers use attained-age pricing, so premiums rise as you get older regardless of which insurer you choose.
Aetna operates in 43 states; Cigna is in 29. Cigna is the only provider of the two in New Mexico. Both offer HMO, HMO-POS and PPO plan types, but availability varies by county within each state. Check CMS Plan Finder to confirm which plans are available in your ZIP code.
Mark Fitzpatrick, a licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident expert in insurance and economics. He has spent nearly a decade covering the market, first at LendingTree and now at MoneyGeek, where he analyzes 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 influence his recommendations.
Mark studied at Boston College before earning a master's in economics and international relations from Johns Hopkins University. Before MoneyGeek, he worked in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.
