Is Aetna gold or Silver better?

Asked by: Dr. Brenden Emmerich Sr.  |  Last update: June 25, 2025
Score: 5/5 (36 votes)

The categories have nothing to do with the quality of care you get in a plan. Generally, the difference between categories is based on the plan's share and your share of costs for covered services. If you qualify for extra savings (based on your income) and enroll in a Silver plan, the plan pays more and you pay less.

What is the difference between Aetna Gold and Silver?

A Silver plan has a lower monthly premium than a Gold one, but a Bronze plan has the lowest monthly premium with the highest cost-sharing requirements of all the plans, while a Platinum insurance plan has the highest monthly premiums and lowest out-of-pocket costs.

Is a Gold plan better than a Silver plan?

Gold plans have a higher monthly premium compared to Silver plans, but lower out-of-pocket costs for care. Gold plans are ideal for individuals and families needing frequent medical services and want their insurer to share more in the cost for care.

What are Aetna tiers?

Tier 1 – Aetna Premier Care Network Plus Multi-Tier providers. Using a provider from this tier results in maximum savings for Aetna® members. • Tier 2 – Aetna Health broad network providers. Using a provider from this tier results in standard savings for Aetna® members.

Is Aetna Silver a good plan?

Silver plans have mid-level monthly rates and are good if you have average health needs. Plus, if you have a low income, Silver plans offer help with other insurance costs like deductibles and copays. Gold and Platinum plans are best for people with high health care needs.

🔥 Aetna Silver Plan Review: Pros and Cons

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Why do I have to choose a Silver plan?

Silver plans fall about in the middle: You pay moderate monthly premiums and moderate costs when you need care. Important: If you qualify for “cost sharing reductions” (or “extra savings”) you can save a lot of money on deductibles, copayments, and coinsurance when you get care — but only if you pick a Silver plan.

How does Aetna health insurance rank?

By membership and revenue, Aetna is ranked third in the country for health insurance. Aetna has over 22 million members and receives annual revenues of over $60 billion.

Why is Aetna so expensive?

Factors influencing Aetna insurance monthly costs

Plans with broader coverage and extensive benefits, such as lower deductibles, co-pays, and comprehensive services like dental and vision care, often come with higher monthly costs.

Do doctors prefer HMO or PPO?

HMO plans might involve more bureaucracy and can limit doctors' ability to practice medicine as they see fit due to stricter guidelines on treatment protocols. So just as with patients, providers who prefer a greater degree of flexibility tend to prefer PPO plans.

What are the ratings for Aetna?

Aetna Medicare Advantage plans are rated above the industry average, receiving an average rating of 4.27 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for all plans is 3.95.

Is the Silver plan worth it?

Choosing a Silver health plan can be an excellent option if you're looking for a balance between your monthly premium and out-of-pocket costs for care, especially if you qualify for cost-sharing reductions.

Are Gold plans worth it?

Gold plans often have high monthly costs, but when you receive care, your costs will be lower. They are a good fit for people who are moderate or heavy users of health services.

Which healthcare insurance is best?

Best Health Insurance Companies for 2025
  • Best Overall and Best for Self-Employed: Kaiser Permanente.
  • Best Widely Available Plans: UnitedHealthcare.
  • Best for Low Complaints and Best for Chronic Conditions: Aetna.
  • Most Affordable: Molina Healthcare.

What is Aetna Golden?

Aetna Golden Medicare Plan MA-PD (HMO) - Features

Members access care through Primary Care Doctors. Medicare prescription drug coverage is included. Some direct access benefits. $0 copay for preventive services. No annual lifetime dollar maximums.

How do I tell what Aetna plan I have?

The best place to find details about your coverage and benefits is your Aetna member website. It takes only a few minutes to register. And you only need your member number, which is on your member ID card. You can still get benefits and coverage information by calling the number on your member ID card.

Is Aetna good insurance for seniors?

Aetna is an established health insurance company with a long history of providing coverage and support to millions of seniors across the country. Their Medigap plans offer a variety of benefits and options to make sure that older adults have the quality care they need and deserve.

Why do dentists prefer PPO over HMO?

Dental PPOs are the most common commercial dental plan types and offer more flexibility in dentist choice. Dental HMO plans charge lower premiums but limit coverage to in-network dentists for most procedures. Consider your needs, budget, and dentist preferences when choosing between HMO and PPO plans.

What is the downside to a PPO plan?

Cons of PPO Plans

Less Coordination: Without a primary care doctor managing your healthcare, there's less oversight, and it can be harder to keep track of your treatments and appointments.

Why are out of pocket costs higher with PPO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral.

Why is Aetna struggling?

Aetna majorly miscalculated utilization trends in pricing Medicare Advantage plans for this year, causing hundreds of thousands of seniors to flock to its generous coverage and saddling the insurer with an unexpectedly steep price tag for their care.

Does Aetna deny a lot of claims?

In the same year, Medicare denied 6.85% of its claims. One year later, AMA reported that all the surveyed insurers were denying fewer claims: Aetna's denial rate was down to 1.81%, Anthem BCBS reduced its rate to 4.34%, and private insurers overall were down to 2.79%, while Medicare denied only 4% of claims.

Does Aetna have copays?

The plan requires only copays for medical services and prescription drugs up to the plan member's out-of-pocket maximum, with no deductibles or coinsurance costs.

Is Aetna considered good insurance?

It also offers benefits like access to 24/7 virtual care at no or low costs, depending on your plan, and mental health coverage. Aetna is regarded as a good health insurance provider overall.

Which health insurance denies the most claims?

According to the analysis, AvMed and UnitedHealthcare tied for the highest denial rate, with both companies denying about a third of in-network claims for plans sold on the Marketplace in 2023, respectively.