Aetna vs. Blue Cross Blue Shield Medicare: Which Is Better?

Aetna and Blue Cross Blue Shield are two of the most recognized names in the insurance industry, and both serve millions of members across the country. But after helping clients compare these companies in real Medicare shopping situations, we do not look at them as interchangeable. They each tend to be stronger in different areas.

For Medicare insurance, we generally find Aetna to be the better overall fit for many people, especially when comparing Medicare Advantage availability, plan extras, prescription drug coverage, and competitive premiums in many markets.

Aetna often does a good job packaging benefits in a way that appeals to Medicare beneficiaries who want a lower monthly premium and are comfortable using a plan network.

Blue Cross Blue Shield, on the other hand, is often a better fit for individual and family health insurance, especially for people who place a high value on broad provider access. One of the biggest advantages of Blue Cross Blue Shield is its provider network. In many areas, Blue Cross has a larger footprint than Aetna, which can matter a great deal if keeping your current doctors, hospitals, or specialists is one of your top priorities.

Editor’s Pick

Best for Medicare insurance: Aetna
Best for individual and family health insurance: Blue Cross Blue Shield

That said, choosing between Aetna and Blue Cross is not as simple as picking the company with the biggest name. Health insurance is local. Medicare Advantage plans, provider networks, drug formularies, copays, deductibles, and out-of-pocket limits can vary by county, ZIP code, and plan year. Aetna may be the better choice in one area, while Blue Cross may clearly offer the stronger option somewhere else.

This is why we never recommend choosing a health insurance company based only on brand recognition. The better approach is to compare the actual plans available where you live, confirm that your doctors accept the plan, check how your prescriptions are covered, and look closely at your expected out-of-pocket costs. That is the same process we use when helping clients compare Medicare and health insurance options one-on-one. Policy Guide’s own process emphasizes learning where someone is in their Medicare journey, comparing pricing and policy differences, and helping them find a plan that fits their needs rather than rushing the decision.

Here are the key differences to consider when comparing Aetna and Blue Cross Blue Shield.

Aetna Medicare Plan Highlights

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Pros

• Most Aetna Medicare Advantage health plans include prescription drug coverage.
• Many Aetna plans provide coverage for wellness programs.
• Aetna ranks second in customer satisfaction with telehealth.
• Aetna is the third-largest for-profit provider of Medicare Advantage plans in the United States, increasing its Medicare Advantage enrollment by 323,000 in 2022.

Cons

• Ranks lower in customer satisfaction surveys than Blue Cross and Blue Shield
• Offers fewer Medigap plans than Blue Cross

Policy Types:

• Medicare Advantage plans: HMO, HMO-POS, POS, EPO, PPO
• Medicare Part D plans
• Medicare Supplement plans (Medigap)
• SNPs (special needs plans)
• Dual-eligible SNPs (D-SNP) if eligible for both Medicare and Medicaid
• Availability: Almost All 50 states
• Waiting Period: Varies by plan/location
• Providers In-Network: 1.2 million
• Covers Telehealth: Yes
• Policy Management: Website, phone, mobile app

Blue Cross Blue Shield Medicare Plan Highlights

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Pros

• Offers a larger provider network than Aetna
• Consistently ranks high in customer satisfaction
• Sells more Medigap plans than Aetna
• Third largest insurer in the country

Cons

• Online customer satisfaction is not uniform across all Blue Cross and Blue Shield companies.
• Medicare Advantage plans are not available in some states

Policy Types:

• Medicare Advantage plans, HMO, HMO-POS, POS, EPO, PPO & D-SNP
• Medicare Part D plans
• Medicare Supplement plans (Medigap)
• SNPs (special needs plans)
• Dual-eligible SNPs (D-SNP) if eligible for both Medicare and Medicaid
• Availability: All 50 state
• Waiting Period: Varies by plan/location
• Providers In-Network: 1.7 million
• Covers Telehealth: Yes
• Policy Management: Website, phone, mobile app

Medicare Plan Availability

Blue Cross Blue Shield and Aetna offer health insurance plans for various markets, including small businesses and individuals. After CVS Health acquired the company in 2018, Aetna began offering individual and family plans. Both companies also offer Medicare plans.

• Aetna

  • Medicare Advantage health insurance plans are found in 44 states and Washington, D.C.
  • Prescription drug plans are found in 50 states and Washington, D.C.
  • Aetna Medicare Eagle plans, designed for veterans, expanded to 43 states this year.
  • Aetna D-SNPs are available in 30 states but might not be available in every county.
  • Medicare Supplement insurance plans are available in all states except Hawaii, Maine, Massachusetts, New York, and Washington.
  • Aetna offers Medicare Supplement Plans A, B, C, D, F, G, and N.

• Blue Cross and Blue Shield

  • BCBS sells Medicare Advantage plans in 48 states (excluding Alaska and Vermont) and Puerto Rico.
  • Prescription drug plans are accessible in 42 states (exceptions are Alaska, Delaware, Hawaii, Louisiana, Maryland, Mississippi, Oregon, and Washington).
  • Blue Cross Blue Shield features Medicare Supplement plans in all 50 states.
  • BCBS sells nine of the ten standardized Medigap plans available in nearly all states, including Plans A, B, C, D, F, G, K, L, and N.

Medicare Plan Costs

The monthly premium for a 65-year-old male through Blue Shield of California is $198 for Medicare Supplement Plan G. The same plan through Blue Cross Blue Shield in Ohio is $160.

The monthly premium for a 65-year-old male in California with Aetna is $307 for Medicare Supplement Plan G.

The cost of an Aetna or Blue Cross Blue Shield plan varies based on location and the type of plan you buy, even among Blue Cross Blue Shield companies.

Other factors also affect your monthly premium:

• Whether the plan includes drug coverage
• Deductible, coinsurance, and copayment amounts
• Age
• Health habits

Most Aetna and BlueCross BlueShield HMO, PPO plans, and some EPO plans require you to see an in-network doctor or use an in-network healthcare facility. Therefore, except in emergencies, you will have a higher cost share if you use an out-of-network provider. Some of these plans also require you to designate a primary care physician to coordinate your care.

Aetna and BCBS Medicare Advantage health insurance plans cap out-of-pocket costs for medical services, giving you a certain amount of financial security from spiraling healthcare expenses.

Medicare Star Ratings

Medicare Star Ratings measure the quality and performance of prescription drug or health insurance plans. The Centers for Medicare and Medicaid Services compile these ratings each year. The highest rating is five stars.

Here’s how Aetna and Blue Cross Blue Shield fared in 2021:

Aetna
• 3.75 on Medicare Advantage plans
• 3.84 on Part D plans

BCBS
• 3.75 on Medicare Advantage plans
• 3.77 on Part D plans

Enrollment Process

The best time to enroll in a Medicare Supplement, Advantage, or Part D plan is during your Initial Enrollment Period when you’re first eligible. After that, you can change your plans during the annual Open Enrollment Period. The Open Enrollment Period varies based on the type of plan. In addition, you also have special enrollment periods for life-changing events.

Events that qualify for special enrollment include:

• Moving into or out of a plan’s service area
• Losing health insurance coverage

You can receive your Medicare benefits through a Medicare Advantage plan rather than Original Medicare. If you choose this option, you cannot buy a Medigap policy. Most Medicare Advantage plans, including PPO plans and HMO plans, provide drug coverage, so you don’t have to buy a separate Part D plan in most instances.

Final Summary

Comparing health insurance companies is difficult because there are many variables to consider. However, regarding health care coverage, both Aetna and Blue Cross Blue Shield are solid companies with a strong history of excellent performance and strong financial ratings.

A comparison between Aetna and BCBS comes down to evaluating the plans in your area to see how they fit in with your financial situation and healthcare needs.

Sources

• The Chartis Group: Medicare Advantage Enrollment
• Medicare Enrollment Periods: What You Need to Know | Aetna Medicare
• Blue Cross Blue Shield Medicare Plans
• AM Best Affirms Credit Ratings of CVS Health Corporation’s Aetna Subsidiaries
• 2022 U.S. Telehealth Satisfaction Study | J.D. Power (jdpower.com)
• 2022 Health Plans Ratings – NCQA (National Committee for Quality Assurance)

FAQs

• Does Aetna have a good reputation?

  Aetna has received an excellent rating of A from AM Best, one of the many credit rating firms that evaluate the financial strength of over 16,000 insurance companies globally. Additionally, Aetna has also received high ratings from other financial ratings services.

• Is Blue Cross Blue Shield good insurance?

  Blue Cross Blue Shield (BCBS) is a leading health insurance provider in the United States. As a major insurer, BCBS offers a variety of plans tailored to meet the needs of individuals and families.

• Is Anthem the same as BCBS?

  No, Anthem and Blue Cross Blue Shield (BCBS) are not the same, although they are related. They operate under the umbrella of a top-level association, but the entity name can vary from state to state or region to region. Additionally, multiple entities may offer services in the same area. While each entity provides health insurance coverage to individuals, they have different networks of doctors and hospitals, policy options, and even coverage areas. Anthem is a for-profit company that provides health insurance plans in 14 states nationwide.