Aetna Medicare Advantage and Aetna Medigap Plans For 2019 – Which Is Right For You

Aetna offers Medicare Advantage plans with and without prescription drug coverage, and the company also provides Part D (prescription drug) plans and Medigap coverage. Subsidiaries and affiliates, which often offer their own unique product lineups, include Coventry, First Health and Meritain. Aetna’s lineup of Medicare Advantage plans includes PPO, HMO and PDP products. Availability varies among service areas.

Aetna’s Medicare Advantage individual plans are available in over 900 counties throughout the United States.

About 7 percent of the country’s 19 million Medicare Advantage enrollees received coverage through Aetna in 2017. The company’s 2018 figures showed a Medicare Advantage enrollment total of over 1.7 million people and a Medigap enrollment total of about 748,000 people. Additionally, more than 2.1 million people had standalone Part D plans through Aetna, and over 1.2 million people received drug benefits through a Medicare Advantage plan.

In 2018, Aetna offered plans with a CMS rating of 4.0 or higher in 91 percent of its Medicare service areas. CMS gave the company’s Medicare Advantage Prescription Drug plans an average rating of 4.0 stars. Of Aetna subscribers, 87 percent chose a plan with at least 4.0 stars.

A.M. Best gives Aetna a Financial Strength Rating of “A.” The company also has a Long-Term Issuer Credit Rating of “a.” Individual subsidiaries and affiliates of Aetna may receive separate ratings from A.M. Best.

Aetna Medicare Advantage in 2019

Aetna sells a variety of Medicare products, and you can find Aetna Medicare plans in most states. Using Los Angeles County, California, we found three options for Medicare Advantage from Aetna:

• Aetna Medicare Select HMO
• Aetna Medicare Prime HMO
• Aetna Medicare Choice PPO

To give you an idea on average costs and coverage, we’ve compiled some examples from the plans listed below.

Aetna Medicare Advantage (2019) Example Pricing And Coverage
	Medicare Select HMO	Medicare Prime HMO	Medicare Choice PPO
Monthly premium	$0	$0	$73
Copay (primary)	$0	$0	$5 in network 40% out of network
Deductibles	$0 for medical $0 for drug	$0 for medical $0 for drug	$0 for medical in network ($750 out of network) $0 for drug
Network	In-network coverage only	In-network coverage only	Coverage for network and non-network care
Rx coverage?	Yes	Yes	Yes
Rx cost	$0 copay for tier 1	$0 copay for tier 1	$0 copay for tier 1
Special features	Fitness membership; $175 to spend on eyewear; $600 to spend on dental	Fitness membership; $300 to spend on hearing aids; $175 to spend on eyewear; $350 to spend on dental	Fitness membership; $125 to spend on eyewear; travel benefits
Out-of-pocket max	$2,000	$2,200	$6,700 in network $9,500 out of network
CMS Star Rating	3.5	3.5	4

Medicare Advantage availability varies based on zip code. When we were looking for plan information in each of the 50 states, several states showed no availability based on the zip codes we used. For instance, Alaska and Vermont – both states that we know sell Aetna plans – listed no results. That’s why it’s important to get a get a quote based on where you live. What’s available to you might not be available to your cousin who lives three hours north in the same state. Getting a personalized quote is the best way to find out which plans you can buy (from any company).

Aetna Medigap in 2019

If you want or need to keep original Medicare, you may need supplemental coverage to cover some out-of-pocket costs. That’s where Medigap (aka Medicare supplement insurance) comes in handy. There are 10 plan types, labeled A through N. These plans vary by letter but not by type. In other words, all Medigap Plan F plans will cover the same benefits as all other Plan F plans, regardless of where you buy that plan or who sells it. 

Cost, customer service and company reputation are among the factors that differentiate Medigap plans from the various companies that sell them. Some companies may also let you add extra benefits to a standardized Medigap policy. But know that these aren’t standardized benefits and usually cost more because they’re considered “riders” (add-ons) to the plan. 

Medicare supplement policies are standardized at the federal level in every state except Massachusetts, Minnesota and Wisconsin, which standardize their plans differently. Aetna sells five plan types nationwide: A, F, high-deductible F, G and N. Plan C is available in New Jersey, Michigan and Vermont, and Vermont residents can also buy Plan D from Aetna.

Aetna Medigap Plan A

Since it’s the basic Medigap plan, Plan A only covers four benefits. Aetna Medigap Plan A could fill a few gaps in your original Medicare coverage. Using information from California, Plan A from Aetna would cost a 65-year-old about $121 a month ($1,450 for the year) at the preferred rate, which is usually given to people who sign up during their initial eligibility window. All Medigap policies, including Plan A, cover these four basic benefits: 

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part B coinsurance or copayment
• The first three pints of blood

Aetna Medigap Plan B

Medigap Plan B from Aetna covers one additional benefit that Plan A doesn’t, and that’s the Medicare Part A deductible. In 2019, that deductible is $1,364 for the year. You can’t predict how much you’ll have to pay for hospital care in a year, but it may be comforting knowing that the deductible and coinsurance rate would both be taken care of under Medigap Plan A. If you’re looking at the cost of Medigap plans for Aetna, a 65-year-old Californian would pay about $152 a month for Medigap Plan B coverage. You’ll find the following benefits under Medigap Plan B:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Part B coinsurance or copayment
• The first three pints of blood

Aetna Medigap Plan C

Aetna sells Medigap Plan C in three states: New Jersey, Michigan and Vermont. Medigap Plan C covers a broader range of benefits than Plans A or B, and it comes with a higher price tag. In Vermont, for example, a 65-year-old would pay about $187 a month for Medigap Plan C from Aetna. That same person would pay $132 a month for Plan A or $166 a month for Plan B. The higher cost, though, includes more benefits. Under Medigap Plan C, you’ll find coverage for:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B deductible
• Part B coinsurance or copayment
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Note that Plan C is one of two Medigap policies that cover the Medicare Part B deductible (Plan F is the other). Both of these plans will be eliminated starting January 1, 2020. You can still buy Plan C or Plan F from Aetna and other companies until then, and you can keep it if you already have it in place before 2020. But Plans C and F will be eliminated after that date, which means costs could go up as fewer people have these plan types.

Aetna Medigap Plan D

Vermont residents also have the option to buy Medigap Plan D from Aetna. This plan covers the same benefits as Plan G except for the Part B excess charges, which only Plans F and G cover. A 65-year-old Vermonter would pay about $168 a month for Aetna Medigap Plan D in 2019. This plan covers:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B coinsurance or copayment
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Aetna Medigap Plan F and High-Deductible F

Medigap Plan F has long been considered among the best values in Medicare supplement policies because it covers every benefit Medigap offers. Plus, many companies price Plan F competitively. Our 65-year-old from California who signs up during his initial enrollment window for Medigap would pay about $195 a month for Medigap Plan F from Aetna. That might seem like a lot, especially when you consider that this is an additional premium on top of what you pay for Medicare Part B, but considering the benefits, it’s a good deal. Medigap Plan F covers:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B deductible
• Part B coinsurance or copayment
• Part B excess charges
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Because it covers the coinsurance for original Medicare (Parts A and B) as well as the deductibles and Part B excess charges – which is the difference between what your plan covers and what a non-Medicare-contracted doctor charges for care – Medigap Plan F would leave you with virtually no out-of-pocket responsibilities beyond the premium for the plan itself. If you need a lot of medical care, Plan F is a great value. Do keep in mind, though, that this plan type will be eliminated in 2020.

There’s also a high-deductible version of Plan F under Medigap. It covers the same benefits as regular Plan F, but you have to meet a high deductible before the benefits pay out. That deductible, set at the federal level, is $2,300 for 2019. The tradeoff is that you’ll have a much lower premium. Our Californian would pay just $46 a month for the high-deductible Plan F from Aetna, saving nearly $150 a month ($1,780 for the year). When you’re shopping for Medigap plans, compare the cost of Plan F with high-deductible Plan F to see if it’s worth the cost savings to have a deductible.

Aetna Medigap Plan G

If you want the benefits of Medigap Plan F but don’t want to buy a plan that will be eliminated next year, consider Medigap Plan G from Aetna. Plan G covers everything that Plan F covers except for the Medicare Part B deductible. In 2019, the Medicare Part B deductible is $185. Plan G from Aetna costs $157 a month for our 65-year-old in California, which adds up to about $500 less for the year vs. Plan F. You would still pay less for Plan G even after factoring in that Part B deductible. Aetna Medigap Plan G covers:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B coinsurance or copayment
• Part B excess charges
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

Aetna Medigap Plan N

Aetna also sells Medigap Plan N, which covers most Medigap benefits. In fact, it’s similar to Medigap Plan G except that it requires a copay for some Part B services and doesn’t cover the Part B excess charges or deductible. These differences make Plan N less expensive than Plan G. In California, a 65-year-old would pay about $114 a month for Aetna Medigap Plan N, which covers:

• Part A coinsurance and hospital costs (up to an extra 365 days after Medicare hospital benefits get used up)
• Part A hospice care coinsurance or copayment
• Part A deductible
• Skilled nursing facility coinsurance
• Part B coinsurance or copayment
• The first three pints of blood
• 80% of foreign travel medical expenses (up to the plan limit)

As we mentioned, Plan N also requires some cost sharing for Part B. With this plan, you’ll have a copay of up to $20 for regular office visits and a copay of up to $50 for trips to the emergency room that don’t lead to inpatient admission. 

Not sure which plan you should go with, or whether you need original Medicare or Medigap? Let us help. We’re Medicare experts, and we can guide you to the right plan for your needs. Get your personalized quote today to see which options will work best for you.