Aetna vs. United Healthcare Medicare Plans

Aetna and United Healthcare are two of the leading Medicare insurance providers in the US, each with strengths and weaknesses in their offerings.

Both Aetna and United Healthcare provide Medicare Advantage (Part C), Medicare Part D drug plans, and Medicare Supplement insurance (Medigap).

In a nutshell:

• United Healthcare offers more Advantage plan options than Aetna and has a larger network of providers.
• Aetna has higher financial ratings than United Healthcare.

Let’s dig deeper into what each of these top providers has to offer.

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Aetna Medicare Plan Highlights

Pros:

• Availability: 50 states (varies by state and insurance plan)
• Over 1.2M primary care doctors and specialists
• Ranks second in telehealth customer satisfaction
• Policy management can be done through the website, phone, and mobile app

Cons:

• Medigap plans are not available in Alaska, Connecticut, Hawaii, Maine, Massachusetts, New York, Washington, or the District of Columbia
• Overall customer satisfaction lands below the industry average
• Online price quotes and applications are unavailable in some states (must be done by phone)

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United Healthcare Medicare Plan Highlights

Pros:

• Availability: 50 states (varies by state and insurance plan)
• Over 1.3M primary care doctors and specialists
• Virtual doctor visits, gym memberships, and vision and hearing care discounts
• Policy management can be done through the website, phone, and mobile app

Cons:

• Customers might feel overwhelmed by the company’s size and many affiliates
• Premiums are much higher in certain regions
• Member experience ratings are mediocre

Aetna vs. United Healthcare: Medicare Plan Availability

Medicare Advantage (Part C)

A Comprehensive Look with Real-World Examples and Risks

When a Medicare beneficiary enrolls in a Medicare Advantage (MA) plan, the federal government pays the private insurer (like Aetna or UnitedHealthcare) a monthly capitation fee, regardless of how much care the enrollee uses. This payment model encourages plans to keep costs down while managing care efficiently.

Both companies offer:

• HMO Plans: Lower premiums, but strict networks.
• PPO Plans: Higher flexibility, but higher costs if you go out-of-network.
• D-SNP and C-SNP Plans: For dual-eligibles and those with chronic conditions, often include care coordination and additional financial support.

UHC has a broader national footprint and often provides more MA options in rural regions, while Aetna excels in urban and suburban areas, enhanced by its integration with CVS Health (which includes CVS pharmacies and MinuteClinics).

Enrollment Windows: Understanding When and How to Join or Switch Plans

Beneficiaries must enroll in or change their Medicare Advantage plan during specific periods:

• Initial Enrollment Period (IEP): When someone first becomes eligible for Medicare (typically at age 65).
• Annual Election Period (AEP): October 15 – December 7 each year. Beneficiaries can switch from Original Medicare to MA, change MA plans, or switch between insurers like Aetna and UHC.
• Medicare Advantage Open Enrollment Period (MA OEP): January 1 – March 31 annually. Allows switching MA plans or reverting back to Original Medicare.
• Special Enrollment Periods (SEPs): Triggered by life events like moving, losing employer coverage, or qualifying for Medicaid.

During these windows, beneficiaries often compare monthly premiums, out-of-pocket costs, and plan benefits between carriers like Aetna and UHC.

Costs, Premiums & Maximum Out-of-Pocket (MOOP) Limits

Cost Category	Aetna	UnitedHealthcare
Monthly Premiums	$0–$50 (many $0 plans)	$0–$75
MOOP (In-Network)	$3,000–$6,700	$4,000–$7,550
PCP Visit Copay	$0–$20	$0–$25
Specialist Visit Copay	$30–$50	$35–$60

• Aetna tends to offer more aggressive pricing in competitive urban areas and may include Part B premium “give-backs” in some plans.
• UHC has generally higher MOOP limits, but this can vary widely by ZIP code.

Note: MOOP is critical – once it is reached, the plan pays 100% of covered services for the rest of the year. These limits protect beneficiaries from catastrophic medical costs.

Provider Networks, Referrals & Prior Authorization

Both insurers rely heavily on network arrangements to manage costs and ensure quality care.

Network Design:

• UHC maintains one of the largest MA provider networks in the U.S., encompassing hospitals, specialists, urgent care centers, and major chains like Walgreens.
• Aetna offers competitive networks, but their access can vary more by region. However, the CVS affiliation ensures easy access to walk-in clinics and pharmacies.

Referrals & Prior Authorizations:

Feature	Aetna	UnitedHealthcare
HMO Referrals	Typically Required	Typically Required
PPO Referrals	Not Required	Not Required
Prior Authorizations	Required for many services	Required for many services

• Prior Authorization (PA) is used by both Aetna and UHC to control utilization of higher-cost services (e.g., MRIs, surgeries, some therapies). This process requires the provider to obtain approval from the insurance company before delivering the service.
• Both carriers may also use step therapy for medications, requiring patients to try less expensive drugs before covering more costly alternatives.

While PAs can help reduce unnecessary costs, critics argue they may cause delays or denials in necessary care, a point worth considering when comparing plans.

Value-Added Features Through Integrated Services

• UHC’s UCard acts as an all-in-one solution: member ID, OTC card, and even a healthy food purchasing card. Members can use it at Walgreens, Walmart, and select grocers.
• Aetna’s CVS Health partnership enables seamless integration for pharmacy fills, MinuteClinic visits, and wellness programs all under one umbrella.

Real-World Scenario 1: Doctor Access in a Medicare Advantage HMO

Mary, age 72, lives in Tampa, FL, and enrolls in a $0 premium Aetna HMO plan. She likes that her PCP visits are free and that she gets an extra $50/month for OTC products through CVS.

A few months later, she is diagnosed with a heart condition. Her PCP refers her to a cardiologist, but the nearest in-network cardiologist is 45 minutes away. She asks to see a closer provider, who is out-of-network, but learns that her plan won’t cover it unless she switches to a PPO during the next enrollment window.

Takeaway: With HMO plans, you’re limited to the plan’s local network and often need referrals, even for serious conditions.

Real-World Scenario 2: Emergency Surgery and MOOP Limit

James, 69, has a UnitedHealthcare PPO plan with a $0 monthly premium and a $6,700 maximum out-of-pocket (MOOP). He experiences sudden gallbladder pain and needs surgery.

• His hospital is in-network, but one of the attending specialists is out-of-network, resulting in unexpected charges.
• Despite being covered, he ends up paying nearly $5,800 out-of-pocket that year due to high specialist copays and post-op physical therapy.

Takeaway: Even with PPO flexibility, out-of-network or multi-provider billing can cause confusion and unexpected costs until the MOOP is met.

Real-World Scenario 3: Delayed Treatment Due to Prior Authorization

Gloria, age 74, has severe knee pain, and her doctor recommends an MRI followed by a surgical consultation. Her Aetna MA plan requires prior authorization for the MRI.

• It takes 11 days to get the approval.
• Then her surgery requires a second PA.
• In total, her surgery is delayed by nearly a month, during which her condition worsens.

Takeaway: PA requirements can delay care even when medically necessary. This is a common concern with all MA plans, not just Aetna or UHC.

Risks & Limitations of Medicare Advantage

While MA plans are popular due to their low premiums and added perks, they come with trade-offs that aren’t always apparent upfront:

Risk Area	Impact on Enrollee
Restricted Networks	Limited access to preferred specialists or hospitals, especially in HMO plans.
Prior Authorization	Delays or denials for MRIs, surgeries, rehab, home health, etc.
Geographic Limitations	Moving out of a plan’s service area may trigger involuntary disenrollment.
High Out-of-Pocket Costs	Although there’s a MOOP, expenses can stack up quickly through copays and coinsurance.
Plan Changes Each Year	Formularies, networks, and benefits can change annually, requiring active review during AEP.

• If you travel frequently or spend time in different states, UnitedHealthcare PPO plans may offer more consistent provider access.
• If you’re budget-conscious and live in an area with dense CVS coverage, Aetna HMO plans might give you the most value.
• If you have chronic conditions or expect complex treatments, always review prior authorization requirements and ask for a list of in-network specialists before enrolling.

Medicare Supplement (Medigap)

Medicare Supplement Insurance (Medigap) helps cover out-of-pocket costs not paid by Original Medicare (Parts A and B), such as:

• Deductibles
• Coinsurance
• Copayments
• Excess charges
• Foreign travel emergency care

Medigap plans are standardized and identified by letter (e.g., Plan G, Plan N). Regardless of the company selling the plan, benefits are the same under each letter; only price and service vary.

Popular Medigap Plans Offered by Aetna and UnitedHealthcare

Plan	Coverage Overview
Plan G	Most comprehensive for new enrollees; covers everything except the Part B deductible.
Plan N	Lower premiums than G; includes copays for office and ER visits, excludes Part B excess charges.
Plan A	Basic coverage; excludes skilled nursing, Part A deductible, and Part B excess charges.
Plan F	Covers all gaps in Medicare - including Part B deductible - but only available to those eligible for Medicare before January 1, 2020.

Medigap Premium Comparison: Aetna vs. UnitedHealthcare

We compared real-world sample quotes for a 65-year-old nonsmoking Medicare beneficiary in four states:

Texas (Male, ZIP 77494)

Ohio (Male, ZIP 45011)

Georgia (Female, ZIP 30044)

Illinois (Male, ZIP 62279)

Plan	Aetna	UHC	Difference
Plan G	$216.08	$188.32	UHC is $27.76 less
Plan F	$258.98	$245.50	UHC is $13.48 less
Plan N	$145.86	$175.20	Aetna is $29.34 less
Plan A	$182.76	$131.59	UHC is $51.17 less

UHC premiums are, on average:

• 21% lower than Aetna’s in Texas
• 13% lower than Aetna’s in Ohio
• 7% lower than Aetna’s in Illinois

Aetna is:

• 21% lower than UHC in Georgia

Important: Rates can vary by gender, ZIP code, tobacco use, and age. Always request localized quotes.

Why Medicare Supplement Can Be Better than Medicare Advantage

Here’s where Medigap plans truly shine – freedom, predictability, and nationwide access.

Real-Life Scenario 1: Nationwide Access

David, a 67-year-old retired pilot, travels frequently between Florida and New York to visit family. He enrolls in Aetna Plan G and can visit any doctor or hospital nationwide that accepts Medicare—no referrals, no networks.

If David had a Medicare Advantage HMO, he’d be limited to a local network and possibly out-of-network charges in other states.

Real-Life Scenario 2: No Prior Authorization Headaches

Nancy, age 70, needs knee replacement surgery. With her UHC Plan G, she schedules the procedure directly with a Medicare-accepting surgeon. No prior authorization required, and her only out-of-pocket cost is the $257 Part B deductible.

With MA plans, Nancy might face delays due to prior authorization and copays for every service.

Real-Life Scenario 3: Consistent Coverage Over Time

Carl, 74, has chronic conditions and sees multiple specialists. He’s enrolled in a Plan N with Aetna. He enjoys predictable billing—a $20 copay for doctor visits and minimal surprise costs.

In an MA plan, Carl could face high coinsurance and MOOP (up to $7,550) if he requires frequent outpatient treatment or hospital stays.

Medigap vs. Medicare Advantage: Key Differences at a Glance

Final Thoughts

While Aetna and UHC both offer solid Medigap plans, UnitedHealthcare consistently comes in cheaper in most states, sometimes by $40–$60/month. That said, Aetna may outperform UHC in rate stability or specific plan combinations in certain markets like Georgia.

Medicare Supplement offers peace of mind, especially for individuals who:

✓ See multiple specialists
✓ Travel often
✓ Want to avoid surprise billing
✓ Prefer no referrals or authorizations

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Aetna vs. United Healthcare: Extra Perks

Aetna members can access discounts on a range of health-related products and services. These include an online health coaching program, massage therapy, acupuncture, chiropractic visits, nutrition services, and vision care services such as eye exams, glasses, contact lenses, LASIK, and sunglasses.

Additionally, Aetna members can access discounts on hearing care services such as exams, hearing aids, repairs, and follow-up services.

Most United Healthcare Medicare Advantage plans offer HouseCalls for annual home visits with licensed clinicians and $0 copays for telehealth.

UHC members can earn rewards for health tasks like their annual physicals. Dual health plan members may also get an allowance for healthy food, over-the-counter items, and utility bills.

• Dental Policies:

  • Aetna and UHC both offer standalone dental plans that start at $16/month and $20/month.  Aetna’s dental network has over 420,000 providers, while UHC’s has more than 1.1 million.

  • The level of coverage you choose will determine what benefits are included, such as preventative care (routine exams, teeth cleanings, X-rays, fluoride treatments), basic services (fillings, tooth extractions), advanced care (root canals, bridges, crowns), and emergency dental care.

Aetna vs. United Healthcare: Ratings

Medicare beneficiaries have access to an impartial rating system, the Medicare Star Ratings, to evaluate healthcare plans and determine how well a provider performs. 

According to the 2023 Medicare Star Ratings, Aetna and United Healthcare’s Medicare Advantage plans received an average rating of 4.5 out of 5 stars.

Additionally, Aetna holds an A+ rating with Standard and Poor’s and the Better Business Bureau, an A rating with Moody’s and A.M. Best, and an A+ with Fitch Ratings. United Healthcare holds an A rating with Moody’s and A.M. Best and an AA with Fitch Ratings.

Is Aetna Bigger Than UnitedHealthcare?

While both Aetna and UnitedHealthcare are among the largest Medicare Advantage providers in the U.S., UnitedHealthcare is significantly larger than Aetna across multiple dimensions:

1. Parent Company Comparison

• UnitedHealthcare is part of UnitedHealth Group, the largest health insurer in the U.S. by revenue and membership.

• Aetna operates as a subsidiary of CVS Health, a major player in pharmacy and healthcare services, but smaller in health insurance-specific operations than UnitedHealth Group.

2. Membership Size

• UnitedHealthcare: Serves over 50 million members across employer-sponsored, individual, Medicare, and Medicaid plans.

• Aetna: Serves approximately 39 million members, which includes a mix of medical, dental, pharmacy, and behavioral health services.

3. Medicare Advantage Enrollment

• UnitedHealthcare: Leads the Medicare Advantage market with around 8.6 million enrollees.

• Aetna: Holds the third-largest share, with over 3.6 million Medicare Advantage members.

4. Revenue and Market Presence

• UnitedHealth Group (UHC’s parent): Reported more than $370 billion in revenue in 2023.

• CVS Health (Aetna’s parent): Reported approximately $357 billion, though much of this revenue stems from its pharmacy and retail segments, not strictly health insurance.

Both Aetna and UnitedHealthcare are reputable Medicare Advantage providers offering highly rated plans and strong financial backing.

However, UnitedHealthcare surpasses Aetna in overall size, membership, and market share, particularly in the Medicare Advantage sector.

Conclusion:

For Medicare beneficiaries comparing plans, both insurers offer high-quality options, but those seeking the widest provider networks and most extensive plan offerings may find UnitedHealthcare holds a competitive edge due to its scale and resources.

Which Company Raises Their Rates More Often?

Bottom Line

United Healthcare and Aetna Medicare plans have minor differences; we consider them top-notch providers.

While United Healthcare offers a more diverse lineup of Special Needs Medicare Advantage plans and a slightly more extensive network of healthcare providers, it’s key to check out various plans in your specific area.

Look at premiums, extra benefits, drug coverage, and if your doctor is in the plan network to pick the best Medicare provider for you.

Sources: Aetna Medicare Plan Info | UHC Medicare Plan Info |  Medicare.gov