Aetna vs Cigna HealthSpring in 2027: The Trade-Off Is Gone

This article is for general educational purposes only and is not insurance or medical advice. We are not affiliated with the U.S. government, Medicare, Aetna, CVS Health, Cigna, HealthSpring or HCSC. For official information, visit Medicare.gov or call 1-800-MEDICARE. See our Medical & Financial Disclaimer for details.

First, a correction to the question. Cigna no longer sells Medicare Advantage. On March 19, 2025, Health Care Service Corporation completed its purchase of Cigna’s Medicare businesses, and those plans now trade as HealthSpring. If you are comparing a “Cigna” Medicare plan against Aetna, you are comparing HealthSpring against Aetna.

Until this fall the two were sold as a clean trade: Aetna had the ratings, HealthSpring had the cost protection, pick the one that matches your temperament. On the 2026 numbers that was broadly true. We have now counted the 2027 plans, and the 2027 star ratings CMS published on October 8, 2026, and neither half of the trade survives.

What Changed Between 2026 and 2027

Counted from the CMS plan file	Aetna 2026	Aetna 2027	HealthSpring 2026	HealthSpring 2027	All plans 2027
Distinct plans on sale	642	654	283	200	5,522
Counties served	2,139	2,072	948	478	3,131
Plans with no monthly premium at all	59.6%	76.3%	76.5%	69.6%	69.7%
Median in-network out-of-pocket limit	$6,750	$7,150	$5,900	$7,150	$7,100
Plans at the highest limit allowed	34.7%	35.0%	10.2%	23.5%	28.2%
Mean overall star rating	4.02	3.67	3.62	3.24	3.86
Rated plans at 4 stars or better	72.0%	48.2%	39.7%	4.6%	61.2%
Special needs plans	159	190	51	51	1,969

The highest limit allowed was $9,250 for 2026 and is $9,850 for 2027. Each year’s star figures are that year’s ratings: the 2026 columns use the ratings published in October 2025, the 2027 columns the ones published in October 2026.

HealthSpring Halved, and Lost Both of Its Arguments

Start with the footprint, because for most readers it settles the question before anything else does. HealthSpring sold in 948 counties for 2026. For 2027 it sells in 478 — about one county in seven. Its catalog fell from 283 plans to 200. Wherever it has pulled out, there is no comparison to make, and the right next step is our Aetna review or simply the plans that are on sale at your address.

Where it does still sell, the cost-protection argument is gone. Its median out-of-pocket limit rose from $5,900 to $7,150 — exactly Aetna’s figure — and the share of its plans parked at the legal ceiling more than doubled, from one in ten to almost one in four.

And the ratings, which were already its weak side, fell further. Of its 194 rated plans for 2027, only nine reach four stars, and all nine belong to a single contract sold in 21 counties of Mississippi and Washington. Everywhere else, every rated HealthSpring plan on the shelf scores 3.5 stars or lower.

Aetna Kept Its Shape, but Not Its Ratings

Aetna’s catalog is almost the same size as last year, and its cost profile barely moved: more of its plans are now free each month, and about a third still sit at the legal ceiling, as they did in 2026.

What moved was the rating. For 2026, 72.0% of Aetna’s rated plans reached four stars. For 2027 it is 48.2%, now well under the market’s 61.2%, and the number of Aetna plans rated 4.5 stars or higher collapsed from 45.2% to 1.6%. Our guide to how star ratings are built explains why a whole company can move this much in one year: CMS rates contracts, and when a large contract slips, hundreds of plans slip with it.

So the honest summary is not that Aetna got worse and HealthSpring held steady. Both got worse on ratings. Aetna got worse from a high starting point and is still in the middle of the market. HealthSpring got worse from a low one, and is now close to the bottom of it.

The Filter That Shows the Real Gap

Company averages are a blunt tool, so here is the test that matters when you are actually choosing. Take only plans rated four stars or better and capped at or below the 2027 market median of $7,100.

• Aetna: 121 of its 643 rated plans pass both tests.
• HealthSpring: 5 of its 194 pass, all of them in that one Mississippi and Washington contract.

For 2026 the same filter left 168 Aetna plans and 79 HealthSpring plans, which is why the two looked like a fair fight. For 2027 it is not one. In the 422 counties where both companies sell, a well-rated, well-capped HealthSpring plan is the exception, and an Aetna one is something you have a reasonable chance of finding.

The Gap Inside Aetna Is Still the Bigger One

One thing from last year’s comparison still holds, and it is the most useful part. More than a third of Aetna’s plans — 229 of them — cap your in-network spending at $9,850, the highest figure any 2027 plan carries. The distance between an Aetna plan at its own median of $7,150 and an Aetna plan at that ceiling is $2,700. That is the money at stake in picking the wrong Aetna plan, and it is larger than anything that separates the two brands.

On top of whichever plan you choose comes the Part B premium, payable on every plan. CMS has not yet announced the 2027 figure; on the 2026 rate of $202.90 a month, that is $2,434.80 a year, so a worst medical year comes to roughly $9,585 on a plan capped at $7,150 and roughly $12,285 on one capped at $9,850, before a single prescription.

Drug Coverage: The One Place HealthSpring Still Leads

The out-of-pocket limit is only half of what a plan costs you. If you take regular prescriptions, the drug deductible and the drug part of the premium matter as much, and the same CMS plan file lists both for every plan. Here are the two companies’ plans with drug coverage (MA-PD), leaving out special needs plans.

Plans with drug coverage	Aetna 2026	Aetna 2027	HealthSpring 2026	HealthSpring 2027
Number of plans	452	428	166	137
Median drug deductible	$615	$700	$250	$500
Deductible at the legal maximum	86.3%	53.5%	13.9%	20.4%
No drug deductible at all	1.1%	1.4%	9.0%	0%
$0 for the drug part of the premium	66.8%	70.8%	87.3%	92.7%

Our own count from the CMS Landscape files. The legal maximum deductible was $615 in 2026 and is $700 in 2027.

This is the one column where HealthSpring keeps a real advantage. Its typical drug deductible doubled, from $250 to $500, and none of its plans now waive it completely, but it is still $200 below Aetna’s typical $700, and nine in ten of its plans charge nothing for the drug part of the premium. Aetna’s plans mostly sit at the maximum deductible: you pay the first $700 of your covered prescriptions yourself each January before the plan shares the cost.

Put in money, the gap is up to about $200 a year in HealthSpring’s favor for someone whose prescriptions reach the deductible. Against that, Aetna’s plans sell in far more counties and are rated better, so for most readers the drug deductible is a tiebreaker between two plans that already pass the filter above, not a reason to choose on its own. Many plans also leave the cheapest generic tiers out of the deductible, so check how your own medications are tiered before counting the $200.

The Extras: HealthSpring Cut, Aetna Held

Every plan also files its extra benefits with CMS, in a separate set of files called the PBP Benefits data. We counted the two companies’ ordinary plans in the 2026 and 2027 files the same way.

Share of plans with the benefit	Aetna 2026	Aetna 2027	HealthSpring 2026	HealthSpring 2027
Over-the-counter allowance	59.9%	61.9%	70.6%	44.5%
Typical OTC amount per year	$120	$120	$200	$120
Meal benefit	43.8%	38.7%	90.4%	61.0%
Transportation to medical appointments	1.6%	0.4%	29.4%	18.5%
Hearing aids	100%	100%	100%	80.8%
Typical eyewear allowance per year	$150	$150	$200	$100

Our own count from the CMS PBP Benefits files, ordinary plans open to anyone. “Typical” is the median among plans that file a dollar amount.

Last year HealthSpring was the more generous of the two on almost every extra. For 2027 it cut nearly all of them: the over-the-counter card went from seven in ten plans to fewer than half and is worth less where it remains, the meal benefit fell from nine in ten plans to six, the eyewear allowance halved, and one in five plans no longer includes hearing aids. Aetna’s extras barely moved. They were modest and stay modest — an over-the-counter card of about $120 a year where it exists, and almost no plans with transportation — but what you saw in 2026 is roughly what you get in 2027.

If you are a current HealthSpring member who chose the plan for its extras, this is the part of your Annual Notice of Change to read first. Our guide to over-the-counter benefits shows how the same cuts look across the whole market.

How to Decide in Ten Minutes

1. Enter your ZIP code on the Medicare Plan Finder and see whether HealthSpring is sold there at all. In six counties out of seven it is not.
2. Write down each candidate plan’s in-network out-of-pocket maximum and cross out anything at or near $9,850.
3. Check the star rating of each plan that survives. For 2027, a HealthSpring plan below four stars is the normal case, not the exception, so this step will usually remove it.
4. Only then compare premiums. Roughly seven plans in ten from either company charge nothing beyond Part B, so a $0 premium separates nothing. Our guide to what a $0 premium really means explains where that money comes from.
5. Check your own doctors and prescriptions against each surviving plan by name. This is the step that decides it.

Questions People Ask About These Two

Is Cigna Medicare now HealthSpring? Yes. HCSC completed its purchase of Cigna’s Medicare businesses on March 19, 2025 and the plans trade under the HealthSpring name.

I am already in a HealthSpring plan rated three stars. Do I have to leave? No. A rating is information, not an instruction, and a plan that covers your doctors and your drugs at a cost you can live with may still be right for you. But between October 15 and December 7 you can switch, and it is worth ten minutes to see what else is sold where you live. What happens if you do nothing is explained in our 2027 overview.

Why did HealthSpring’s ratings fall so far? CMS publishes the scores, not the reasons, and we are not going to invent one. What the file shows is that most of HealthSpring’s contracts are rated three stars on the medical side for 2027, and none reaches 4.5.

Which of the two has the lower drug deductible for 2027? HealthSpring, on the typical plan: a median of $500 against Aetna’s $700, and 92.7% of HealthSpring’s plans with drug coverage charge $0 for the drug part of the premium, against 70.8% of Aetna’s. Neither company has any meaningful number of plans with no drug deductible at all for 2027.

Does HealthSpring still give an over-the-counter card? On fewer plans than before. In the 2027 filings 44.5% of its ordinary plans include one, down from 70.6% in 2026, and the typical card is worth about $120 a year, the same as Aetna’s. If your current plan has one, check your Annual Notice of Change to see whether it survives into January.

Is HealthSpring the same as my local Blue Cross plan? Not in the way most people mean. HCSC, the company that bought HealthSpring, also runs the Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, but HealthSpring plans are sold under their own name and their own networks. A Blue Cross card in those states and a HealthSpring card are different plans with different doctors, so compare them as you would any two insurers.

The Short Version

For 2027 this is no longer a trade between ratings and cost protection. HealthSpring has the same median cap as Aetna, sells in half as many places as it did, and has well-rated plans in only 21 counties. Aetna’s ratings fell too, but it remains the company where a well-rated, well-capped plan is realistically on offer. Inside Aetna, though, the cap still varies by $2,700 from one plan to the next, so the brand decides less than the plan does.

Our separate reviews go through each in full: Aetna Medicare Advantage Review and Cigna HealthSpring Medicare Advantage Review.

What We Counted for This Comparison

Neither company supplied any of these numbers. We counted them plan by plan in the CY2027 and CY2026 Landscape files that CMS published in September 2026, grouping by parent organization: 654 distinct 2027 plans under CVS Health Corporation and 200 under Health Care Service Corporation, from 5,522 on sale nationally. The 2027 star figures come from matching each plan’s contract to its overall rating in CMS’s 2027 Star Ratings data tables, and cover the 643 Aetna and 194 HealthSpring plans that carry a rating; plans too new to be rated are left out of every star figure and every premium share.

The dollar gaps in this article — $2,700, and the annual totals built on the 2026 Part B premium — are our own arithmetic, not figures anyone reports. What we keep, what we exclude, and why a share of plans is not a share of members, are set out on our Editorial Methodology page.

Sources

• CY2027 and CY2026 Medicare Advantage and Part D Landscape files — Centers for Medicare & Medicaid Services, September 2026 versions. Source for plan counts, county coverage, premiums, out-of-pocket limits, the $9,850 and $9,250 ceilings, special needs plans and the filtered counts. All calculations are our own.
• 2027 Star Ratings Data Tables — Centers for Medicare & Medicaid Services, published October 8, 2026. Source for every 2027 star figure, matched contract by contract. See also CMS’s 2027 Star Ratings fact sheet.
• HCSC Completes the Acquisition of The Cigna Group’s Medicare and CareAllies Businesses — Health Care Service Corporation. Source for the March 19, 2025 closing date.
• 2026 Medicare Parts A & B Premiums and Deductibles — Centers for Medicare & Medicaid Services. Source for the $202.90 Part B premium used in the annual totals until the 2027 figure is announced.
• PBP Benefits – 2027 and PBP Benefits – 2026 — Centers for Medicare & Medicaid Services. The benefit filings each plan submits. Source for the extra-benefit shares and amounts in the table of extras (our own count of plans open to anyone, excluding employer plans and SNPs).

All figures on this page were counted from the CMS files on October 12, 2026. The drug-coverage and extra-benefit tables were added on October 17, 2026 from the same Landscape files and the CMS PBP Benefits files. Plan availability changes; confirm current details on Medicare.gov before enrolling.

Disclaimer: Plan figures reflect 2027 and 2026 data from the Centers for Medicare & Medicaid Services (CMS) and vary by state, county and plan. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, or a licensed agent before making a decision.