What is Aetna Advantage rating?
Asked by: Mr. Louie Runolfsson V | Last update: July 25, 2025Score: 4.5/5 (67 votes)
What is the rating of Aetna Medicare Advantage?
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.
What is the difference between Aetna and Aetna Advantage?
Aetna Medicare Advantage provides the same coverage as Original Medicare but with extra benefits like $0 deductibles and prescription benefits. You'll also get access to programs that may help you reach your health goals. These include SilverSneakers® fitness membership and more.
Why is Aetna dropping Medicare Advantage plans?
Aetna is bracing to lose up to 10% of its 4.2 million Medicare Advantage members next year as it prioritizes profitability and exits an unknown number of counties where it believes it can't be profitable, executives said in May.
Is Aetna better health a Medicare Advantage plan?
Aetna® offers many Medicare Advantage Dual Eligible Special Needs plans (D-SNP) to people on Medicare who are also eligible for Medicaid. A HMO is a health maintenance organization that requires you to use network providers for covered services.
Aetna Medigap Plan Review | Pricing and Revews
What states is Aetna pulling out of?
Aetna is planning to withdraw their participation in 11 states, including Texas, South Carolina, Pennsylvania, Ohio, North Carolina, Missouri, Kentucky, Illinois, Georgia, Florida, and Arizona, as the provider suffered major financial losses due to high-risk patients in the regions.
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
Are there any 5 star Medicare Advantage plans?
"There isn't one Medicare Advantage plan that's the highest-rated; there are multiple plans that get an overall rating of 5 stars, which is the highest rating from CMS.
What is the biggest disadvantage of the Medicare Advantage plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
Do most doctors accept Medicare Advantage plans?
In 2022, the vast majority (98%) of physicians and practitioners billing Medicare were participating providers. Non-participating providers accept Medicare patients, but can choose whether to take assignment (i.e., Medicare's approved amount) on a claim-by-claim basis.
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.
What changes are coming to Aetna Medicare Advantage plans in 2025?
In 2025, Aetna Medicare will merge its three individual PDP products into a single plan — SilverScript® Choice (PDP) — available in all 50 states and D.C. The SilverScript Choice (PDP) will offer a $0 monthly plan premium to members with full Extra Help in 33 states and D.C. SilverScript Choice (PDP) premiums will ...
Is Medicare Advantage really better?
Many Medicare Advantage plans offers as much, if not more, coverage than Original Medicare—at a lower cost. However, Original Medicare provides greater flexibility when it comes to finding doctors to work with.
Is Aetna Medicare Advantage better than Medicare?
Medicare Advantage plans can offer richer benefits at a more reasonable price, because they harness the power of coordinated care within a network of providers. But keep in mind not every doctor or hospital is part of your network, and if I a provider is outside your network, their services may not be covered.
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.
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.
Is Aetna dropping advantage plans?
You'll lose your current Aetna Medicare Advantage coverage. Beginning January 1, 2025, you'll only be covered by Original Medicare, which doesn't include additional benefits.
Why do doctors not like Medicare Advantage?
Many doctors and healthcare physicians don't like Medicare Advantage plans due to coverage restrictions, limited networking, and overpayment rates, which cause increasing difficulties for patients. Since pre-authorization and referral requirements often impede patients' needs, doctors refuse to accept these plans.
Why are seniors losing Medicare Advantage plans?
Medicare vs Privatized Medicare Advantage
Beneficiaries are tossed aside because they live in an unprofitable market for their insurer or because they are actually using the insurance they signed up for to access services.
Is Aetna insurance in financial trouble?
Aetna's revenues hit $33 billion in Q3, up from $26.3 billion in Q3 2023. But it posted an adjusted operating income loss of $924 million this year. Its Medical Benefits Ratio was 95.2% in the quarter, compared to 85.7% in the same period last year.
Why are hospitals dropping Medicare Advantage plans?
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
Who bought out Aetna?
2017: On December 3, 2017, CVS Health announced the acquisition of Aetna for $69 billion. Larry Merlo became chief executive of the two brands. Aetna CEO Mark Bertolini resigned and Aetna President Karen S.