Aetna Medicare Plans in Pennsylvania
Star Rating
4 out of 5
Source: CMS Medicare Star Ratings — verify current-year rating
Enrollment
3.2M+ members
National Rank
#3
Network Types
HMO, PPO
Aetna is one of the largest Medicare insurance providers in Pennsylvania, offering Medicare Advantage, Medicare Advantage with prescription drug coverage, Part D prescription drug plans to beneficiaries across the state. With 4-star ratings and coverage in Philadelphia, Pittsburgh, Allentown and surrounding areas, Aetna serves Pennsylvania's 2.8+ million Medicare-eligible residents.
Pennsylvania has 52% of Medicare beneficiaries enrolled in Medicare Advantage plans, above the national average. Aetna's Pennsylvania plans typically include cvs pharmacy integration and minuteclinic access, making them a strong choice for beneficiaries in the PA market.
The Bottom Line
Aetna is a top-tier choice for Pennsylvania Medicare beneficiaries who want cvs pharmacy integration with 4-star rated plans. Compare Aetna options with other Pennsylvania carriers to find the best fit for your healthcare needs and budget.
Aetna Pros and Cons
Pros
- CVS pharmacy integration with $0 copays on some drugs
- MinuteClinic access for convenient care
- Strong PPO options with out-of-network benefits
- Good dental and vision coverage
- Resources for Living wellness program
Cons
- Limited presence in some rural areas
- Fewer plan options than UHC or Humana
- Some plans require CVS for preferred pricing
- Customer service reviews are mixed
Aetna Plan Types in Pennsylvania
Aetna offers multiple Medicare plan types to Pennsylvania residents, each designed for different healthcare needs and budgets:
Medicare Advantage (Part C): Aetna's Pennsylvania Medicare Advantage plans combine hospital (Part A), medical (Part B), and usually prescription drug (Part D) coverage into one plan. Many Aetna MA plans in Pennsylvania have $0 monthly premiums beyond the Part B premium, with benefits including dental, vision, hearing, and fitness programs.
Medicare Supplement (Medigap): Aetna offers standardized Medigap plans in Pennsylvania that work with Original Medicare to cover costs like the Part B coinsurance and deductibles. Popular options include Plan G and Plan N.
Part D Prescription Drug Plans: Aetna's standalone Part D plans in Pennsylvania provide prescription drug coverage for those on Original Medicare. Plans vary in formulary coverage and preferred pharmacy networks.
Aetna Provider Networks in Pennsylvania
Aetna's Pennsylvania Medicare Advantage plans use HMO and PPO networks. Network size and provider participation vary by plan and county.
In Philadelphia and surrounding Philadelphia County, Aetna networks typically include major health systems. However, provider participation can change annually, so always verify your doctors are in-network before enrolling.
For beneficiaries in Philadelphia, Pittsburgh, Allentown, Reading, Aetna generally offers good hospital and specialist coverage. Rural areas of Pennsylvania may have more limited network options, making PPO plans with out-of-network benefits a consideration.
Use Aetna's online provider directory at https://www.aetnamedicare.com/find-a-doctor to verify network participation for any Pennsylvania doctor or facility.
Aetna Pennsylvania Plan Costs
Aetna Medicare plan costs in Pennsylvania vary by plan type, county, and coverage level. Here's what to expect:
Medicare Advantage Premiums: Many Aetna MA plans in Pennsylvania offer $0 monthly premiums beyond the Part B premium (often $0). Higher-benefit plans may have premiums of $20-$100+/month.
Out-of-Pocket Maximums: All Aetna Medicare Advantage plans include annual out-of-pocket limits, protecting you from catastrophic costs. Limits typically range from $3,000-$8,000 depending on the plan.
Medigap Premiums: Aetna Medigap plans in Pennsylvania average $150-$250/month for Plan G, varying by age, gender, and tobacco use. Rates are typically lower when you enroll during your Medigap Open Enrollment Period.
Aetna Star Ratings in Pennsylvania
Aetna's Medicare plans currently hold 4-star ratings (out of 5) from CMS. Star ratings measure quality across categories including:
- Staying healthy (screenings, tests, vaccines) - Managing chronic conditions - Member experience and satisfaction - Member complaints and access to care - Customer service quality
Plans with 4+ stars are considered high-performing and may offer additional benefits. Aetna's above-average ratings in Pennsylvania reflect strong performance across these quality measures.
Aetna Key Facts
Frequently Asked Questions
Is Aetna a good Medicare plan in Pennsylvania?
Aetna is one of the largest and most established Medicare insurers in Pennsylvania with 4-star ratings. Whether it's the best choice for you depends on your doctors, medications, and coverage preferences. Aetna is known for cvs pharmacy integration and minuteclinic access.
Does Aetna Medicare cover my Philadelphia doctors?
Aetna's Pennsylvania provider networks include many doctors and hospitals in Philadelphia and surrounding areas. However, network participation varies by specific plan. Always verify your doctors are in-network using Aetna's provider directory before enrolling.
How much do Aetna Medicare plans cost in Pennsylvania?
Many Aetna Medicare Advantage plans in Pennsylvania have $0 monthly premiums beyond the Part B premium. Costs vary by plan type, benefits, and your county. Aetna Medigap plans typically cost $150-$250/month for Plan G.
Can I switch to Aetna Medicare in Pennsylvania?
You can switch to Aetna during the Annual Enrollment Period (October 15 - December 7), during a Special Enrollment Period if you qualify, or during the Medicare Advantage Open Enrollment Period (January 1 - March 31) if you're currently in a Medicare Advantage plan.
Does Aetna offer $0 premium plans in Pennsylvania?
Yes, Aetna offers several $0 premium Medicare Advantage plans in many Pennsylvania counties. These plans still require you to pay your Part B premium. $0 premium plans may have different benefit levels and cost-sharing than plans with monthly premiums.
Compare Aetna Plans in Pennsylvania
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Plan availability, benefits, premiums, and costs vary by ZIP code and change annually. This information is for educational purposes only and is not a guarantee of coverage, savings, star ratings, or plan availability. Star ratings are sourced from CMS Medicare Star Ratings; confirm the current-year rating before enrolling. Contact a licensed advisor for current plan options in your area.
HealthPlan Connect is not affiliated with or endorsed by Aetna. We do not offer every plan available in your area. We are also not affiliated with or endorsed by the federal Medicare program or any government agency. Any information we provide is limited to the plans we do offer in your area; please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.