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Aetna Medicare Advantage for Providers Only

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In general, Medicare Advantage plans will offer private health insurance through Medicare and give common benefits which original Medicare does not. Aetna is one of the most popular Medicare Advantage providers, with an obvious focus on your overall well-being.


Aetna is one of the largest providers of Medicare Advantage plans. A CVS Health company, Aetna offers a strong array of benefits, with most Aetna Medicare Advantage plans including vision, dental, and hearing coverage, and lots of plans offering additional perks. Also, they are largely low cost, with an estimated 84 percent of Medicare beneficiaries having access to a $0-premium Aetna plan. It is one of the cheapest stand-alone drug plans in the country. Although the company’s offerings are notable, the Aetna Medicare Advantage plans score in the average range for member satisfaction and quality of care.

Aetna Medicare Providers

Health care providers who accept Aetna Medicare Advantage plans are able to be found in lots of areas of the country. Also, Aetna Medicare Advantage plans offer global coverage for emergency care. By the way, do you want to discover Medicare providers who accept Aetna Medicare Advantage plans? One method to do so is to compare specific plans offered in your area and search for the providers who are in those plan networks.

Aside from that, you are also able to speak with a licensed insurance agent by calling 1-866-977-1496 TTY Users: 711. They are available 24 hours a day, 7 days a week. They will be able to help you find a doctor, pharmacist or other health care provider near you who accepts an Aetna Medicare Advantage plan.

Aetna® Provider Networks

Aetna networks include approximately 1.2 million health care professionals, more than 700,000 primary care doctors and specialists and over 5,700 hospitals. Whether or not your provider will accept your Aetna Medicare Advantage plan will depend on the specific plan you enroll in. Of course, each kind of plan has different network rules.

If you are enrolled in an Aetna Medicare Advantage plan, you are likely a member of an:

    • Aetna MedicareSM Plan (HMO)
    • Aetna Medicare Open Access Plan (HMO)
    • Aetna Medicare Prime Plan (HMO)
    • Aetna MedicareSM Plan (PPO)
    • Aetna Medicare Prime Plan (PPO)
    • Aetna Medicare Advantage Dual Special Needs plans (DNSP)

Please be sure to ask your health care provider if they accept the terms of your plan before you seek care.

Need to know that the Centers for Medicare and Medicaid Services releases annual Star Ratings for Medicare Advantage plans. For the year of 2022, Aetna Medicare Advantage Prescription Drug plan obtained an overall weighted average rating of 4.29 out of 5 stars.

How to Find an Aetna Medicare Provider Near You?

You are able to speak with a licensed insurance agent to know what Aetna Medicare Advantage plans are offered in your area. Also, the agent can tell you whether your healthcare provider is in that plan’s network. To speak with a licensed insurance agent, simply you are able to call 1-866-977-1496 TTY Users: 711 24 hours a day, 7 days a week.

Does Aetna Have a Provider Portal?

Aetna has a free Provider Portal. It will allow you to securely access critical information online wherever and whenever you need it. This great tool is available for Aetna plans to directly connect with up-to-date information including:

    • Eligibility verification
    • Claims inquiries
    • Prior Authorization information and requests
    • Remittance Advices

Their online tool is designed and maintained with the highest standards, promising accurate information and faster access to the information you require, when you need it. For your information, there is a Paper Registration Form. You have to complete and return the form in full to complete registration. The form is for the Secure Provider Web Portal.

Available Medicare Advantage Plans

Aetna offers some types of Medicare Advantage plans. Most plans offer vision, dental, and hearing benefits, worldwide emergency care, and fitness benefits via SilverSneakers.

Generally, Aetna offers Medicare Advantage Prescription Drug plans, as well as stand-alone prescription drug plans and Medicare Advantage Plans with no drug coverage. The company has expanded its Medicare Advantage plan for veterans, Aetna Medicare Eagle to 41 states in the year of 2022. The plan is specially designed to complement the health care coverage vets receive from Veterans Affairs.

Aetna Medicare Advantage Pros and Cons

Here are pros and cons of Aetna Medicare Advantage:


    • Many benefits offerings
      Besides dental, vision and hearing, Aetna Medicare beneficiaries have access to benefits such as an over-the-counter allowance, in-home health visits and meal delivery services.
    • Strong $0 premium offerings
      In the year of 2022, Aetna estimates that 84 percent of Medicare-eligible beneficiaries in the United States will have access to a $0-monthly-premium Aetna Medicare Advantage plan.
    • Low-cost drug coverage
      Aetna offers one of the lowest-premium stand-alone Medicare prescription drug plans nationwide, including in Washington, D.C.
    • Broad availability
      Aetna will offer Medicare Advantage plans in 46 states and Washington, D.C., as well as stand-alone drug plans in 50 states plus Washington, D.C.
    • Walk-in clinic access
      Aetna will offer the members to visit one of a network of walk-in clinics or MinuteClinics for the same copay as a regular visit to a primary care physician, as long as the members are in PPO and HMO plans that do not need a PCP visit. For your information, this network includes walk-in locations across 33 states and Washington, D.C.


    • Average star ratings
      The Centers for Medicare and Medicaid Services gives Aetna’s Medicare Advantage plans an average rating of 3.8 out of 5 stars. For note: The national average for all providers is 4.37.
    • Mediocre member love
      J.D. Power found that Aetna Medicare Advantage scored 795 points out of 1,000 points. That places it sixth overall out of nine Medicare Advantage companies ranked.
    • Limited plan types
      Aetna offers PPO, HMO, and Special Needs plans, but does not offer private fee-for-service or medical savings account plans.

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