This article is for general educational purposes only and is not insurance, medical, or financial advice. We are not affiliated with the U.S. government, Medicare, Aetna, or Cigna/HealthSpring. For official information, visit Medicare.gov or call 1-800-MEDICARE. This post may contain links from which we earn a referral fee at no extra cost to you. See our Medical & Financial Disclaimer for details.
Aetna and Cigna are both major names in U.S. health insurance, and both sell Medicare Advantage plans — but before you compare them, there’s one important update you need to know: in 2025, Cigna sold its entire Medicare Advantage and Part D business to Health Care Service Corporation (HCSC), a Blue Cross Blue Shield company, and those plans now operate under the HealthSpring brand. This isn’t just a rebrand — it’s a genuine change in underwriting ownership. If you see «HealthSpring» on a plan while shopping, that’s the former Cigna Medicare coverage, now backed by HCSC. This guide compares Aetna and Cigna/HealthSpring head-to-head for 2026.
The Quick Answer
- Aetna (owned by CVS Health) tends to win on quality: higher average CMS star ratings, a lower out-of-pocket maximum on average, and deep integration with CVS pharmacies and MinuteClinic locations.
- Cigna/HealthSpring tends to win on price: a higher share of $0-premium plans and lower average monthly premiums, though its star ratings trail Aetna’s in most markets.
Aetna is also available in more states, which matters if you’re comparing options where you live — Cigna/HealthSpring’s Medicare Advantage footprint is narrower.
Aetna Medicare Advantage
Aetna is part of CVS Health, and that ownership shows up directly in its Medicare Advantage plans.
What stands out about Aetna in 2026:
- Average CMS star rating in the high 3s to low 4s (roughly 3.9–4.2 depending on the specific plan type — HMO plans tend to rate higher than PPO plans)
- Available in roughly 43–45+ states, one of the broader Medicare Advantage footprints among major carriers
- $0-premium plans available to a large share of members, though the exact percentage varies by state
- Strong integration with CVS pharmacies, including $0 copays on many CVS Health brand prescriptions and MinuteClinic access for routine care
- A comparatively lower average annual out-of-pocket maximum than Cigna/HealthSpring on PPO plans
Where it tends to fall short: customer satisfaction survey scores have lagged some competitors in independent surveys, even though its CMS quality ratings are strong.
Cigna / HealthSpring Medicare Advantage
Cigna’s Medicare Advantage plans are now marketed under the HealthSpring name. The coverage itself is still backed by Cigna, but you’ll see «HealthSpring» on plan documents and marketing materials.
What stands out about Cigna/HealthSpring in 2026:
- A high percentage of $0-premium plans — among the highest of the major national carriers
- Lower average monthly premiums than Aetna in most markets where both are available
- Both basic and enhanced prescription drug benefit options
- Available in a narrower footprint, roughly 29 states
Where it tends to fall short: average CMS star ratings sit below Aetna’s in most plan categories, and PPO plans in particular have struggled to consistently cross the 4-star threshold that unlocks extra benefits and special enrollment flexibility. The average out-of-pocket maximum on Cigna/HealthSpring PPO plans has also run noticeably higher than Aetna’s in recent comparisons — something worth weighing carefully if you expect a high-cost medical year.
Side-by-Side Comparison
| Aetna | Cigna / HealthSpring | |
|---|---|---|
| Average CMS star rating (2026) | Roughly 3.9–4.2, higher on HMO plans | Roughly 3.7–3.8 nationally, often lower on PPO plans |
| States available | ~43–45+ | ~29 |
| $0-premium plans | Available to a large share of members | Among the highest % of $0-premium plans in the industry |
| Average PPO out-of-pocket max | Lower on average | Higher on average |
| Pharmacy integration | Strong — CVS Health, MinuteClinic | Standard network pharmacy access |
| Best known for | Quality ratings, CVS pharmacy perks | Low premiums, wide $0-premium availability |
Pros and Cons
Aetna — Pros:
- Higher average star ratings across most plan types
- Broader state availability
- CVS pharmacy and MinuteClinic integration can mean real savings if you already shop there
Aetna — Cons:
- Customer satisfaction surveys have been inconsistent
- Not every plan is $0-premium — check your specific county
Cigna/HealthSpring — Pros:
- Very high rate of $0-premium plans
- Lower average monthly costs in markets where it’s available
Cigna/HealthSpring — Cons:
- Narrower state footprint — not available everywhere
- Lower average star ratings, particularly on PPO plans
- Higher average out-of-pocket maximum, which matters most if you have a high-cost health year
Which One Should You Choose?
- Lean toward Aetna if: you already fill prescriptions at CVS, you want a plan more likely to carry a 4-star-or-higher rating, or you want the broadest possible state availability.
- Lean toward Cigna/HealthSpring if: minimizing your monthly premium is the top priority, it’s available in your county, and you’re comfortable with a plan that may carry a lower quality rating in exchange for lower cost.
As with any Medicare Advantage comparison, the carrier-level averages only tell part of the story. Star ratings, premiums, and out-of-pocket maximums vary by the specific plan available in your ZIP code — not just by carrier.
A Note on the Cigna → HealthSpring Ownership Change
If you’re researching plans and see «HealthSpring» show up in search results, plan documents, or a quote — that’s not an unrelated company. In 2025, Cigna sold its Medicare Advantage and Part D business to HCSC, and it’s now underwritten by HCSC Medicare and Supplemental Group under the HealthSpring name. The underwriting entity holds an A (Excellent) financial strength rating from AM Best, while parent company HCSC holds A+ (Superior) — AM Best’s highest rating, confirmed in January 2026. If you previously had a Cigna Medicare Advantage plan, your coverage may now appear under the HealthSpring brand at renewal. Many core benefits carried over, but ownership transitions can sometimes bring formulary or network adjustments, so always confirm what’s actually happening with your specific plan directly with the carrier or on Medicare.gov.
Frequently Asked Questions
Is HealthSpring the same as Cigna? Not anymore, for Medicare specifically. Cigna sold its Medicare Advantage and Part D business to HCSC in 2025, and plans are now underwritten by HCSC Medicare and Supplemental Group under the HealthSpring name.
Which carrier has better prescription drug coverage? It depends on your specific medications. Aetna’s CVS integration can mean $0 copays on certain CVS Health brand drugs, while Cigna/HealthSpring offers both basic and enhanced drug benefit tiers. Always check your exact medications against each plan’s formulary.
Does Aetna still sell ACA marketplace plans? No — Aetna exited the ACA (Affordable Care Act) individual marketplace as of January 1, 2026. This doesn’t affect its Medicare Advantage or Medicare Supplement business, which continues to operate normally.
Which one has lower out-of-pocket costs if I get seriously ill? Based on recent averages, Aetna’s PPO plans have carried a lower average annual out-of-pocket maximum than Cigna/HealthSpring’s. This can matter more than the monthly premium if you expect a high-cost year.
Can I compare Aetna and Cigna/HealthSpring Medicare Supplement (Medigap) plans too? Yes. Both carriers sell Medigap policies in many states. Because Medigap benefits are standardized by federal law, the price — not the coverage — is usually the deciding factor between carriers for the same plan letter (like Plan G).
Bottom Line
Aetna and Cigna/HealthSpring take two different approaches to Medicare Advantage: Aetna leans on quality ratings, broader availability, and CVS pharmacy perks, while Cigna/HealthSpring leans hard on affordability and $0-premium availability. If your health needs are more complex or you want the highest chance of a 4-star-plus plan, Aetna tends to edge ahead. If your top priority is the lowest possible monthly cost and you’re comfortable with a lower average quality rating, Cigna/HealthSpring is worth a close look.
Before enrolling in either, compare the exact 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, premiums, and benefits mentioned in this article are based on 2026 figures and general industry averages, 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.