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Aetna Medicare Plans: What They Cover, Cost & How to Compare

Understand the coverage behind the benefits. Aetna offers Medicare Advantage, Special Needs, standalone Medicare Part D and Medicare Supplement coverage. But knowing that Aetna offers a Medicare plan where you live is only the beginning.

 

The more important questions are: Will the plan cover the doctors you want to keep? How much will your prescriptions cost? Which benefits actually apply to your plan? What could you pay if you need significant medical care? And ultimately: Is a particular Aetna Medicare plan better for your needs than the other Medicare options available where you live?

 

Medicare Plan Assistance created this guide to help you answer those questions before you enroll.

Your Aetna Coverage Check

CARE

Doctors • Hospitals • HMO/PPO • Prior authorization

PRESCRIPTIONS

Drug list • Pharmacy • SilverScript • CVS Caremark

EXTRA BENEFITS

Dental • Vision • Hearing • OTC • Extra Benefits Card

Before comparing Aetna plans, answer these 3 questions

1. Who do you need to keep?

Doctor / specialist / hospital

2. What medications do you take?

Medication search

3. Which coverage matters most?

Low medical costs / dental / prescriptions / Medicaid benefits / provider freedom

Aetna Medicare in 2026: The Big Picture

Aetna is part of CVS Health and is one of the country’s major Medicare insurers. For 2026, Aetna says its Medicare Advantage Prescription Drug plans are offered in 43 states plus Washington, D.C. and are accessible to approximately 57 million Medicare-eligible beneficiaries. Aetna also offers Special Needs Plans, Medicare Advantage plans without drug coverage in certain circumstances, standalone prescription drug coverage and Medicare Supplement insurance.

43 states + D.C.

MAPD availability

~57 million

Medicare-eligible with access

81%

of MA members in 4-star-or-higher plans

Depending on your location and eligibility, Aetna Medicare coverage may include:

Not every option is available in every county. That is why Medicare plan comparisons should begin with your ZIP code.

The Three Parts of an Aetna Medicare Decision

Instead of starting with an advertised premium or dental allowance, evaluate Aetna Medicare plans in three layers.

Medical Coverage

Start with:

Prescription Coverage

Check:

Prescription Coverage

Then evaluate:

A plan should perform well in all three layers. An attractive extra benefit does not make up for losing an important doctor or paying substantially more for a medication.

What Does Aetna Medicare Advantage Cover?

Medicare Advantage plans must cover the Medicare Part A and Part B benefits required under Medicare rules. Private Medicare insurers may then add additional benefits and services. For 2026, Aetna says its individual Medicare Advantage portfolio includes dental, vision and hearing benefits. Aetna also continues to include SilverSneakers fitness benefits across its individual Medicare Advantage offerings, subject to plan-specific exceptions such as Institutional Special Needs Plans.

 

Depending on the specific plan, Aetna Medicare Advantage coverage can include:

Benefits and cost sharing vary by plan. Always review the specific Summary of Benefits and Evidence of Coverage.

Aetna HMO Plans

Aetna Medicare Advantage HMO plans generally use a defined network of participating doctors, hospitals and other healthcare providers.

 

Members select an in-network primary care provider. Depending on the plan and service, the primary care provider may coordinate referrals to specialists or hospitals.

 

Aetna explains that traditional HMO members generally must use network providers except for situations such as emergency care, urgent care and out-of-area kidney dialysis.

An Aetna HMO may work well if:

Be more cautious if:

Aetna PPO Plans

Aetna PPO Medicare Advantage plans generally provide more provider flexibility. Aetna says PPO members can receive covered services from providers inside or outside the Aetna network when the provider accepts Medicare and Aetna’s plan terms. Members generally pay less when using in-network providers. Aetna’s PPO guidance states that PPO members generally do not need a PCP referral for specialist or hospital visits.

But PPO flexibility should not be confused with Original Medicare. Out-of-network providers may cost more, and a provider that is not contracted with the plan generally is not obligated to treat a PPO member except in emergencies. Before relying on out-of-network benefits, confirm that the provider accepts the particular plan.

Aetna HMO-POS Plans

Aetna also offers HMO-POS coverage in certain markets.

HMO-POS means Health Maintenance Organization with Point-of-Service benefits.

Aetna describes its HMO-POS structure as primarily network-based medical coverage while providing specified out-of-network flexibility.

For many Aetna HMO-POS plans, one notable example is routine dental coverage: members may be able to use licensed dentists inside or outside the Aetna dental network, although out-of-network care can cost more.

Do not assume an HMO-POS provides the same broad out-of-network medical access as a PPO. Read the exact plan rules.

Aetna HMO vs PPO vs HMO-POS

QuestionAetna HMOAetna HMO-POSAetna PPO
Primarily uses network careYesYesNo
PCP requiredDepends on planDepends on planUsually not
Specialist referralDepends on planDepends on planUsually less restrictive
Routine out-of-network medical coverageLimitedLimited and service-specificGenerally available
Out-of-network costsOut-of-network costsUsually member responsibility outside exceptionsMay be higherUsually higher than in-network
Annual medical MOOPYesYesYes

The exact plan remains more important than the plan-type label.

How Do I Know if My Doctor Accepts Aetna Medicare?

Do not ask only: “Do you take Aetna?” A medical practice may accept one Aetna product but not another. Instead ask: “Do you participate with this exact Aetna Medicare Advantage plan?” Aetna maintains an online provider search for Medicare members and consumers. Use this verification process:

Step 1: Get the exact plan name

Do not rely solely on the Aetna carrier name.

Step 2: Search Aetna's provider directory

Search the specific plan.

Step 3: Call the doctor's office

Confirm current participation.

Step 4: Check specialists separately

Your PCP being in network does not mean your cardiologist or oncologist is.

Step 5: Check hospitals and facilities

Verify: Hospital, Outpatient surgery center, Imaging facility, Lab, Therapy provider.

Step 6: Repeat every plan year

Provider networks can change.

What if I Spend Part of the Year in Another State?

This matters particularly for snowbirds and frequent travelers. Aetna PPO plans generally provide greater out-of-network flexibility than HMO plans. Aetna states that some PPO plans may provide national network access that allows members to receive in-network pricing from participating Aetna PPO providers elsewhere in the United States. HMO plans are generally more dependent on the local service-area network.

 

Before choosing a plan because you travel, verify:

Emergency and urgent coverage is not the same thing as routine nationwide coverage.

Aetna Prescription Drug Coverage

Many Aetna Medicare Advantage plans include Medicare Part D prescription coverage. These are often called MAPD plans. Aetna also offers standalone Part D insurance through its SilverScript product. For 2026, Aetna reported that more than 98% of its existing general-enrollment MAPD members would have access to $0 coverage on Tier 1 and Tier 2 drugs for up to a 100-day supply at preferred pharmacies, subject to the applicable plan and formulary.

 

That does not mean every prescription is free. Before enrolling, check each medication individually.

How to Check an Aetna Prescription

For every prescription you take, answer six questions.

Is the drug on the formulary?

A formulary is the plan’s covered drug list.

Which tier is the drug on?

Higher tiers can result in substantially higher copayments or coinsurance.

Does the drug have prior authorization?

If so, the prescriber may need to obtain approval before coverage applies.

Does step therapy apply?

The plan may require trying another medication first.

Is there a quantity limit?

The plan may limit how much of the medication can be filled within a certain period.

Which pharmacy will you use?

Prescription prices can differ between pharmacies and depending on preferred-network status.

Aetna members can use CVS Caremark tools to review drug pricing, find pharmacies, manage prescriptions and arrange mail delivery where available.

Aetna SilverScript Medicare Part D

SilverScript is part of Aetna Medicare. For 2026, Aetna markets its standalone prescription drug coverage primarily as the Aetna Medicare SilverScript Choice PDP.

 

Aetna says SilverScript Choice is available in 49 states and Washington, D.C., with Oklahoma excluded, and offers access to more than 63,000 network pharmacies.

 

Premiums vary substantially by state. Aetna’s 2026 announcement reported SilverScript Choice premiums ranging from approximately $14.70 to $116 for people not receiving full Extra Help, while full Extra Help beneficiaries could have access to $0 premiums in certain states.

Do not choose a Part D plan based on premium alone. The best Part D comparison is generally: monthly premium + deductible + projected medication costs at your pharmacy

The 2026 Medicare Part D Out-of-Pocket Cap

For 2026, Medicare Part D limits annual out-of-pocket spending on covered Part D prescriptions to $2,100.

 

After the applicable threshold is reached, beneficiaries generally owe no additional out-of-pocket cost for covered Part D drugs for the remainder of the plan year.

 

For 2027, CMS has announced that the standard Part D out-of-pocket threshold will rise to $2,400.

 

The Aetna page should update its plan-specific prescription details when Aetna publishes its full 2027 portfolio.

Dental, Vision, Hearing & More

Throughout this page, two labels matter: Included broadly for things Aetna indicates are broadly available across its individual MA portfolio, versus Plan-specific / eligibility required for things such as Extra Supports Wallet benefits.

Aetna Dental Benefits

Aetna says its 2026 individual Medicare Advantage plans include dental benefits. But “dental included” tells you very little by itself. Before selecting a plan, check:

Preventive dental

How frequently are exams and cleanings covered?

Comprehensive dental

Does the plan cover services such as: Fillings, Crowns, Root canals, Extractions, Dentures, Periodontal treatment?

Dental maximum

Is there an annual plan maximum?

Coinsurance

How much do you pay for major services?

Dental network

Does your dentist participate?

Out-of-network dental

Does the plan provide any reimbursement or point-of-service benefit?

Dental should be compared based on the treatment you expect to need—not simply the largest advertised allowance.

Aetna Vision Coverage

Aetna’s 2026 individual Medicare Advantage plans include routine vision benefits. Benefits may include:

But there is an important 2026 network change. Effective January 1, 2026, EyeMed became the exclusive routine vision network for most Aetna Individual Medicare Advantage members, with exceptions including Florida, certain integrated D-SNPs and certain employer/group arrangements. That means a consumer should check not only whether Aetna advertises vision coverage but also whether their preferred optometrist or optical provider participates in the applicable vision network. This is a good example of why supplemental benefits require the same type of network verification as medical care.

Aetna Hearing Coverage

Aetna says its 2026 Medicare Advantage plans include hearing benefits and $0 routine in-network hearing exams. The amount available toward hearing aids, approved devices, participating providers and frequency limitations can vary. When hearing benefits are important, verify:

Hearing-aid allowance

Number of devices covered

Approved manufacturers

Copays

Network requirements

Replacement frequency

SilverSneakers With Aetna Medicare

Aetna continues to offer SilverSneakers fitness membership with its individual Medicare Advantage plans in 2026, subject to plan-specific exceptions. SilverSneakers includes access to thousands of participating fitness locations and instructor-led fitness opportunities.

 

Aetna specifically notes that SilverSneakers is not offered with its Institutional Special Needs Plans. Fitness benefits are useful, but they should remain a secondary consideration after medical access, prescriptions and financial exposure.

Aetna Medicare Extra Benefits Card

The Aetna Medicare Extra Benefits Card can provide one or more benefit “wallets” containing plan-specific allowances. But not every Aetna plan includes the same card or wallets. Aetna identifies several possible wallet types.

OTC Wallet

Can be used for qualifying over-the-counter health and wellness products. Examples may include: Pain relievers, First-aid supplies, Cold and flu products, Dental care supplies, Certain health-related products.

CVS OTC Wallet

Similar OTC coverage restricted to eligible products and participating CVS purchasing channels

Medical Expense Wallet

Certain plans may allow card funds to help pay eligible plan-covered medical expenses.

Extra Supports Wallet

This is the wallet that receives substantial advertising attention. When the member and plan meet applicable eligibility requirements, approved spending categories can include: Healthy foods, Personal care products, OTC products, Transportation, Certain utilities. Aetna explains that Extra Supports benefits are generally Special Supplemental Benefits for the Chronically Ill and require applicable chronic-condition eligibility.

Important consumer warning: Do not assume that because you saw an Aetna television advertisement showing groceries or utilities, you personally qualify for that allowance. Confirm: your plan + your wallet + your eligibility + the allowance amount + approved spending categories before enrolling.

Aetna Resources For Living

Resources For Living is one of Aetna’s more unusual Medicare support programs. Rather than paying medical claims, the program connects qualifying Aetna Medicare Advantage members and their families with community resources. Aetna says consultants can help locate services involving areas such as:

Food and meal assistance

Senior housing

Home modifications

Financial assistance

Caregiver resources

Recreational programs

Social connection

Personal coaching

The consultation itself is provided at no added charge, although outside services found through the program can carry their own costs. Resources For Living is not available with Aetna standalone Part D plans, Medicare Supplement plans or I-SNPs.

Aetna Healthy Home Visits

Aetna’s 2026 Medicare Advantage portfolio includes an annual Healthy Home Visit through Signify Health at no additional charge. A licensed clinician can conduct an in-home health assessment and evaluate the home environment for issues such as fall risk and social-support needs. Aetna says the Healthy Home Visit is intended to complement—not replace—the member’s relationship with their primary doctor.

 

This benefit may be particularly useful for people who:

Aetna 24-Hour Nurse Line

Many Aetna Medicare Advantage members have access to a 24-hour nurse line. A registered nurse can provide general health information and guidance about health concerns. The service does not replace a physician’s diagnosis or emergency care. Aetna describes the nurse line as available to help members decide how to respond to health concerns and better understand health-related questions.

Aetna Telehealth

Some Aetna Medicare Advantage plans provide virtual-care benefits for covered services through video, phone or compatible digital platforms. Telehealth availability, providers and cost sharing depend on the specific plan and service. Do not assume every virtual provider or app is automatically covered.

What's broadly included vs what requires a closer look

Benefit2026 Aetna positionWhat MPA says to verify
DentalBroadly included in individual MADentist, annual maximum, major-service cost
VisionBroadly includedEyeMed/network rules and eyewear allowance
HearingBroadly includedHearing-aid provider, devices and copay
SilverSneakersBroad individual MA benefitLocal participating gyms; I-SNP exception
Part DIncluded in many MA plansEvery medication and pharmacy
OTCAvailable on applicable plansAllowance and approved products
Extra SupportsEligibility-specificChronic-condition eligibility and wallet
Healthy foodEligibility-specificDo not assume based on advertising
UtilitiesEligibility-specificConfirm wallet and qualifying condition
Resources For LivingMost applicable MANot PDP, Medigap or I-SNP
Healthy Home Visit2026 MA benefitUnderstand it supplements PCP care

Aetna Special Needs Plans

Aetna D-SNP Plans

An Aetna Dual Eligible Special Needs Plan is a Medicare Advantage plan designed for people who qualify for both Medicare and Medicaid. For 2026, Aetna says it expanded its D-SNP footprint by 119 counties. Aetna’s enrollment resources indicate D-SNP offerings in participating counties across approximately 30 states. D-SNPs include Medicare prescription drug coverage and may coordinate benefits between Medicare and Medicaid. Aetna’s D-SNP offerings can include:

All 2026 Aetna D-SNP members receive a monthly Extra Benefits Card allowance for qualifying OTC products. Members meeting applicable chronic-condition requirements may be able to use the allowance for additional categories such as healthy food, transportation, personal care items or utilities.

Eligibility varies according to:

Aetna C-SNP Plans

Aetna significantly expanded its Chronic Condition Special Needs Plan offerings for 2026. Aetna says C-SNPs are available in 18 states, including expansion into 16 additional states for the 2026 plan year. Aetna currently identifies qualifying conditions including:

The qualifying condition must be verified by a healthcare provider. If verification is not received within Aetna’s required timeframe, the member can be involuntarily disenrolled. Aetna’s C-SNP benefits can include:

Specific benefits depend on the plan and eligibility.

Aetna I-SNP / Medicare Longevity Plans

Aetna also offers Institutional Special Needs Plans, which may be marketed as Aetna Medicare Longevity plans. These plans are designed for qualifying people who live in long-term care or meet institutional-level-of-care requirements. 

 

Aetna’s current enrollment information lists I-SNP offerings in Connecticut, New York, Ohio and Pennsylvania. I-SNP availability is highly specialized and should be evaluated based on the member’s living arrangement, facility participation, medical needs and eligibility.

How Much Do Aetna Medicare Advantage Plans Cost?

There is no single Aetna Medicare premium. Costs differ by county and plan. Aetna says it offers at least one $0 monthly-premium Medicare Advantage plan in every county where it offers MA coverage for 2026, and estimates that approximately 82% of Medicare-eligible beneficiaries nationally can access a $0-premium Aetna MA option.

$0 Premium ≠ $0 Cost. That does not mean Aetna Medicare is free. Even with a $0 plan premium, members generally continue paying the Medicare Part B premium and can have healthcare cost sharing.

Compare:

Monthly plan premium

What does the private plan charge?

Medical deductible

Is there a deductible before certain services are covered?

Primary care

What is the copay?

Specialists

What does each specialist visit cost?

Hospital

Is inpatient care charged by day or admission?

Outpatient surgery

What is the copay or coinsurance?

Diagnostic imaging

What will an MRI, CT scan or other imaging cost?

Durable medical equipment

What percentage do you pay?

Prescription costs

What are the deductible and drug copays?

Maximum out-of-pocket

What is your worst-case annual medical exposure for covered Part A and Part B services?

The maximum out-of-pocket amount may matter far more than the monthly premium during a serious illness.

Aetna Medicare Maximum Out-of-Pocket Limits

Medicare Advantage plans include an annual maximum out-of-pocket limit for covered Part A and Part B services. After the member reaches the plan’s applicable limit, the Medicare Advantage plan pays covered medical costs subject to that limit for the remainder of the plan year. The specific limit varies by plan. A PPO may also distinguish between:

Before enrolling, understand both.

Does Aetna Medicare Require Prior Authorization?

Some Aetna Medicare Advantage services and items require prior authorization. Aetna explains prior authorization as approval that the healthcare provider obtains from the plan before Aetna will cover certain services or items. Each Aetna plan has its own authorization rules. The Evidence of Coverage identifies which services require approval.

 

Services that can involve authorization requirements may include certain:

Prior authorization is different from a referral. A referral generally comes from your PCP and directs you to another provider. Prior authorization is approval from the insurance plan before a covered service or item is provided. A plan can require one, both or neither depending on the service.

Aetna Medicare Star Ratings

CMS rates Medicare Advantage and Part D contracts each year on a 1-to-5-star scale. For the 2026 Star Ratings, Aetna reported:

Those are strong carrier-level statistics. But consumers should understand an important distinction: Aetna does not have one Medicare Star Rating. Ratings apply to specific CMS contracts. For example, one Aetna contract can have a different rating from another Aetna contract serving another market. Always check the Star Rating of the specific plan available in your ZIP code.

Medicare Supplement

Aetna also offers Medicare Supplement insurance, commonly called Medigap. Aetna Medigap coverage works with Original Medicare rather than replacing Original Medicare. 

 

Aetna currently markets standardized Medigap Plans A, B, D, G, N and—when the beneficiary’s Medicare eligibility date permits—Plans C and F, with plan availability varying by state. High-Deductible Plan G is also available in certain states.

 

Aetna Medicare Supplement insurance may be issued through Aetna-controlled subsidiaries including:

Continental Life Insurance Company of Brentwood, Tennessee

American Continental Insurance Company

Aetna Health and Life Insurance Company

Aetna Life Insurance Company

Aetna Health Insurance Company

certain other Aetna companies depending on the market

The underwriting company can therefore differ even though the policy is marketed within the Aetna family.

Aetna Medicare Supplement Plan G

Aetna Medicare Supplement Plan G generally covers most standardized Original Medicare cost-sharing obligations except the Medicare Part B deductible. Standard Plan G benefits include coverage for:

Part A hospital coinsurance

Additional hospital coverage after Medicare benefits are exhausted

Part A deductible

Skilled nursing coinsurance

Part B coinsurance

Part B excess charges

Foreign-travel emergency coverage within plan limits

High-Deductible Plan G may also be available. With High-Deductible G, the standardized Plan G benefits begin paying after the applicable annual high deductible is satisfied.

Aetna Medicare Supplement Plan N

Aetna also offers standardized Plan N in qualifying markets. Plan N generally provides broad Medigap coverage while requiring more member cost sharing than Plan G. Under standardized Plan N benefits, members can pay:

Up to $20 for certain office visits

Up to $50 for certain emergency-room visits that do not result in inpatient admission

Plan N does not cover Medicare Part B excess charges.

Aetna Medicare Advantage vs Aetna Medicare Supplement

Aetna Medicare AdvantageAetna Medicare Supplement
Who administers Parts A & B coverageAetna MA planOriginal Medicare
Provider networkUsually yesNo Medigap network; use Medicare-participating providers
Drug coverageOften includedSeparate Part D generally needed
Dental/vision/hearingCommonly includedNot standardized Medigap benefits
Medical MOOPYesCost-sharing structure depends on Medigap plan
Monthly premiumSome plans $0Separate Medigap premium
Prior authorizationCan applyOriginal Medicare rules primarily govern
Travel/provider flexibilityDepends on planBroad Original Medicare access

One is not inherently better than the other. The right structure depends on your healthcare preferences and financial situation.

What Is Aetna's Evidence of Coverage?

The Evidence of Coverage, or EOC, is one of the most important Medicare Advantage documents you can read. It explains:

Covered services

Copayments

Coinsurance

Authorization requirements

Network rules

Prescription benefits

Supplemental benefits

Member rights

Appeals

Maximum out-of-pocket limits

Aetna also provides access to:

Summary of Benefits

A shorter overview of coverage and costs.

Annual Notice of Change

Explains what is changing for existing members during the next plan year.

Formulary

Lists covered prescription medications.

Provider directory

Shows participating healthcare providers.

Star Ratings document

Shows CMS ratings for the applicable contract.

Aetna provides plan-document lookup tools online.

Is Aetna Medicare a Good Choice?

Aetna can be a strong Medicare option in markets where its network, prescriptions and benefits align with the member’s healthcare needs.

Aetna may deserve a closer look if:

Aetna may deserve more comparison if:

There is no meaningful answer to: "Is Aetna good?" without adding: "Which Aetna plan, in which county, for which person?" That is the comparison that matters.

The Aetna Medicare Checklist

Before enrolling in an Aetna Medicare Advantage plan, verify all of the following.

My primary doctor

Is the provider in the exact plan network?

My specialists

Check each one individually.

My hospital

Is the hospital system participating?

My prescriptions

Are all drugs covered?

My pharmacy

What will the prescriptions cost there?

Prior authorization

Do any ongoing treatments require approval?

Specialist referrals

Does the plan require them?

Maximum out-of-pocket

What is the annual medical maximum?

Dental

What services and annual amounts apply?

Vision

Which provider network applies?

Hearing

What hearing-aid coverage exists?

Extra Benefits Card

Do you actually qualify and what wallets are included?

Travel

How does routine care work outside your service area?

If one of these items is particularly important, verify it before submitting an enrollment application.

Compare Aetna With Other Medicare Companies

Different Medicare insurers can have very different networks and cost structures in the same ZIP code. Compare:

Aetna may win one category while another company wins another. That is why Medicare Plan Assistance evaluates: coverage + doctors + prescriptions + costs + benefits rather than carrier reputation alone.

When Can I Enroll in an Aetna Medicare Plan?

Medicare enrollment depends on your individual eligibility. Common enrollment periods include:

Initial Enrollment Period

For many people becoming eligible at age 65, this is a seven-month period surrounding the month they turn 65.

Annual Enrollment Period

October 15 through December 7

Eligible Medicare beneficiaries can change Medicare Advantage or Part D coverage for the following plan year.

Medicare Advantage Open Enrollment Period

January 1 through March 31

People already enrolled in Medicare Advantage can generally switch to another Medicare Advantage plan or return to Original Medicare.

Special Enrollment Period

Certain life circumstances can create an additional enrollment opportunity. Examples may include: Moving, Losing qualifying coverage, Gaining or losing Medicaid, Becoming eligible for certain Special Needs Plans, Other Medicare-recognized circumstances

The enrollment period available depends on the individual’s situation.

Aetna and CVS Health: What Does the Relationship Mean?

Aetna is part of CVS Health. This relationship is particularly visible in Aetna’s prescription and supplemental-benefit infrastructure. Depending on your plan, the CVS Health connection can involve:

CVS Caremark prescription management

CVS Caremark Mail Service Pharmacy

OTC Health Solutions

Extra Benefits Card purchases at participating CVS locations

CVS Health Resources For Living

Signify Health Healthy Home Visits

However, having Aetna Medicare does not mean every service at every CVS-related healthcare location is automatically free or covered. Your medical and prescription benefits still follow the specific Aetna plan’s network, coverage and cost-sharing rules. That distinction matters.

Compare Aetna Medicare Plans Available Near You

Humana’s Medicare offerings can differ by ZIP code, county and eligibility.

Instead of choosing based only on an advertisement or benefit amount, compare the entire plan:

Frequently Asked Questions About Aetna Medicare

Does Aetna offer $0-premium Medicare Advantage plans?

Yes. For 2026, Aetna says it offers at least one $0-premium Medicare Advantage plan in every county where it offers Medicare Advantage coverage. Availability and plan features vary by location.

Aetna says its 2026 individual Medicare Advantage plans include dental benefits. Exact covered services, annual limits, networks and cost sharing vary by plan.

Aetna’s 2026 individual Medicare Advantage plans include routine vision benefits. For most Aetna Individual Medicare Advantage members outside certain exceptions, EyeMed became the exclusive routine vision network beginning January 1, 2026.

Aetna Medicare Advantage plans include hearing benefits in 2026. Hearing-aid coverage, approved devices, provider networks and member costs vary by plan.

Aetna offers SilverSneakers with its individual Medicare Advantage plans in 2026, subject to applicable plan exceptions. Aetna Institutional Special Needs Plans do not include SilverSneakers.

Many Aetna Medicare Advantage plans include Medicare Part D prescription coverage. Aetna also offers standalone Part D through SilverScript Choice.

SilverScript is part of Aetna Medicare. Aetna and CVS Caremark are both part of the CVS Health family of companies.

Aetna has a broad pharmacy network that includes CVS as well as other chains and pharmacies, but pharmacy participation and drug pricing depend on the specific plan. Verify the pharmacy before assuming a particular CVS location provides the lowest plan cost.

Yes. Aetna offers Dual Eligible Special Needs Plans in participating counties for people who qualify for both Medicare and Medicaid.

Aetna offers Chronic Condition Special Needs Plans in qualifying areas for beneficiaries with conditions including diabetes, chronic heart failure and certain cardiovascular disorders.

The Extra Benefits Card is available with certain Aetna Medicare Advantage plans and can contain one or more benefit wallets. Depending on the plan and eligibility, these wallets can cover OTC products and certain other approved expenses.

Certain qualifying members with an Extra Supports Wallet may be able to purchase approved healthy foods. This benefit is not available to everyone with Aetna Medicare and can require chronic-condition eligibility.

It depends on the plan. Some HMO plans require PCP referrals for certain specialist services. PPO plans generally provide more direct specialist access.

Certain Aetna PPO plans allow covered out-of-network care and some may include access to Aetna’s broader national PPO network. Verify the exact plan’s rules before relying on routine out-of-state coverage.

Certain Aetna PPO plans allow covered out-of-network care and some may include access to Aetna’s broader national PPO network. Verify the exact plan’s rules before relying on routine out-of-state coverage.

Yes. Aetna offers standardized Medicare Supplement Plan G in qualifying states and may also offer High-Deductible Plan G.

Yes. Aetna offers standardized Medicare Supplement Plan N in qualifying markets.

Aetna is a CVS Health company. CVS Health businesses that may interact with Aetna Medicare benefits include CVS Caremark, OTC Health Solutions and other CVS Health entities. Coverage still depends on the specific Medicare plan.

For 2026, Aetna reported that more than 81% of its Medicare Advantage members were enrolled in plans rated 4 stars or higher by CMS and more than 63% were in plans rated 4.5 stars. Ratings vary by Medicare contract, so check the rating of the specific plan available to you.

Start with your ZIP code, then compare provider networks, hospital participation, prescriptions, pharmacies, medical copays, maximum out-of-pocket amounts and supplemental benefits against other plans available in your market.

Original Verification Tools

We’re confident enough in our guidance to show you the source.

Aetna Medicare provider search

Aetna Medicare plans

Aetna SilverScript information

Aetna Medicare coverage and plan documents

Medicare.gov Plan Compare

Independent Medicare Guidance

 

Medicare Plan Assistance is an independent insurance agency and is not Medicare, Aetna, CVS Health or a government agency. Plan availability, premiums, benefits, provider networks, formularies, pharmacies, cost sharing, eligibility criteria and supplemental benefits can vary by location and plan and may change from year to year. Aetna Medicare is responsible for its own plan terms and coverage decisions. Before enrolling, review the applicable Summary of Benefits, Evidence of Coverage, formulary and provider directory.

 

Aetna has a lot of benefits. The important part is knowing which ones belong to your exact plan.

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