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Aetna has been a CVS Health subsidiary since 2018, and that ownership defines its Medicare Advantage plans more than almost any other factor — from pharmacy pricing to MinuteClinic access. With roughly 4 million Medicare Advantage members, Aetna is the third-largest carrier in the country, behind UnitedHealthcare and Humana. Here’s a full, honest look at what that CVS integration actually means for you, alongside costs, star ratings, and the customer service reality.
The Quick Verdict
- CMS Star Rating (2026): Around 3.9–4.2 depending on the specific measure — above the 3.81 national average, with over 81% of members in plans rated 4 stars or higher
- Availability: 43–46 states plus Washington D.C., depending on plan type, with particular strength in the Northeast, Southeast, and major metro areas
- $0-premium access: Aetna estimates 82% of Medicare-eligible beneficiaries have access to a $0-premium plan for 2026
- The defining feature: Deep CVS Health integration — CVS Caremark manages prescription benefits, and most MinuteClinic services carry a $0 copay
- The catch: Like most major national carriers, Aetna scores below average on independent customer satisfaction surveys, with claim denials and phone wait times as recurring complaints
What CVS Ownership Actually Means for You
Aetna was founded in 1853 and became a wholly owned subsidiary of CVS Health in 2018, creating a vertically integrated company spanning insurance, pharmacy benefits, and retail health services. In practice, this shows up in several concrete ways:
- CVS Caremark manages prescription drug benefits for most Aetna Medicare plans, which directly affects which medications are covered and at what cost
- MinuteClinic access — CVS operates more than 900 MinuteClinic locations inside CVS stores nationwide, and most services there carry a $0 copay for Aetna Medicare Advantage members in 2026. For routine issues, this can be genuinely convenient if you’d rather walk into a CVS than schedule a primary care appointment — though it isn’t a substitute for ongoing primary care.
- A 20% discount on select CVS Health brand products, both in-store and online
- Drug pricing through CVS Caremark tends to be competitive: Tier 1 generics typically run $0–$5, Tier 2 generics $5–$15, and preferred brand-name drugs (Tier 3) around $35–$50
Star Ratings: Strong Overall, With One Notable Weak Spot
Aetna’s star ratings vary meaningfully by plan type, similar to other major carriers:
| Plan type | 2026 average star rating |
|---|---|
| HMO | 4.14 (vs. 3.86 national average) |
| PPO | 4.05 (vs. 3.63 national average) |
| HMO-POS | 3.41 (well below the 4.01 national average) |
The takeaway: Aetna’s HMO and PPO plans are genuinely strong performers, but its HMO-POS line is a clear weak point — worth checking closely if that’s the specific plan type you’re considering.
Costs for 2026
- Primary care copays: $0–$10 on most HMO plans, $25–$40 on PPO plans
- Specialist copays: $40–$55
- Emergency room: $90–$130 (typically waived if you’re admitted)
- Urgent care: $40–$65
- Out-of-pocket maximum: Runs middle-of-the-pack compared to other major carriers — not as low as UnitedHealthcare’s HMO average ($3,233), but more competitive than some PPO-heavy competitors
The Honest Part: Customer Satisfaction Is Mixed, Like the Rest of the Industry
This is worth stating plainly, and it’s not unique to Aetna: J.D. Power’s most recent Medicare Advantage satisfaction survey shows Aetna ranking below the state average in most markets surveyed — for example, 6th out of 6 in Florida, 4th out of 5 in Illinois, and 5th out of 6 in New York. Independent review platforms tell a similarly rough story, with Trustpilot ratings around 1.2 out of 5 — among the lowest of any major national insurer, on par with UnitedHealthcare.
Common complaints center on:
- Claim denials, with roughly 40% of denied claims reportedly approved on appeal — meaning persistence and escalation often pays off
- Extended phone wait times, ranging from about 17 minutes to over 2 hours depending on the report
- Friction between Aetna and CVS Caremark specifically around prescription processing — one documented complaint described being «passed around» between the two when trying to resolve a delayed medication
To be fair to Aetna, its complaint rate is reported as below the industry average among major carriers, its prior authorization denial rates run at or below industry norms, and its A.M. Best financial strength rating (A, Excellent) has held steady even as CMS methodology changes hurt some competitors’ star ratings for 2026. Physician satisfaction surveys generally place Aetna in the middle tier — better than Humana on administrative burden, roughly comparable to UnitedHealthcare, and behind Kaiser specifically where Kaiser operates.
The honest industry context: no major Medicare Advantage insurer currently performs well on customer satisfaction metrics — ratings across the five largest carriers cluster in a similarly rough 1.0–2.2 star range on independent platforms, reflecting what’s fairly described as an industry-wide service pattern rather than an Aetna-specific failure.
Pros and Cons
Pros:
- Above-average CMS star ratings on both HMO (4.14) and PPO (4.05) plans
- Genuinely useful CVS integration — MinuteClinic access, competitive Caremark drug pricing, retail discounts
- Strong A.M. Best financial strength rating (A, Excellent)
- Below-average complaint rate and prior authorization denial rate relative to industry peers
- 82% of Medicare-eligible beneficiaries have access to a $0-premium plan for 2026
Cons:
- HMO-POS plans significantly underperform Aetna’s HMO and PPO offerings
- Below-average J.D. Power satisfaction scores in most surveyed markets
- Very low independent review platform ratings, consistent with most major carriers industry-wide
- Documented friction specifically between Aetna and CVS Caremark on prescription issues
- Not available in every state — confirm coverage in your specific ZIP code
Frequently Asked Questions
Do I have to use CVS pharmacies with an Aetna Medicare Advantage plan? Not necessarily, but CVS Caremark manages the drug benefit for most plans, and pricing is often most competitive at CVS locations. Check your specific plan’s pharmacy network before assuming you’re limited to CVS.
Is MinuteClinic a substitute for a primary care doctor? No — it’s useful for routine, minor issues, but it doesn’t replace ongoing primary care and chronic condition management with a dedicated physician.
Why is Aetna’s HMO-POS rating so much lower than its HMO and PPO ratings? This isn’t clearly explained in available data, but it’s a consistent pattern across recent star rating cycles. If you’re specifically considering an HMO-POS plan, check that individual plan’s current rating carefully.
Is Aetna’s customer service worse than other major carriers? Not distinctly — independent review data shows most major national Medicare Advantage carriers, including UnitedHealthcare, scoring similarly poorly on consumer review platforms. This appears to be an industry-wide pattern rather than an Aetna-specific issue.
How many Medicare Advantage members does Aetna have? Approximately 3.7–4.2 million, making it the third-largest Medicare Advantage carrier nationally, behind UnitedHealthcare and Humana.
Bottom Line
Aetna’s defining strength is its CVS Health integration — genuinely useful pharmacy pricing and MinuteClinic access that few competitors can match — combined with above-average star ratings on its HMO and PPO plans specifically. The honest caveat is customer satisfaction, which trails industry leaders in most surveyed markets, though this appears to reflect a broader industry pattern rather than an Aetna-specific failure. If you value CVS pharmacy integration and strong HMO/PPO quality ratings, Aetna is worth serious consideration — just verify your specific plan type’s rating and go in with realistic expectations about the claims and service experience.
Compare the exact Aetna plans available in your ZIP code using the official Medicare Plan Finder, or speak with a licensed insurance agent or your local State Health Insurance Assistance Program (SHIP) for free, unbiased guidance.
Disclaimer: Star ratings, costs, and figures mentioned in this article are based on 2026 CMS data and industry sources, and vary by state, county, and specific plan. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.