Medicare Advantage plans are an alternative way for people to get Medicare part A and part B benefits. Most plans also cover prescription drugs.

Private companies such as Aetna offer Medicare Advantage plans throughout the country.

This article looks at the different Aetna Medicare Advantage plans available, exploring their benefits, availability, costs, and waivers.

Glossary of Medicare terms

  • Out-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
  • Premium: This is the amount of money someone pays each month for Medicare coverage.
  • Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.
  • Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.
  • Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
A senior doctor looking at medical recordsShare on Pinterest
Raul Navarro/Stocksy

Aetna is a healthcare benefits company that CVS Health acquired in 2018. It serves around 39 million people.

According to Aetna’s website, 88% of its Medicare Advantage members are enrolled Medicare Advantage Prescription Drug (MAPD) plans for 2025 that are rated 4 out of 5 stars or higher by the Centers for Medicare and Medicaid Services.

Aetna has a range of Medicare Advantage plans, which typically include prescription drug coverage and some additional benefits. It offers individual MAPD plans in 44 states and Washington, D.C.

Aetna’s Medicare Advantage plans include:

  • mail-order benefits, if the plan includes prescription drug cover
  • dental, vision, and hearing cover, except for Institutional Special Needs Plans (I-SNPs)
  • worldwide emergency care cover

The key differences between these plans involve the requirements around using services from within a specific network of doctors and healthcare facilities. The following sections outline these requirements in more detail.

Health Maintenance Organization plans

When someone joins a Health Maintenance Organization (HMO) plan, they choose an in-network primary care physician who coordinates their healthcare.

If someone needs to see a specialist or requires a hospital visit, the primary care physician may need to provide a referral, depending on the plan.

Like most HMO plans, Aetna’s Medicare Advantage HMO plans require members to use services from within a specific network of doctors and healthcare facilities, unless they are in an emergency situation. These plans have limited out-of-network benefits.

HMO Point of Service plans

Aetna’s Medicare Advantage HMO Point of Service (HMO-POS) plans also offer the benefits of coordinated care through a primary care physician.

These plans generally require people to visit an in-network doctor or hospital for medical care outside of emergency situations, but members have the flexibility to choose out-of-network professionals for dental services, though this is likely to be at a higher cost.

Preferred Provider Organization plans

Aetna’s Medicare Advantage Preferred Provider Organization (PPO) plans allow members to visit any healthcare professional or hospital that accepts Medicare and the plan’s terms. Usually, the person will not need a referral.

However, when someone uses in-network services, they do not need to make a claim, and the cost is lower.

With some Aetna PPO plans, the member can choose a primary care physician, which can also help them save on costs.

Other Aetna plans include:

  • Prescription Drug Plan (PDP): In 2025, Aetna offers one PDP, SilverScript Choice, which is available in all 50 states and D.C. It has a $0 premium for people receiving Extra Help and premiums ranging from $23.50 to $66 for people not receiving Extra Help.
  • Dual Eligible Special Needs Plan (DSNP): DSNP plans offer $0 deductibles and $0 prescription drug copays at in-network pharmacies for people who qualify for Medicare and Medicaid benefits.
  • Medicare supplement plans: Aetna offers supplement plans that provide additional coverage and allow people to customize their plans to suit their health needs.
  • Chronic condition special needs plans (C-SNPs): C-SNPs provide support for people with diabetes, chronic heart failure, and cardiovascular disease, including lower copays for essential prescription drugs.
  • Medicare Eagle MA-only plans: These plans offer additional benefits for veterans who already have prescription drug coverage.
  • SmartFit plans: These plans are available in 10 states for people with prescription drug coverage considering switching to a Medicare Advantage plan.
  • Group Medicare: This gives employees access to condition and case management support, health advocacy, preventive care, and wellness benefits.

Most Aetna Medicare Advantage plans offer a range of benefits, though these can vary by plan. This range of benefits includes:

  • Dental, vision, and hearing: Free checkups, exams, eyeglasses, and hearing aids are available with in-network professionals.
  • Fitness benefits: Aetna Medicare Advantage plan members can use the Silver Sneakers fitness programs at 16,000 gyms nationwide. (Note that I-SNP plans do not offer this benefit.)
  • Over-the-counter benefits: Members can get some nonprescription drugs and health products, such as vitamins and cold medications, directly from a pharmacy at no cost.
  • Total health benefits: These include a 24-hour nurse hotline, free annual flu vaccinations, and prescription home delivery.
  • Meals-at-home program: This program offers meal delivery during someone’s recovery after a hospital stay. Aetna provides 14 meals per week.
  • Resources For Living program: This is a helpline that gives members access to services and resources in their community, including help at home, caregiver support, social support, and other activities.

Aetna offers Medicare Advantage plans in all 50 states. People can visit the Aetna website and enter their zip code to find out which plans are available in their area.

The costs of Aetna Medicare Advantage plans will depend on someone’s circumstances and the plan they choose.

The coinsurance and copay amounts vary with individual plans and the medical service.

Medicare resources

For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

Aetna offers a range of Medicare Advantage plans, including HMO, HMO-POS, and PPO plans, throughout the United States. However, people will need to check whether Aetna offers the plan they want in their location.

The plans offer the same coverage as Original Medicare and a range of benefits, such as dental and vision care, depending on the plan.

Individuals can choose the plan that best suits their specific health needs and offers the best value for money.