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How Aetna vs. Blue Cross compare for health insurance and Medicare plans
By
David Rodeck
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Full Bio
David is a financial content writer in New York City. He specializes in covering insurance, investing, and retirement planning. Before writing full-time, he worked as a financial advisor and passed both the CFP and Series 6 exams.
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Updated February 24, 2024
Reviewed by
Samantha Silberstein
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Reviewed bySamantha Silberstein
Full Bio
Samantha (Sam) Silberstein, CFP®, CSLP®, EA, is an experienced financial consultant. She has a demonstrated history of working in both institutional and retail environments, from broker-dealers to RIAs. She is a current CFA level 3 candidate and also has her FINRA Series 7 and 63 licenses. Throughout her career, Samantha has used her expertise and various licenses and certifications to provide in-depth advice about household and business-specific financial planning, investing, credit cards, debt, student loans, taxes, retirement, and income strategies.
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Fact checked by
Bobby L. Hickman, FLMI CLU
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Fact checked byBobby L. Hickman, FLMI CLU
Full Bio
Bobby L. Hickman is a longtime business and financial journalist who brings decades of experience in insurance and financial services to his editor role at Investopedia. He has worked with insurance and financial services companies, such as AFLAC, Allstate, Confederation Life, Farm Bureau, SunLife, and others. His editorial clients include the Atlanta Business Chronicle and Advisors magazine.
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Aetna and Blue Cross Blue Shield are two of the largest health insurance companies in the country. Both offer a wide selection of plan options, extensive provider networks, and extra discounts through partnerships. For this review, we compared these two companies for their Affordable Care Act (ACA) and Medicare Advantage plans. We considered factors like availability, policy options, costs, and customer satisfaction. Blue Cross Blue Shield stood out as the better overall choice for ACA plans, while Aetna was better for Medicare Advantage plans. Still, there are a lot of factors to consider when deciding which makes sense for your health insurance. Read on to see how these two insurers stack up. Pros Allows policyholders to get discounted care with CVS All ACA plans are eligible for the full premium tax credit Sells low-cost Medicare Advantage plans Highly rated mobile app Cons Limited policy types for ACA plans Only sells ACA plans in 12 states About Aetna Aetna launched in 1853. It was originally the Aetna Life Insurance Company, then expanded into selling health insurance. In 2018, Aetna became a subsidiary of CVS and is now part of CVS Health. It sells various health insurance policies, including: Pros Extensive selection of ACA plan types Quoted lowest overall costs for ACA plans Policyholders traveling out of state can get in-network care from BCBS partners Cons App and website quality vary among states’ BCBS networks High average premiums for Medicare Advantage plans About Blue Cross Blue Shield Blue Cross Blue Shield is an association of 33 local independent organizations operating under the Blue Cross Blue Shield license. Together, they insure roughly one-third of all Americans. Blue Cross Blue Shield specializes in health insurance, including ACA plans, Medicare/Medicaid plans, travel insurance, dental insurance, and vision insurance. The exact plans available depend on the BCBS organization in your state of residence. Each local organization has its own name, such as: Aetna vs. Blue Cross: Comparisons, Costs, and More Aetna vs. Blue Cross: Comparisons, Costs, and More Policy Types Cost Availability Medicare Advantage Policy Management Customer Experience Discounts and Savings Enrollment Process Alternatives Frequently Asked Questions (FAQs) Methodology There are different types of ACA health insurance plans based on the level of coverage and provider network. Each ACA plan receives a metal level showing the amount of coverage versus the cost. Bronze plans charge lower premiums but have higher out-of-pocket fees when you need care. Platinum plans offer the most coverage but charge the highest premiums. ACA plans also use different networks for medical providers: Aetna has fewer policy types than Blue Cross Blue Shield. However, it still provides a decent selection. It offers expanded bronze, silver, and gold ACA plans. You could find a metal level for all budgets ranging from low to high. Aetna also sells the three main types of plans: HMO, EPO, and PPO. Besides ACA plans, Aetna sells insurance for the Medicare market, including Medicare Advantage plans. As the country’s largest health insurance organization, Blue Cross Blue Shield naturally provides a massive selection of policy types. It offers a broader selection than Aetna. Blue Cross Blue Shield offers six metal categories versus three at Aetna. These metal levels range from catastrophic, which is even less expensive than bronze, to platinum, the highest level of coverage. Blue Cross Blue Shield offers HMOs, EPOs, and PPOs. It also sells point-of-service (POS) health insurance plans. These plans let you see out-of-network providers, as a PPO plan does, but can charge lower premiums. Aetna does not sell POS plans. In addition, Blue Cross Blue Shield sells plans for the Medicare market, including Medicare Advantage plans. Overall, Blue Cross Blue Shield has lower costs than Aetna for its ACA plans. Our analysis determined this result by looking at average premiums, deductibles, and copays for bronze and silver plans in Hialeah, Florida, and El Paso, Texas. However, the cost of health insurance plans depends on the area. You might find a different result when collecting quotes for yourself. We collected quotes for ACA plans for people ranging from 25 to 60 years old. Overall, BCBS had lower premiums and lower deductibles. BCBS stood out for quoting significantly lower premiums for applicants who are 60 years old. Otherwise, the price quotes were similar across age groups. When it comes to plan type, Aetna quoted better premium and deductible pricing for bronze plans. Blue Cross Blue Shield quoted better premium and deductible pricing for silver and gold plans. Aetna could be the better choice if you are healthy and want a bronze plan because you don’t expect to need much care. On the other hand, if you want more coverage, you could potentially find a better deal with the Blue Cross Blue Shield’s silver or gold plans. If you need to see a doctor, your health insurance plan could charge you a copayment for each visit. We checked the Aetna and Blue Cross Blue Shield copayments, using their bronze and silver plans with the lowest possible copay as a reference point. We checked copays for both primary care providers and specialists. Blue Cross Blue Shield had lower copayments for both types of plans. Keep this in mind if you’re worried about paying out-of-pocket to see a doctor. Blue Cross Blue Shield has far more availability for ACA plans. The company sells ACA plans in 36 states. While it doesn’t sell nationwide, it sells plans throughout nearly every major region. Aetna only sells ACA plans in 12 states. It sells primarily in states up and down the East Coast, plus California, Nevada, and Texas. If you plan to travel outside your state, both Aetna and BCBS offer decent out-of-network coverage. Aetna allows you to use your insurance with any CVS MinuteClinic. You can go to these pharmacies throughout the country for wellness exams, screenings, and treatment for minor injuries. With BCBS, you join its BlueCard program. If you travel to a different state where BCBS has another member organization, you qualify for in-network rates with its in-network doctors and hospitals. Medicare Advantage plans are private insurance plans working as an alternative to Original Medicare. If you join a Medicare Advantage plan, you leave Original Medicare. Your private insurance company then pays for your healthcare bills and prescriptions according to the policy rules. Aetna and Blue Cross Blue Shield both sell Medicare Advantage plans throughout most of the United States. Aetna has more availability, with 47 states versus 42 for BCBS. Our research found that Aetna Medicare Advantage plans performed better on average versus BCBS Medicare plans. Aetna’s plans had better overall customer satisfaction, according to average NCQA ratings. Aetna also has much lower average premiums and drug deductibles. Blue Cross Blue Shield does have a lower average out-of-pocket expenditure, which is the average amount people pay in a year using its Medicare Advantage plans. Still, most applicants likely would save money using the Aetna plans when you consider the lower premiums and drug deductible. Aetna provides a website tool called the Aetna Navigator and a mobile app with similar functions. Through these tools, you can manage and pay claims, check the balance of health savings accounts, get cost estimates for medications and procedures, and find doctors, clinics, and hospitals. The Aetna app mainly received positive ratings, with a 4.7/5.0 score on the Apple App Store and 4.6/5.0 on Google Play. Reviewers enjoyed the app design and ease of use. Negative reviewers said the app was on the basic side and that they would have liked more features. Each Blue Cross Blue Shield network uses its own website and app. In general, you should be able to pay claims, view information about your deductibles and out-of-pocket limits, find doctors, and research drug costs. What’s available and the quality depends on the network. For example, Blue Cross and Blue Shield of Michigan offers its own app with these features. Highmark Blue Cross and Blue Shield of Delaware does not offer an app and only provides a website. The National Committee for Quality Assurance (NCQA) is a nonprofit organization. It rates health insurance plans based on the quality of care patients receive, patient satisfaction, and insurers' efforts to improve coverage. Blue Cross Blue Shield received a higher score here for customer service, with an average rating of 3.59/5.00 for its plans. Aetna was a little bit lower with an average rating of 3.46/5.00. J.D. Power also releases a study each year to find the best-rated insurer for different regions based on customer satisfaction. Aetna did better here. It was the best in the Northwest, Southwest, and East South Central regions. Blue Cross Blue Shield scored best in the Delaware/West Virginia/Washington D.C. region and the Heartland. It also tied for the best in the Northeast. Aetna and Blue Cross both offer extra discounts and savings to policyholders. Aetna offers discounts through its partnership with CVS. You can schedule $0 virtual visits with CVS MinuteClinics and buy $5 copay generic medications at CVS pharmacies. You also receive a $100 credit per year to buy CVS wellness products such as cold remedies, allergy medicine, and pain relief pills. As a Blue Cross Blue Shield member, you are eligible for ongoing deals through Blue365. During the year, this platform announces deals that you can use for clothing, fitness, hearing and vision, nutrition, and travel. You can log in and see what discounts are available to save money with partners such as Office Depot, Crocs, and ContactsDirect. The process of joining Aetna and Blue Cross is roughly the same. It depends on what kind of insurance you are looking for. You sign up for ACA plans during open enrollment, which runs from Nov. 1 to Jan. 15 each year. You may also qualify for a special enrollment period for specific reasons, such as moving or losing coverage from your job. You sign up for ACA plans using your state’s health insurance exchange. If your state does not run its own health insurance exchange, you use the federal exchange at Healthcare.gov. On these websites, you can compare all the plans available in your network. You’ll see the premium, out-of-pocket costs, provider networks, and other benefits. Click the plan you want from either Aetna or Blue Cross Blue Shield. The website will walk you through the enrollment process. You’ll need to pay the first month’s premium to complete enrollment. Aetna and Blue Cross Blue Shield also use roughly the same process for Medicare Advantage plans. Once again, you can only apply during an approved enrollment period (such as when you first qualify for Medicare) or during the annual open enrollment period (Oct. 15 to Dec. 7 for first-timers; Jan. 1 to March 31 if you’re switching plans). You enroll in Medicare Advantage plans using the Medicare marketplace at Medicare.gov. Enter your ZIP code on this website to see what plans are in your area. You can compare the options from Aetna, Blue Cross Blue Shield, and other insurers. Click the one you want to submit an application for and pay your premium to start coverage. You don’t have to join these plans using an exchange. Another option is to apply through the websites of Aetna and Blue Cross Blue Shield. You could also request a meeting with one of their health insurance agents. You can follow this same process for other off-exchange health insurance plans, such as short-term health insurance, international plans, and student plans. Blue Cross Blue Shield is our top pick in our list of the best health insurance companies overall. Aetna is best for same-day service, thanks to its CVS Minute Clinics. There are other high-quality alternatives. Kaiser Permanente has the highest-quality health insurance plans. Its plans earn high customer satisfaction and quality ratings from the NCQA. We named Oscar the best for health management programs. If you join its health insurance plans, you can use numerous programs to manage conditions like asthma, diabetes, high cholesterol, and low back pain. Oscar also offers a weight management program. Aetna and Anthem are different health insurance companies. Aetna has broader availability, especially with Medicare Advantage plans. Aetna sells health insurance in 47 states. Anthem is a brand of the Blue Cross Blue Shield network. It only operates in 14 states. Anthem is separate from the Blue Cross Blue Shield network, so we covered it in a separate review. You can enroll for an Aetna or Blue Cross Health Insurance policy using the relevant health insurance exchange. For ACA plans, you enroll using your state’s health insurance exchange. If your state does not have a health insurance exchange, you use the federal exchange at Healthcare.gov. You enroll in an Aetna or Blue Cross Blue Shield Medicare Advantage plan using the Medicare.gov exchange. For both options, you could also contact an insurance agent from either company for help with enrollment. You should choose a health insurance company based on its overall costs, coverage options, customer satisfaction, provider network, and availability in your area. This is a highly personal decision, and the plans available depend on where you live. You can use your ACA or Medicare exchange to search what’s available in your area. You’ll see the premiums, out-of-pocket costs, and a star plan quality rating. This can help you narrow your search. You can then read online reviews for more information on the plans. To review Aetna and Blue Cross Blue Shield, we focused on some of the most important factors when comparing health insurance companies. For each provider, we looked at the policies available, the cost of coverage, the coverage limits for various plans, the policy management tools, the overall customer experience, and the enrollment process. We also paid attention to the network size and area of availability for both companies. Article Sources Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in our editorial policy. J.D. Power. "Medicare Advantage Plans Struggle to Communicate Effectively With Members, J.D. Power Finds." Aetna. "Explore Your Plan Options." Blue Cross Blue Shield. "The Blue Cross Blue Shield System." Blue Cross Blue Shield. "BCBS® Companies and Licensees." Aetna. "Aetna Insurance Coverage." Blue Cross Blue Shield. "BCBS Coverage Travels with You." J.D. Power. "2023 U.S. Commercial Member Health Plan Study." Aetna. "ACA Health Insurance Plan Coverage." Blue Cross Blue Shield. "Blue365." Healthcare.gov. "When Can You Get Health Insurance?" Healthcare.gov. "How to Apply & Enroll." Medicare.gov. "Joining a Plan." Article Sources Investopedia requires writers to use primary sources to support their work. These include white papers, government data, original reporting, and interviews with industry experts. We also reference original research from other reputable publishers where appropriate. You can learn more about the standards we follow in producing accurate, unbiased content in oureditorial policy. J.D. Power. "Medicare Advantage Plans Struggle to Communicate Effectively With Members, J.D. Power Finds." Aetna. "Explore Your Plan Options." Blue Cross Blue Shield. "The Blue Cross Blue Shield System." Blue Cross Blue Shield. "BCBS® Companies and Licensees." Aetna. "Aetna Insurance Coverage." Blue Cross Blue Shield. "BCBS Coverage Travels with You." J.D. Power. "2023 U.S. Commercial Member Health Plan Study." Aetna. "ACA Health Insurance Plan Coverage." Blue Cross Blue Shield. "Blue365." Healthcare.gov. "When Can You Get Health Insurance?" Healthcare.gov. "How to Apply & Enroll." Medicare.gov. "Joining a Plan." Related Terms What Is Open Enrollment? Open enrollment is an annual period when you can enroll in, adjust, or cancel certain types of insurance plans, such as health, vision, and dental insurance. more What Is the National Committee for Quality Assurance (NCQA)? The NCQA evaluates health insurance plans on quality and customer satisfaction. Learn how to use its star ratings to choose a plan that’s right for you. more What Is Indemnity Health Insurance? Indemnity health insurance plans are not ACA-compliant. They are not a replacement for major medical insurance, but you can use them to supplement your existing coverage. more What Is an Annual Maximum Benefit in Insurance? An annual maximum benefit in insurance is the most a policy will pay per year for care. Understanding your limit can prevent surprise bills. more What Is Supplemental Health Insurance? Supplemental health insurance can help pay for expenses not fully covered by your health insurance plan within certain limits. more What Is Short-Term Health Insurance? Short-term health insurance offers healthcare coverage for a limited period of time. more Investopedia is part of the Dotdash Meredithpublishingfamily.At a Glance Aetna Blue Cross ACA Policy Types Available HMO, PPO, EPO HMO, PPO, EPO, POS ACA Metal Levels Available Expanded bronze, silver, gold Bronze, expanded bronze, silver, gold, platinum, catastrophic ACA Availability 12 36 ACA Costs Middle of the 9 companies we gathered quotes for Best of the 9 companies we gathered quotes for Medicare Advantage Availability 47 states 42 states App Yes Yes Customer Service (3-year avg. NCQA Ratings) 3.46 3.59 Discounts and Savings Yes Yes Investopedia Lists It Appears On Best Medicare Advantage Plans, Best Health Insurance Companies, Best Affordable Health Insurance Companies, Best Health Insurance Companies for the Unemployed, Best Health Insurance Companies for the Self-Employed Best Medicare Supplement (Medigap) Companies, Best Health Insurance Companies, Best Affordable Health Insurance Companies, Best Health Insurance Companies for the Unemployed, Best Health Insurance Companies for the Self-Employed Aetna
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Blue Cross
Aetna vs. Blue Cross: Policy Types
Aetna Blue Cross Blue Shield ACA Policy Types HMO, PPO, EPO HMO, PPO, EPO, POS ACA Metal Levels Expanded bronze, silver, gold Bronze, expanded bronze, silver, gold, platinum, catastrophic Aetna Policy Types
Blue Cross Blue Shield Policy Types
Aetna vs. Blue Cross: Price Comparison
Cost by Age
Cost by Plan Type
Cost by Copays
Aetna vs. Blue Cross Blue Shield: Availability
Aetna Blue Cross Blue Shield ACA State Availability 12 36 Medicare Advantage: Aetna vs. Blue Cross Blue Shield
Aetna Blue Cross Blue Shield State Availability 47 42 NCQA Rating (Out of 5 Stars) 3.83 3.5 Average Premium $16.73 $52.90 Average Drug Deductible $107.43 $178.34 Average Out-of-Pocket Expenditure $5,566.89 $4,996.85 Aetna vs. Blue Cross Blue Shield: Policy Management
Aetna and Blue Cross Blue Shield offer their policyholders online member portals and apps for policy management. Since BCBS is a collection of individual companies/networks, each uses its own portal and app. The user experience could be different depending on your location. Aetna Policy Management
Blue Cross Policy Management
Aetna vs. Blue Cross Blue Shield: Customer Experience
Aetna Blue Cross Blue Shield NCQA Rating (Out of 5 Stars) 3.46 3.59 Aetna vs. Blue Cross: Discounts and Savings
Aetna vs. Blue Cross: Enrollment Process
Individual and Family (ACA)
Medicare Advantage
Off-Exchange
Alternatives to Aetna and Blue Cross
Frequently Asked Questions
What’s the Difference Between Aetna and Anthem?
How Do I Enroll for an Aetna or Blue Cross Health Insurance Policy?
How Should I Choose a Health Insurance Company?
Methodology
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