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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 or CVS Health. For official information, visit Medicare.gov or call 1-800-MEDICARE. See our Medical & Financial Disclaimer for details.
Aetna, owned by CVS Health, is the third largest Medicare Advantage insurer in the country, with 12% of enrollment in 2026 after a year in which it lost nearly 29,000 members. It sells 654 plans for 2027, more than anyone except Humana, UnitedHealthcare and Devoted Health.
We counted all of them in the CMS plan file and matched each one to the 2027 star ratings CMS published on October 8, 2026. A year ago Aetna’s profile was the inverse of its advertising: good quality scores, weak out-of-pocket limits. For 2027 the good half of that has gone — fewer than half its rated plans now reach four stars — and the weak limits have stayed. If you only read one section of this review, read the second one.
The Numbers
| From the CMS plan file | Aetna (CVS Health) 2027 | All Medicare Advantage plans 2027 | Aetna 2026 |
|---|---|---|---|
| Distinct plans on sale | 654 | 5,522 | 642 |
| States and territories | 41 | — | 43 |
| Counties served | 2,072 of 3,131 (66%) | 3,131 | 2,139 of 3,147 (68%) |
| Rated plans at 4 stars or better | 48.2% | 61.2% | 72.0% |
| Mean overall star rating | 3.67 | 3.86 | 4.02 |
| Plans with no monthly premium at all | 76.3% | 69.7% | 59.6% |
| Median in-network out-of-pocket limit | $7,150 | $7,100 | $6,750 |
| Plans capped at the legal maximum ($9,850 in 2027, $9,250 in 2026) | 35.0% | 28.2% | 34.7% |
| Special needs plans | 190 | 1,969 | 159 |
The Ratings: Above Average for 2026, Below It for 2027
For 2026 nearly three quarters of Aetna’s rated plans reached four stars, against 60.5% across the market, and among the big national insurers only UnitedHealthcare and Kaiser did better. On the 2027 ratings the figure is 48.2%, against 61.2% market-wide, and its plan-level mean fell from 4.02 to 3.67, below the market’s 3.86. Weighted by membership the fall is smaller — from 81% to 69% of members in four-star plans — so Aetna’s biggest plans held up better than its catalog as a whole. Humana, which Aetna comfortably outscored a year ago, now has 93.6% of its rated plans at four stars or better.
This matters beyond the badge. Plans at four stars or better earn bonus payments from CMS, and that money funds later benefits, so a fall like this one tends to show up in what a plan can offer in following years rather than right away — which matters if you intend to stay in the same plan rather than re-shop every fall. If you are choosing an Aetna plan for 2027, check whether it is one of the 310 still rated four stars or better. Our guide to how star ratings are built sets out what the score actually measures, and why a company-level average stops being useful the moment you have a shortlist.
Its reach is broad without being universal: 2,072 counties for 2027, about 66% of the country. And it is a PPO-first insurer, with 264 PPOs against 121 HMOs, so it is one of the more flexible large carriers on out-of-network care. Our HMO versus PPO guide covers what that buys you.
The Problem: More Plans at the Ceiling Than Almost Anyone Else
Federal rules let a Medicare Advantage plan set its in-network out-of-pocket limit as high as $9,850 for 2027, up from $9,250 for 2026. That figure is the worst a plan is allowed to be, and it is the number that decides what a serious illness costs you.
Across the whole market, 28.2% of 2027 plans sit at that ceiling. Aetna puts 35.0% of its plans there — more than one in three, and the highest share of the big national insurers apart from WellCare’s owner Centene, at 48.1%. For comparison, Kaiser is at 21.4%, the Blue-branded plans at 22.0%, HealthSpring at 23.5%, Humana at 26.9% and UnitedHealthcare at 30.8%. Its median limit, $7,150, is above the market median of $7,100.
This does not mean an Aetna plan will expose you to $9,850. It means that if you pick one of its plans without checking that number, your odds of landing on a maximum-exposure plan are about a quarter higher than they would be choosing at random across the market. It is a reason to be specific, not a reason to walk away.
It is also a choice about money. A plan bidding below its county benchmark gets rebate money it must spend on lower cost sharing, extra benefits or a lower premium. Aetna’s profile — more plans with no monthly premium than the market, 76.3% against 69.7%, and some of the weakest cost ceilings in the group — suggests a company that has consistently chosen to spend that money somewhere other than your out-of-pocket maximum. Our guide to what a Medicare Advantage plan actually costs goes through how those four numbers relate.
On the CVS Connection
Aetna has been part of CVS Health since 2018, and plans are frequently sold on the idea that having the pharmacy, the insurer and the clinic under one corporate roof produces better care. That is a claim about coordination, and it is not one we can check against a published document, so we do not repeat it as fact.
What you can check is specific and worth doing: whether your own pharmacy is preferred on the plan’s network, and whether your prescriptions are on its formulary at a tier you can afford. Those two answers are in the Plan Finder and in the plan’s own documents, and they will tell you more than any statement about integration.
Drug Coverage: Most Plans Start at the Maximum Deductible
The pharmacy question has a second half the marketing rarely mentions: the drug deductible, the amount you pay for covered prescriptions each year before the plan starts sharing the cost. The CMS plan file lists it for every plan, and Aetna’s figures stand out.
| Ordinary plans with drug coverage | Aetna 2026 | Aetna 2027 | Market 2027 |
|---|---|---|---|
| Number of plans | 452 | 428 | 3,196 |
| Median drug deductible | $615 | $700 | $650 |
| Deductible at the legal maximum | 86.3% | 53.5% | 36.0% |
| No drug deductible | 1.1% | 1.4% | 10.5% |
| $0 for the drug part of the premium | 66.8% | 70.8% | 71.7% |
Our own count from the CMS Landscape files, excluding special needs plans. The legal maximum was $615 in 2026 and is $700 in 2027.
Read the third row carefully, because the improvement it seems to show is smaller than it looks. In 2026 almost nine in ten Aetna drug plans charged the full $615. For 2027 the share at the ceiling fell to about half — but the ceiling itself rose to $700, and the typical Aetna plan now charges exactly $700. The plans below the ceiling mostly cluster at $400 (101 plans) and $500 (47 plans), and only 6 of the 428 have no drug deductible. Across the market the typical deductible is $650, and one plan in ten has none at all; at Aetna, almost none do.
So the plain reading for someone who takes regular medicines: on most Aetna plans you will pay the first $700 of your covered drug costs yourself in 2027, usually in the first months of the year. That is not a reason to rule Aetna out, because many plans leave cheap generic tiers out of the deductible and the annual drug cap of $2,400 applies everywhere. It is a reason to run your own prescriptions through the plan, not just its premium.
The split inside Aetna follows its network types. Its HMOs with drug coverage have a typical drug deductible of $400, and about a third of them (35.3%) charge the full $700. Its PPOs — the plans Aetna is best known for — have a typical deductible of $700, with 68.6% at the maximum. Across the whole market PPOs also run higher than HMOs, but by less: $685 against $500. So if you want an Aetna PPO for the wider choice of doctors, expect the drug deductible to be part of the price of that choice.
Extra Benefits: Steady, but Smaller Than Average
The extras each plan offers are filed separately with CMS, in the PBP Benefits files. Counting Aetna’s ordinary plans in the 2026 and 2027 filings gives a picture that barely moved between the two years.
| Share of plans with the benefit | Aetna 2026 | Aetna 2027 | Market 2027 |
|---|---|---|---|
| Over-the-counter allowance | 59.9% | 61.9% | 58.3% |
| Typical OTC amount per year | $120 | $120 | $200 |
| Eyewear | 100% | 100% | 94.5% |
| Typical eyewear allowance per year | $150 | $150 | $200 |
| Hearing aids | 100% | 100% | 93.7% |
| Meal benefit | 43.8% | 38.7% | 45.0% |
| Transportation to medical appointments | 1.6% | 0.4% | 19.0% |
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.
Aetna’s approach is breadth over size. Every one of its ordinary plans includes eyewear and hearing aids, and it is one of the few large insurers that did not cut its over-the-counter card for 2027. But the amounts are smaller than the market’s — about $120 a year on the card and $150 for glasses — and transportation to medical appointments is almost absent, at 2 plans out of 470. If getting to appointments is a problem for you, that single row matters more than the rest of the table.
Who It Suits
Aetna suits someone who wants a PPO from a large national carrier and who is willing to do the work of filtering out its weaker plans — on out-of-pocket exposure and, for 2027, on star rating as well. In a county where it offers several, the spread between its best and worst is likely to be wide, and the good ones are genuinely good.
It suits badly anyone who is going to pick on premium and brand alone, because that is exactly the path that leads to the $9,850 plans. And if your priority is capping the worst case rather than the monthly cost, compare it directly against the insurers that do that better before you settle. Our Aetna versus HealthSpring comparison does that for one of them.
Frequently Asked Questions
Is Aetna a good Medicare Advantage company? For 2027, below average on quality scores: 48.2% of its rated plans reach four stars against 61.2% market-wide, down from 72% for 2026. On out-of-pocket protection it is among the weakest of the large insurers, with 35.0% of its plans at the legal maximum.
Is Aetna the same as CVS? Aetna is owned by CVS Health Corporation, which is the parent organization CMS lists for its 654 Medicare Advantage plans for 2027.
What is Aetna’s star rating? There is no single company rating, because CMS rates contracts rather than companies. Across its 643 plans with a published 2027 rating the mean is 3.67, down from 4.02 for 2026. Look up the rating of the specific plan in your county.
Does Aetna have $0 premium plans? Yes, 76.3% of its 2027 plans charge nothing beyond the Part B premium, above the market’s 69.7%. That is not a reason to choose one — check its out-of-pocket limit first.
Is Aetna available where I live? In about two thirds of US counties. The Medicare Plan Finder will confirm for your ZIP code.
What is the drug deductible on Aetna plans for 2027? On the typical plan, $700, which is the most the law allows. 53.5% of Aetna’s plans with drug coverage sit exactly at that figure and only 1.4% have no drug deductible. Check whether your regular medications are on a tier the plan exempts from the deductible.
Does Aetna give an over-the-counter card? On 61.9% of its ordinary plans for 2027, slightly more than the market’s 58.3%, but the typical card is worth $120 a year against $200 across the market.
Bottom Line
A year ago Aetna was a well-run insurer by the measure CMS publishes and a careless one by the measure that decides what a bad year costs. For 2027 it is below average on the first and still weak on the second: fewer than half its rated plans clear four stars, and more than a third of its plans cap your spending at the highest figure the law allows.
So the advice here is narrow and specific: if you are looking at an Aetna plan, find its out-of-pocket maximum before you look at anything else and hold it against the $7,100 market median, then check that plan’s own 2027 star rating. If it clears both bars, it is a perfectly good plan. If it clears neither, there is very likely a better one in your county.
What We Counted for Aetna
The Aetna figures above are our own count of the 654 distinct plans CMS lists under CVS Health Corporation in the CY2027 Landscape file, set beside the 642 it listed in the CY2026 file, both in their September 2026 versions. The 2027 star figures come from matching each plan’s contract to its overall rating in the 2027 Star Ratings data tables published on October 8, 2026, and cover the 643 plans that carry one; the share sitting at the ceiling and the median limit are counted across all plans.
The market column beside them is the same count applied to all 5,522 plans in the 2027 file, and the other insurers named here were counted the same way on the same date. What we keep, what we exclude, and why a share of plans is not a share of members, are set out in full 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 the plan counts, states and counties served, premium shares, out-of-pocket limits including the $9,850 ceiling for 2027, the 2026 star figures and plan-type mix, for Aetna and for every insurer compared with it. All calculations are our own, by the method above.
- 2027 Star Ratings Data Tables — Centers for Medicare & Medicaid Services, published October 8, 2026. Source for every 2027 plan-level star figure, matched contract by contract.
- Humana rebounds, Aetna slips: Winners and losers in the 2027 MA star ratings — Fierce Healthcare, October 9, 2026. Source for the share of Aetna members in four-star-or-better plans falling from 81% to 69%.
- Medicare Advantage in 2026: Enrollment Update and Key Trends — KFF. Source for CVS Health’s 12% share of Medicare Advantage enrollment in 2026 and the decline of nearly 29,000 members over the year.
- Medicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits and Prior Authorization — KFF. Source for the $9,250 statutory in-network out-of-pocket limit for 2026.
- PBP Benefits – 2027 and PBP Benefits – 2026 — Centers for Medicare & Medicaid Services. The benefit filings each plan submits. Source for the extra-benefit table (our own count of Aetna Medicare’s ordinary plans and of all ordinary plans).
All figures on this page were checked against the sources above on October 12, 2026; the drug-coverage and extra-benefit tables were added on October 17, 2026, from the CMS Landscape and 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.
Unai Sampedro founded and edits Medicare Plan Compass. He is not a licensed insurance agent or broker and takes no commission from any insurer; the site is funded by advertising. Articles are written from CMS and Medicare.gov documents and reviewed each year when new figures are published. Nothing here is personalized advice: the goal is to explain the rules in plain language so readers can ask better questions before they speak to someone who can advise them.