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Aetna and UnitedHealthcare are two of the largest Medicare Advantage insurers in the United States—and both sit inside enormous integrated healthcare organizations.
But national averages cannot tell you which plan works better in your county. The real questions are whether the plan includes your doctors, your hospital, your prescriptions and acceptable expected and worst-case costs.
Aetna
CVS Health company
4.20 weighted CMS rating*
60% $0-premium plans*
$6,963 avg. MOOP*
91% Tier 2 $0 drug share*
SilverSneakers
UnitedHealthcare
UnitedHealth Group / Optum
4.11 weighted CMS rating*
52% $0-premium plans*
$6,492 avg. MOOP*
~9.3M MA enrollment*
Renew Active
*National 2026 data. Individual plan costs, ratings, networks and benefits can differ substantially.
Aetna may deserve stronger consideration when its local network fits, generic drug pricing is favorable, the contract has a stronger rating or CVS-related convenience matters. UHC may deserve stronger consideration when its local network is broader for you, the MOOP is lower, its PPO fits better or Optum Home Delivery reduces your drug costs.
| 2026 National Metric | Aetna | UnitedHealthcare |
|---|---|---|
| Enrollment-weighted CMS Star Rating | 4.20 | 4.11 |
| Plans with $0 premium | 60% | 52% |
| Avg. premium among non-$0 plans | $32.89 | $33.90 |
| Avg. medical MOOP | $6,963 | $6,492 |
| Plans including prescription coverage | 94% | 92% |
| Tier 1 drugs with $0 copay/coinsurance | 99.9% | 97.6% |
| Tier 2 drugs with $0 copay/coinsurance | 91% | 23.4% |
Different local plans have different strengths. Your healthcare fit matters more than the carrier logo.
Aetna’s ecosystem includes CVS Pharmacy, CVS Caremark, OTC Health Solutions, Signify Health and other CVS Health care-delivery operations.
Important: Aetna does not mean every prescription is cheapest at CVS, every CVS product qualifies for OTC, or every Aetna member receives the same CVS benefits.
Mutual of Omaha determines:
Premium
Household discount
Rate behavior
Underwriting
Company/service
Optional perks
Choose carrier second.
Vertical integration can create convenience—but it does not replace plan-specific verification.
Eligible plans can reward members who select participating high-value PCPs through additional Extra Benefits Card funds, lower specialist/podiatry copays or other reduced cost sharing.
UHC’s 2026 portfolio includes plan designs that can emphasize lower medical costs (Essentials) or richer supplemental benefits (Extras), showing that two plans from the same carrier can serve different priorities.
UnitedHealthcare is much larger nationally, but you do not need access to one million doctors. You need access to your PCP, specialists, hospital, imaging center and the facilities you may actually use.
Don't ask only “Do you take UnitedHealthcare?” or “Do you accept Aetna?”
Verify the exact Medicare Advantage product and recheck the carrier directory.
Snowbird checklist:
Routine care in both states • out-of-network costs • provider acceptance • pharmacy access • dialysis • specialist treatment • separate out-of-network maximum.
Approximately 82% of Aetna members enrolled in rated plans are in contracts rated at least four stars for 2026.
UHC’s weighted average is also above the approximate 4.02 national average, and multiple UnitedHealth Group contracts earned 5-star high-performing status.
You do not enroll in a national carrier average.
You enroll in a specific Medicare contract. Use Star Ratings as a tiebreaker when healthcare access, prescriptions and costs are otherwise close.
Star Ratings measure:
Preventive care • chronic-condition management • member experience • complaints • customer service • drug-plan performance • medication adherence • operational quality.
| 2026 Cost Measure | Aetna | UnitedHealthcare |
|---|---|---|
| $0-premium plans | 60% | 52% |
| Avg. non-$0 premium | $32.89 | $33.90 |
| Avg. medical MOOP | $6,962.60 | $6,492 |
Premium + PCP + specialist visits + labs + imaging + routine outpatient care + prescriptions.
Hospital + outpatient surgery + advanced imaging + Part B drugs + chemotherapy + skilled nursing + rehab + frequent specialists + MOOP.
UnitedHealthcare's national average MOOP is about $471 lower.
That does not mean UHC saves everyone $471, but someone with heavy healthcare use could care greatly about the difference.
$0 premium is not free healthcare.
Specialist, hospital, ambulance, surgery, imaging and prescription costs can still apply.
| Prescription Metric | Aetna | UHC |
|---|---|---|
| MA plans including Part D | 94% | 92% |
| Tier 1 with $0 copay/coinsurance | 99.9% | 97.6% |
| Tier 2 with $0 copay/coinsurance | 91% | 23.4% |
| Tier 3 with $0 copay/coinsurance | 0.2% | 1.5% |
Run every drug.
National Tier 2 numbers tell you little about the annual cost of higher-priced drugs such as Eliquis, Jardiance or Trelegy. Your expensive medications can outweigh hundreds of dollars in supplemental benefits.
Different blocks and filings can exist under the same brand.
Aetna members may use CVS Caremark Mail Service Pharmacy for maintenance prescriptions depending on the plan. Aetna’s national strength is especially visible in retail generic pricing.
UHC emphasizes Optum Home Delivery. For 2026, UHC reports nearly all members retain $0 Tier 1 at network retail and $0 Tier 2 opportunities through eligible home delivery, subject to plan rules.
How often does the doctor need permission?
How often is an authorization request initially denied?
What happens when the denial is challenged?
New 2025 transparency data deserve attention.
KFF’s August 2026 analysis reported UnitedHealth Group with the highest standard-request denial rate among six large MA insurers at 17%. CVS Health/Aetna’s standard denial rate was lower. This does not prove every Aetna plan is easier to use because authorization frequency and service mix also matter.
Earlier 2024 analysis showed about 1.0 determination per enrollee with an initial denial rate around 12.8%—fewer requests per member, but a higher share denied.
Aetna contract H2056 reported 92.78% of standard requests approved and 7.22% denied in 2025; among appealed standard denials, 88.46% were later approved. That is one contract, not a nationwide Aetna rate.
An initial Medicare Advantage denial is not necessarily final.
Broader analyses show many appealed denials are overturned. Beginning in 2026, standard MA authorization timeframes also shortened from 14 to 7 calendar days, while expedited requests remain 72 hours.
Both carriers broadly include dental. Compare dentist network, preventive/comprehensive care, crowns, root canals, dentures, implants, coinsurance, authorization and frequency limits.
Both broadly offer routine eye exams, eyewear/contact allowances, hearing exams and hearing-aid benefits. Networks, brands, frequencies and dollar amounts differ.
Aetna generally uses SilverSneakers; UHC generally uses Renew Active. Check whether your preferred local gym participates before using fitness as a tiebreaker.
Depending on plan, Aetna’s card can support OTC products and other approved plan-specific expenses at CVS and other participating locations.
Depending on plan and eligibility, UCard can combine member ID with OTC, food, utility or other supplemental allowances.
Aetna Healthy Home Visit through Signify Health and UHC HouseCalls can identify care gaps but should not replace your regular PCP.
A $3,000 dental benefit can be worse than $2,000 if the dentist or procedure you need is not usable under the richer-looking plan.
UHC reports D-SNP reach for nearly 80% of dual-eligible consumers. Aetna also operates substantial D-SNP coverage. Confirm Medicaid category first because cost sharing and benefits can differ by QMB, SLMB and other status.
Both expanded chronic-condition plans. Compare disease-specific specialists, hospitals, formulary, insulin/supplies, transportation, MOOP and care management before assuming a C-SNP is better.
Both can offer veteran-oriented MA options. Compare Part B giveback, civilian providers, hospital access, VA pharmacy use, Part D need and emergency coverage—not only the giveback.
AARP-branded Medicare Advantage plans are insured through UnitedHealthcare or affiliates. AARP is not the insurer, and AARP membership is generally not required for AARP-branded UHC Medicare Advantage.
Doctors + hospital fit
Local contract rating is stronger
Generic drugs are favorable
CVS convenience helps
SilverSneakers matters
High-value PCP program changes economics
More providers participate
Local MOOP is lower
PPO fits travel better
Optum Home Delivery saves money
Renew Active fits your gym
UHC SNP / Essentials plan is stronger
Humana, Devoted, Florida Blue, CarePlus, HealthSun, Wellcare, Simply, Gold Kidney, Kaiser Permanente, Prominence, regional plans or Original Medicare + Medigap + Part D may fit better.
| Reason Former Members Reported | Aetna | UnitedHealthcare | All-Company Avg. |
|---|---|---|---|
| Problems getting covered care | 10% | 11% | 11% |
| Doctor/hospital network problems | 13% | 15% | 17% |
| Financial issues | 20% | 16% | 17% |
| Prescription drug problems | 5% | 1% | 3% |
| Problems getting information | 9% | 8% | 9% |
Total network size and network fit are different things.
Aetna can have stronger generic economics nationally while former UHC members report fewer prescription-related problems. Different metrics measure different things; online review scores are especially poor substitutes for Medicare-specific evidence.
| 2026 Category | Current National Edge |
|---|---|
| Enrollment-weighted CMS rating | Aetna |
| Members in 4+ star contracts | Aetna |
| MA enrollment | UnitedHealthcare |
| Reported provider-network scale | UnitedHealthcare |
| $0-premium plan share | Aetna |
| Avg. medical MOOP | UnitedHealthcare |
| Tier 2 generic pricing | Aetna, substantially |
| D-SNP national reach | UnitedHealthcare |
| Local doctor network | Depends on plan |
| Best overall plan | Depends on the person |
Do not give either carrier an artificial national score.
A transparent personal Plan Fit Score is more useful than “Aetna 9.4/10 vs UHC 9.2/10.”
As of August 25, 2026, complete consumer-level 2027 Medicare Advantage plan information has not yet been released for final comparison. Refresh this module when finalized plan-level data is available.
2026 already showed meaningful market movement.
UnitedHealthcare exited 225 counties and entered 14; CVS Health/Aetna exited 160 counties and entered 17. Existing members should read the Annual Notice of Change and separately recheck provider directory, pharmacy network and formulary.
Neither is universally better. Aetna has slightly higher enrollment-weighted CMS quality ratings for 2026 and stronger national generic-drug pricing, while UnitedHealthcare has a larger Medicare Advantage network and lower average maximum out-of-pocket limits. Compare the specific plans available in your county.
At the national enrollment-weighted level for 2026, Aetna averages approximately 4.20 CMS stars compared with 4.11 for UnitedHealthcare. Individual Medicare contracts can have different ratings.
Yes. Aetna is part of CVS Health. That relationship supports pharmacy, OTC, care-delivery and other services, but it does not mean every CVS product or prescription is automatically covered or cheaper for every Aetna Medicare member.
AARP-branded Medicare Advantage plans are insured through UnitedHealthcare or its affiliated companies. AARP is not the insurance company.
Generally no. AARP membership is not required to enroll in an AARP-branded UnitedHealthcare Medicare Advantage plan.
UnitedHealthcare reports a Medicare Advantage medical network of nearly one million providers. However, national network size does not determine whether your individual doctors participate. Check the exact plan.
National enrollment-weighted 2026 averages favor UnitedHealthcare at approximately $6,492 versus approximately $6,963 for Aetna. Individual plans may differ significantly.
Aetna has a substantial national advantage in $0 Tier 2 generic-drug coverage for 2026. However, the better plan for an individual depends on the specific prescriptions, formulary, drug tiers, pharmacy and coverage rules.
No. Aetna Medicare plans can include broader pharmacy networks. Pharmacy preference and drug cost depend on the specific plan and medication.
No. UnitedHealthcare members are not generally required to use Optum physicians simply because both businesses are part of UnitedHealth Group. Provider participation and pharmacy benefits depend on the specific plan.
There is no simple universal answer. Newly reported 2025 data show UnitedHealth Group with a higher standard Medicare Advantage prior-authorization denial rate than CVS Health/Aetna in KFF’s analysis, but authorization frequency, service categories and local plan practices also matter.
Both carriers offer substantial dental benefits. Compare the actual plan’s covered procedures, dental network, allowance or maximum, coinsurance and coverage for procedures such as crowns, dentures and implants.
Aetna generally uses SilverSneakers. UnitedHealthcare generally uses Renew Active. Check whether your preferred fitness facilities participate before using fitness benefits as a tiebreaker.
Certain Medicare Advantage plans from both carriers can reduce part of the Medicare Part B premium. The amount and availability vary by plan and service area.
Both offer D-SNP plans. UnitedHealthcare has very broad national D-SNP reach, while Aetna also operates significant dual-eligible offerings. The better plan depends on Medicaid eligibility, doctors, prescriptions, medical cost sharing and supplemental benefits.
Neither carrier automatically wins. Compare the specific PPO or HMO-POS rules, second-state provider acceptance, out-of-network costs, pharmacy access and routine out-of-area coverage.
You can change Medicare Advantage plans during applicable Medicare enrollment periods, including the Annual Enrollment Period from October 15 through December 7. Other enrollment opportunities may apply depending on your circumstances.
Aetna has the stronger 2026 quality-rating profile and generic-drug profile. Its weighted rating is approximately 4.20 vs 4.11, and about 91% of Aetna plans have $0 Tier 2 copay/coinsurance versus 23.4% of UHC plans.
UnitedHealthcare has the stronger scale story and lower national average MOOP. UnitedHealth Group represents about 26% of nationwide Medicare Advantage enrollment and UHC reports a network approaching one million providers; average MOOP is about $471 lower nationally.
Aetna’s current prior-authorization transparency picture also looks somewhat more favorable, while former UHC members report fewer prescription and financial issues in CMS disenrollment data.
Choose the healthcare fit first. Choose the logo second.
Helping make Medicare easier to understand.
Independent Medicare Guidance
Medicare Plan Assistance is not connected with or endorsed by the U.S. government or the federal Medicare program. Plan availability, premiums, provider networks, benefits, formularies and Star Ratings vary by service area and can change each year.