Aetna Medicare plans provide access to both Medicare Advantage and Medigap plans to help extend your Medicare coverage. If it is time to update your prescription drug coverage or you want to obtain extra benefits, the comprehensive member services and outstanding resources available make Aetna an ideal choice. Annual updates for Medicare enrollees are essential to ensuring you get the coverage as life changes.
Aetna, established in 1853, was one of the largest health insurance providers in the US. In 2018, the company became a subsidiary of CVS and continues to offer Aetna Medicare Plan options for eligible parties in the US. Today, you can enter your zip code and find out if you can get member services from Aetna and potentially qualify for competitive rates.
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What’s New for 2025
Aetna, a CVS Health company, has introduced several changes to its Medicare plans in 2025, including updated costs, benefits, and availability. However, one of the most significant updates is that Aetna has reduced its Medicare Advantage offerings in certain regions, affecting approximately 420,000 members across multiple states (Axios).
Key updates for Aetna Medicare Plans in 2025:
- Reduced Medicare Advantage availability: Some counties and states will no longer have certain Aetna plans, impacting plan renewals.
- $0 deductible for Tier 1 and Tier 2 prescription drugs on Aetna’s Medicare Advantage Prescription Drug (MAPD) plans.
- $2,000 out-of-pocket maximum for prescription drug costs per calendar year, aligned with new Medicare Part D guidelines (CVS Health).
- Expanded Aetna Medicare Eagle MA-only plans, covering veterans and those with prescription drug coverage in 43 states and D.C.
- SmartFit plan expansion for members switching to Medicare Advantage, including $0 premiums, dental, vision, and hearing benefits.
The company also announced changes to its medical plan drug list or formulary coverage. If you are using any of the following medications, you may wish to update your coverage or ensure your current plan offers what you need:
- Zemaira
- Elfabrio
- Fabrazyme
- Bortezomib
- Belcade
- Izervay
- Syfovre
- Evenity
- Prolia
- Benlysta
- Saphnelo
The Expanded Aetna Medicare Eagle MA-only plans are available in 43 states plus D.C., which offer additional benefits for veterans or individuals who already have prescription drug coverage. It includes plans that feature a $0 monthly plan and $0 primary care copay, including walk-in clinics, dental, vision, hearing, OTC allowance, and SilverSneakers fitness benefits. It also includes a $0 copay for labs, colonoscopies, and routine eye and hearing exams.
The Aetna Medicare SmartFit plan is available in 10 states and provides those who obtain the prescription drug plan who are switching to a Medicare Advantage plan to reach a $0 monthly premium plan that includes dental, vision, and hearing. It also features a $0 in-network primary care visit benefit with labs and a $0 copay for Tier 1 and Tier 2 drugs.
Plan Types Explained: Types of Aetna Medicare Plans for 2025
Aetna Medicare Plans provide a wide range of coverage options and additional benefits. Keep in mind that coverage details, along with costs, deductibles, and plan exclusions, differ from one area to the next. Always read the details of any proposed plan before making a decision. The coverage of plans depends on service area, age, and other factors.
Medicare Advantage
Aetna Medicare Advantage plans connect members with the health and wellness coverage they need, including hospital care, medical support, prescriptions, and more. Options include:
- Medicare Advantage HMO Plans: You choose a primary care provider who will coordinate your care within the Aetna network of providers, including provider hospitals.
- Medicare Advantage HMO-POS plans: These plans allow you to receive the benefits of care through a network provider that accepts Aetna Medicare. HMO-POS plans allow you to choose the provider from a group of participating providers. Most HMO-POS plans provide dental care from in or out-of-network providers. You pay more when you choose out-of-care benefits.
- Medicare Advantage PPO Plans: PPO plans provide the flexibility to see both in-network and out-of-network providers. While out-of-network visits may come with higher costs, these plans offer broader provider access than HMOs.
- Medicare Advantage Special Needs Plans: Special Needs Plans (SNPs) are tailored for individuals with specific chronic conditions, those eligible for both Medicare and Medicaid (Dual Eligible SNPs), or residents of institutional care facilities.
Medicare Supplement (Medigap)
Medicare Supplement Insurance Plans, or Medigap, help fill in coverage where needed and work alongside Original Medicare. It pays for the costs that Original Medicare doesn’t, such as copayments, coinsurance, and deductibles. Plans and rates change frequently. They are based on your zip code and other factors, such as your age.
Medicare Part D Drug Plans
Aetna’s Part D plans have changes in 2025:
- $2,000 out-of-pocket maximum per year for prescription drugs.
- $0 deductible for Tier 1 and Tier 2 drugs, with $0 copays available at preferred network pharmacies for certain medications.
- Expanded pharmacy networks with 63,000 locations and 22,000 preferred pharmacies.
- 100-day supply of medications available for Tiers 1–4 via mail order.
- $0 copays and $0 deductibles for Dual Eligible Special Needs Plan (D-SNP) members.
- Insulin capped at $35 per month under the Insulin Savings Program.
- Vaccines covered at a $0 copay, including Shingrix and other recommended immunizations.
- Premiums range from $23.50 to $66 for those not receiving Extra Help (Medicare.gov).
Benefits of Choosing Aetna Medicare Plans
Aetna Medicare Advantage plans typically offer prescription drug coverage as well as additional benefits. However, due to recent plan reductions, availability has changed in 2025. Some of the key advantages of these plans include:
- Comprehensive coverage, including hospital, medical, and prescription drug benefits.
- $0 premium plans available in select areas.
- Additional benefits, such as dental, vision, and hearing coverage.
- SilverSneakers fitness program included in many plans.
- Emergency medical coverage while traveling.
- Mail-order prescription options for added convenience.
- Specialized plans, including:
- Dual Eligible Special Needs Plans (D-SNPs) with $0 deductibles and $0 prescription drug copays for in-network pharmacies.
- Medicare supplemental plans tailored to individual needs.
- Chronic condition special needs plans.
- Medicare Eagle MA-only plans for veterans and those with separate prescription drug coverage.
- SmartFit Plans for individuals transitioning to Medicare Advantage.
- Group Medicare plans for employer or union-based coverage.
How to Enroll in Aetna Medicare Plans
You can enroll in Medicare plans when you meet eligibility requirements. For most people, that is a few months prior to your 65th birthday or within the enrollment period. Your initial enrollment period starts 3 months prior to your 65th birth and extends for 7 months. This is when you can initially select coverage.
The General Enrollment Period runs from January 1 through March 31 each year. It applies if you did not sign up when you were first eligible or if you are not eligible for a Special Enrollment Period.
The Annual Enrollment Period, when you can make changes to your plan, starts on October 15 and runs through December 7.
FAQs:
How much does Aetna Medicare Advantage cost?
For 2025, Aetna expects 83% of those eligible to receive Medicare benefits to have access to a $0 monthly premium Aetna Medicare Advantage Plan.
What should I do if my Aetna Medicare Advantage plan was discontinued?
Each year, Medicare Advantage Plans could be discontinued. This often allows for the creation of new plans. If your plan is discontinued, you will receive notice of that in the year prior. You will then be able to enroll in a new plan. New options also roll out each year.
Should I choose Aetna Medicare Advantage Plans or Original Medicare?
This is a decision you must make based on your health, budget, and care goals. Original Medicare may not offer you the extensive coverage you need, or you may want different hospitals or providers. By comparing your options for Medicare Advantage Plans from Aetna, you can determine which policy is best for you.
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