Aetna vs. Anthem BlueCross BlueShield - Which is Best?

Medicare Health Plans is an independent review site. However, we may earn money when you click on links on our site. Read more about How We Make Money

Aetna vs. Anthem BlueCross BlueShield: An In-Depth Comparison

  • Over 50 years Medicare experience
  • Advantage monthly plan premiums as low as $0
Read Review
  • Second-largest health insurance company
  • Advantage monthly plan premiums as low as $0
Read Review

On this page we compare two of the largest insurance companies that offer private plans: Aetna vs. Anthem BlueCross and BlueShield (BCBS). The details are broken down by Medicare Advantage (MA), Medicare Supplement (MS), and Part D Prescription Drug Plans (PDPs).

If you’ve been searching for a health plan, you have probably found yourself with many different options to choose from. This can make it complicated to choose the right plan for your health needs. We’re here to help make the process easier for you.

Aetna vs. Anthem BlueCross BlueShield: Company comparison overview

Provider networks1.5 million providers worldwide including 664,301 primary care doctors & specialists70,000 pharmacies
Medicare Advantage plans39 states and DC14 states
Medicare Supplement plans44 states14 states
Prescription Drug plansNationwide14 states
Medicare Advantage optionsHMO and PPOHMO, PPO, and PFFS
Medicare Supplement optionsA, B, F, G, and N
(D and high-deductible F in some areas)
A, N, and F
(Select N & Select F in some areas)
Prescription Drug options3 plans3 plans
Financial rankingsAA-1AA-2

Data effective 04/26/2017.

 Aetna Pros

  • Large network. Aetna has approximately 1.2 million healthcare professions, over 691,109 primary care physicians and specialists, and 5,708 hospitals in its network across the world.3
  • Three types of Medicare plans are available. You can purchase stand-alone prescription drug plans, Medicare Advantage plans and supplement plans from Aetna. Aetna offers PPO, HMO and Special Needs Plans (SNPs).
  • Plans are available in every state. Part D plans are sold in all 50 states and Advantage plans are offered in all but a handful of states.
  • Low basic stand-alone PDP premium. Out of 10 other insurance companies, Aetna’s Medicare Rx Saver* had the second-lowest minimum monthly premium at $14.50 and third-lowest maximum monthly premium at $39.10 in 2016 for national and near-national basic stand-alone PDPs.4
  • A low number of denied claims. Aetna only denied 1.5% of claims in 2013, compared to Medicare’s 4.9% denial rate.5
  • Strong financial rating. Aetna received an AA- (excellent) ALIC financial strength rating from Standard & Poor’s.

Aetna Cons

  • No Advantage plans in some states. Aetna doesn’t sell Medicare Advantage several states, including Arkansas and Oregon.
  • No Private Fee-for-Service (PFFS) plans.

Anthem Pros

  • Anthem sells three types of Medicare plans. You can find Anthem Blue Cross and Blue Shield Advantage plans, Supplement plans, and prescription plans. Anthem’s Advantage offerings include HMO, PPO, and Special Needs Plans (SNPs).
  • Very strong financial rating. Anthem received an AA- financial strength rating from Standard & Poor’s.
  • Offers Medicare Private Fee-for-Services (PFFS) plans.6

Anthem Cons

  • Doesn’t sell plans in all states. However, you may find plans from other Blue Cross Blue Shield companies in these states.

Comparing access to provider networks

MA plans sometimes require you to visit doctors, clinics, and other providers that participate with the plan’s network. For this reason, a plan’s provider network may help you make a decision about what’s right for you.

Aetna has approximately 1.2 million health care professionals in its global provider network.7 This includes access to more than 691,109 doctors and specialists and 5,708 hospitals. Anthem BCBS claims to have a “leading network” of physicians and facilities,8 but we’re unsure whether it rivals Aetna’s broad provider network in states where both companies offer plans. Anthem also touts a pharmacy network that includes more than 70,000 locations in the United States.

However, knowing that Anthem is a regional insurance company with a smaller footprint, you may be able to assume that Aetna has wider provider access across the nation. In a nutshell, if you have multiple doctors you see on a regular basis, Aetna may be a good choice for you because of its expansive network.

How plan availability may impact your decision

Whether you can get a plan from one these companies depends on the type of coverage you want and where you live. Comparing the two, Aetna definitely has wider plan availability than Anthem.

With Aetna, you can get a prescription plan in any state, but MS and MA plans are more limited. If you want an Advantage plan, you need to reside in one of the 39 states or DC where Aetna offers this coverage. Supplement plans are sold in 44 states. MS plans from Aetna are available in most states. But according to this site, you’re out of luck in AK, CT, HI, ME, MA, WA, and DC.

Anthem offers plans in even fewer states than Aetna—just 14. These states include CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA, and WI.9 However, plans are offered in GA through BlueCross BlueShield of Georgia, in NY through Empire Blue Cross Blue Shield.

Anthem is part of the larger insurance corporation called Blue Cross Blue Shield, which means you may be able to find a similar plan in states where Anthem doesn’t sell. To find out which Blue Cross Blue Shield company operates in your state, visit this website.

Get a Medicare Quote


OR

Speak to a licensed agent.

855-802-1206

Comparing the plans offered

Aetna offers all three of the major plan types: MA, MS, and PDP. It also sells Special Needs Plans (SNPs), which are for people with certain conditions.

Advantage

If you want an Advantage plan, we found a few HMO and PPO choices from each company when we searched in Orange County, California. We didn’t find Private Fee-for-Service (PFFS) plans in this area from either company. We compare these plans in the charts below.

Plan TypeAetnaAnthem BCBS
HMO plan*Aetna Medicare Prime PlanAnthem MediBlue Select
HMO plan*Aetna Medicare Select PlanAnthem MediBlue Plus
PPO plan*Aetna Medicare Choice PlanAnthem MediBlue Coordination Plus
PDP plan*Aetna Medicare Rx SaverAnthem Blue Cross MedicareRx Plus First Health
PDP plan*Aetna First Health Part D Value PlusPart D Premier Plus

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult medicare.gov.

Now let’s dive into these plans in more detail. Below are the $0 premium HMO plan offered by each company. They are very similar, but Aetna’s plan includes lower prescription drug copayments for lower Tiers. Anthem, on the other hand, includes more comprehensive dental and vision services with its basic HMO plan, and it gives you more optional dental and vision benefit choices.

Benefit/Limits
(in-network)
Aetna Medicare
Prime Plan*
Anthem MediBlue
Select*
Monthly premium$0$0
Yearly deductible$0$0
Yearly out-of-pocket maximum$1,950$1,900
Doctor visit copayment
(primary care)
$0$0
Doctor visit copayments
(specialist)
$0$0
Yearly prescription drug deductible$0$0
Prescription drug copayment
30-day supply
(Tiers 1/2/3/4/5)
$0 / $5 / $47 / $100 / 33%
(preferred retail)
$4 / $12 / $42 / $95 / 33%
(preferred retail)
Dental servicesOptional coverage available for $12.40 per month$0 for 1 yearly dental exam and 1 yearly cleaning
Vision Services$150 coverage per year$0 for 1 yearly eye exam
Hearing services$500 coverage for hearing aids$0 for 1 yearly hearing exam and 1 yearly hearing aid fitting. Hearing aids $3,00 yearly maximum benefit for unlimited hearing aids.
Optional benefitsDental planPreventative dental package, dental and vision package, and enhanced dental and vision package.
Plan detailsH0523-060. Data effective 01/01/2017.H0564-063 Data effective 01/01/2017.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult medicare.gov.

Next, we compare the two PPO plans offered in the same location. We found that Aetna’s PPO plan is more than $40 less per month, has no prescription deductible, and has lower copayments for drug Tiers 1 and 2. But again, Anthem’s plan has more included and optional coverage for dental and vision services.

Benefits/LimitsAetna Medicare Choice Plan*Anthem MediBlue Access*
Monthly premium§$107$150
Yearly deductible
in-network
$0$1,250 in-and out-of-network combined
Yearly deductible
out-of-network
$750N/A
Yearly out-of-pocket maximum
in-network
$6,700$6,700
Yearly out-of-pocket maximum
combined in & out-of-network
$10,000$10,000
Doctor visit copayment
(in-network primary care)
$10$10
Doctor visit copayment
(out-of-network primary care)
40%$30
Doctor visit copayment
(in-network specialist)
$40$35
Doctor visit copayment
(out-of-network specialist)
40%$50
Yearly prescription drug deductible$0$230
Prescription drug copayment
30-day supply
(Tiers 1/2/3/4/5)
$0 / $5/ $47 / $100 / 33%$5 / $10 / $42 / $95 / 28%
Dental servicesNot covered$0 for 1 yearly dental exam, 1 yearly cleaning (in-network)
Vision servicesNot covered$0 for 1 yearly eye exam ($69 limit, in-network)
Hearing servicesNot covered$35 for hearing exam (in-network)
Optional benefitsNot coveredPreventive dental package, dental and vision package, enhanced dental and vision package
Plan detailsH5521-056 Data effective 01/01/2017.H8552-020. Data effective 01/01/2017.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

HMO plans typically require you see doctors in the plan’s network, choose a primary care doctor, and get a referral to see a specialist. They also tend to cost less than PPO and PFFS plans. For more details, visit our HMO, PPO, and PFFS explainer.

Supplement

In most states, Aetna offers five Medigap plans while Anthem offers three.10 Each company may also offer additional MS plans in some areas.

Medigap PlansAetnaAnthem
Plan A
Plan BNot offered
Plan CNot offeredNot offered
Plan DSome areasNot offered
Plan F
Plan G
Plan KNot offeredNot offered
Plan LNot offeredNot offered
Plan MNot offeredNot offered
Plan N
High-deductible FSome areasNot offered
Select Plan FNot offeredSome areas
Select Plan NNot offeredSome areas

Data effective 05/03/20187.

Remember, MS plan benefits are standardized nationwide. Refer to the chart below to find out which benefits each Medigap plan includes. For more details on Medigap plans, visit our MS plan page.

Prescription drug plans

If you’re looking for a stand-alone PDP, both company’s options come in three versions. When comparing the two, they have a lot of similarities, but for the most part Aetna PDP monthly premiums come in a little cheaper than Anthem’s. Use the charts below to see how the company’s plans stack up against each other.

Benefits/LimitsFirst Health Part D Premier Plus*Anthem Blue Cross MedicareRx Gold*
Monthly premium$120.70$158.80
Yearly deductible$0$0
Initial coverage limit$3,700$3,700
Donut hole coverageAvailable for Tiers 1 & 2, partially for Tier 4Available for Tier 1
Out-of-pocket threshold$4,950$4,950
Prescription drug copayment
30-day supply
(Tiers 1/2/3/4/5)
$2 / $5 / $34 / 50% / 33%$1 / $2 / $40 / 39% / 33%
Plan detailsS5768-194 Data effective 01/01/2017.S5596-035 Data effective 01/01/2017.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Benefits/LimitsAetna First Health Part D Value Plus*Anthem Blue Cross MedicareRx Plus*
Monthly premium$42.30$106
Yearly deductible$0$0
Initial coverage limit$3,700$3,700
Donut hole coverageAvailable for Tiers 1 & 2Available for Tier 1
True out-of-pocket threshold $4,950$4,950
Prescription drug copayment
30-day supply
(Tiers 1/2/3/4/5)
$2 / $5 / $47 / 50% / 33%$1 / $3 / $40 / 39% / 33%
Plan DetailsS5768-155 Data effective 01/01/2017.S5596-034 Data effective 01/01/2017.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Benefits/LimitsAetna Medicare Rx Saver*Anthem Blue Cross MedicareRx Standard*
Monthly premium$32.10$68.20
Yearly deductible$0 (Tiers 1 & 2)
$400 (Tiers 3-5)
$0 (Tier 1)
$400 (Tiers 2-5)
Initial coverage limit$3,700$3,700
Donut hole coverageNot availableNot available
True out-of-pocket threshold$4,950$4,950
Prescription drug copayment
30-day supply
(Tiers 1/2/3/4/5)
$1 / $2 / $30 / 38% / 25% $1 / $5 / $32 / 40% / 25%
Plan detailsS5810-066. Data effective 01/01/2017.S5596-033. Data effective 01/01/2017.

This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

According to the Kaiser Family Foundation, out of 10 other insurance companies in 2016, the Medicare Rx Saver plan had the second-lowest minimum monthly premium at $14.50 and third-lowest maximum monthly premium at $39.10 for national and near-national basic stand-alone prescription drug plans.11

Comparing industry rankings

Both companies get positive reviews from financial rankings companies. They each earned the rating AA- for Financial Strength rating from Standard & Poor’s.12 13 These rankings represent Standard & Poor’s judgement of whether the companies will be able to meet their financial obligations in the future. In short, you can expect both Aetna and Anthem to be around for a long time to come.

About Aetna

Aetna is currently the third-largest health insurer in the United States.14 The company’s enormous size is a reason that it offers so many in-network provider options than many of its competitors. To learn more, visit our Aetna company page.

About Anthem BlueCross BlueShield

Anthem is even larger than Aetna, coming in as the second-largest health insurance company in the nation.15 According to the company, one in nine Americans get their coverage through Anthem’s affiliated plans.16

Final thoughts

Although the two companies do have differences, both Aetna and Anthem BlueCross BlueShield are companies that offer several plan choices in many parts of the United States. However, Aetna does offer more plans in more areas, so If you don’t live somewhere where Anthem plans are available, you may want to consider signing up for Aetna.


Disclaimers:

* Aetna Medicare Prime, Aetna Medicare Select, Anthem MediBlue Select, and Anthem MediBlue Plus are HMOs with Medicare contracts. Aetna Medicare Choice and Anthem MediBlue Coordination Plus are PPOs with Medicare contracts. Aetna Medicare Rx Saver, Anthem Blue Cross MedicareRx Standard, Aetna First Health Part D Value Plus, Anthem Blue Cross MedicareRx Plus, First Health Part D Premier Plus, and Anthem Blue Cross MedicareRx Gold are PDPs with Medicare contracts. Enrollment in these plans depends on contract renewal.

† This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year.

‡ You must continue to pay your Part B premium.

Sources:

1 Aetna, “Ratings

2 Anthem Insurance Companies, “Financial Strength Ratings

3 Aetna, “Aetna Facts

4 Kaiser Family Foundation, “Medicare Part D in 2016 and Trends Over Time

5 Pittsburgh Post-Gazette, “How do national health insurers compare on denying claims?”

6 Anthem BlueCross BlueShield, “SmartValue

7 Aetna Medicare, “Aetna Facts

8 Anthem Insurance Companies, “Medicare Advantage Plans: Part C in California

9 Anthem Insurance Companies “Medicare Plans & Coverage

10 Aetna Medicare, “CL | Medicare Supplement Plans

11 Kaiser Family Foundation, “Medicare Part D in 2016 and Trends Over Time

12 Aetna, “Ratings

13 Anthem Insurance Companies, “Financial Strength Ratings

14 S. News & World Report, “Aetna’s fourth-quarter earnings surged 38 percent in a performance that trumped analyst estimates, but the health insurer issued initial guidance for the new year that fell short of Wall Street expectations

15 Forbes, “America’s Biggest Insurance Providers

16 Anthem, “About Anthem, Inc.

This site is a U.S. Consumer site. You can learn more about our site and privacy policy here.