Aetna, a CVS Health company, provides health insurance across many parts of the United States. Its plans include Medicare Advantage, Medicaid, and commercial options for individuals and employers. Knowing where Aetna offers coverage helps you choose the right plan for your needs.
In 2025, Aetna’s reach includes a vast network of providers and pharmacies. However, coverage varies by state, plan type, and specific regions. Some states have limited or no Aetna plans due to market or regulatory factors.
This guide details Aetna’s coverage by state and plan type. It includes tips to verify availability and maximize benefits. Let’s explore where Aetna operates and how to access its services.
Overview of Aetna’s Coverage
Aetna offers health insurance through Medicare Advantage, Medicaid, and commercial plans. Its network includes 1.8 million health professionals and 6,200 hospitals. Coverage availability depends on your state, county, and ZIP code.
Medicare Advantage plans are offered in 46 states and Washington, D.C. Medicaid plans operate in select states, while commercial plans have broader reach. ACA Marketplace plans are available in 17 states until the end of 2025.
Aetna’s plans include medical, dental, vision, and pharmacy benefits. Use Aetna’s online tools to check coverage in your area. Always confirm with your plan’s documents for exact details.
Medicare Advantage Coverage
Aetna’s Medicare Advantage plans cover 46 states and Washington, D.C. in 2025. These plans include HMO, PPO, HMO-POS, and Dual Special Needs Plans (D-SNPs). They serve over 2,269 counties, reaching millions of beneficiaries.
New expansions include D-SNP PPO programs in Michigan, North Carolina, Oklahoma, South Carolina, and West Virginia. Medicare Eagle plans, designed for veterans, now cover 43 states plus D.C. Coverage varies by county, so check specific availability.
Use AetnaMedicare.com/FindProvider to find plans in your area. Enter your ZIP code to see available options. Call 1-833-570-6670 (TTY: 711) for personalized help.
Medicaid Coverage
Aetna Better Health offers Medicaid plans in 16 states. These include California, Florida, Illinois, Kentucky, and New York, among others. Coverage focuses on low-income individuals, families, and those with disabilities.
Each state’s Medicaid program has unique benefits and eligibility rules. For example, Florida’s plan includes a $65 monthly OTC allowance. Check AetnaBetterHealth.com and select your state for details.
Some states, like Pennsylvania, offer specialized plans like Aetna Better Health Kids. Verify eligibility with your state’s Medicaid office. Contact Aetna at 1-800-282-5366 (TTY: 711) for support.
Commercial and Employer Plans
Aetna’s commercial plans are available in most states for individuals and employers. These include HMO, PPO, and high-deductible health plans (HDHPs). Coverage is offered through employers or private insurers, not the ACA Marketplace after 2025.
Some states, like Alaska, Hawaii, and Idaho, have limited commercial plan options. Justworks notes restrictions in Maryland, Missouri, Montana, South Dakota, and Vermont. Always check with Aetna for local availability.
Employer plans often include dental, vision, and wellness benefits. Use Aetna.com to explore options or call 1-800-872-3862 for details. Your employer’s HR department can provide plan specifics.
ACA Marketplace Plans
Aetna offers ACA Marketplace plans in 17 states through 2025. These include Arizona, Florida, Georgia, and Texas, among others. Coverage ends December 31, 2025, affecting about 1 million members.
States without ACA plans include California, Delaware, Maryland, New Jersey, and Utah. After 2025, members must find new coverage via Healthcare.gov or state exchanges. Open Enrollment for 2026 runs from November 1, 2025, to mid-January.
Aetna cited financial losses and regulatory challenges for exiting the ACA Marketplace. Use Healthcare.gov to compare alternative plans. Licensed agents can assist at 1-877-890-1409 (TTY: 711).
What States Does Aetna Cover: 2025 Breakdown
In 2025, Aetna’s Medicare Advantage plans cover 46 states and Washington, D.C., including new counties in states like Rhode Island and Maryland. Medicaid plans operate in 16 states, such as California, Florida, and Pennsylvania. Commercial plans are available in most states, with some limitations.
Aetna’s SilverScript Choice Part D plan covers all 50 states and D.C. It offers a $0 premium for Extra Help beneficiaries in 33 states. The network includes over 63,000 pharmacies nationwide.
ACA Marketplace plans are limited to 17 states until year-end. Check your state’s status using Aetna’s Plan Finder tool. Some states, like Alaska and Hawaii, have restricted commercial plan availability.
Pharmacy and Provider Networks
Aetna’s pharmacy network includes over 70,000 locations, like CVS, Walgreens, and Rite Aid. CVS is a preferred provider, offering lower copays. Use AetnaMedicare.com/FindProvider to locate in-network pharmacies.
The provider network includes 1.8 million professionals and 6,200 hospitals. MinuteClinics at CVS offer $0 copay services for many plans. Coverage is strongest in urban areas but varies in rural regions.
Some states, like Vermont, have limited network options for certain plans. Always verify your doctor or pharmacy’s in-network status. Call 1-855-338-7027 (TTY: 711) for assistance.
Comparing Aetna Plan Availability
| Plan Type | States Covered | Key Features |
|---|---|---|
| Medicare Advantage | 46 states + D.C. | HMO, PPO, D-SNP, $0 premium options |
| Medicaid | 16 states | State-specific benefits, OTC allowances |
| Commercial | Most states, limited in AK, HI, ID, others | HMO, PPO, HDHP, employer-based |
How to Verify Coverage in Your State
Visit Aetna.com or AetnaMedicare.com and enter your ZIP code in the Plan Finder tool. This shows available plans and providers in your area. The tool updates biweekly for accuracy.
The Aetna Health app, available on the App Store or Google Play, offers mobile access. Scan your member ID card’s QR code to log in. Check plans, pharmacies, and providers on the go.
Call Member Services at 1-833-570-6670 (TTY: 711) for Medicare or 1-800-282-5366 (TTY: 711) for other plans. Representatives can confirm state-specific coverage. Have your member ID ready.
Why Aetna’s Coverage Varies
Aetna adjusts its market presence based on regulations, demand, and competition. In 2025, it exited the ACA Marketplace in 17 states due to financial losses. Regulatory changes, like those under the Inflation Reduction Act, also impact offerings.
Some states have stricter insurance laws, limiting plan availability. For example, Hawaii’s Prepaid Health Care Act requires specific plans, affecting Aetna’s options. Market dynamics influence where Aetna focuses resources.
Aetna prioritizes areas with high membership and provider networks. Rural states like Montana or South Dakota may have fewer options. Check your state’s status for precise details.
Tips to Maximize Aetna Benefits
- Use In-Network Providers: Choose CVS or other in-network pharmacies for lower costs.
- Check Plan Availability: Confirm your state and county offer your desired plan.
- Explore Mail-Order: Use CVS Caremark for 90-day prescription supplies.
- Contact Aetna: Call Member Services for personalized plan guidance.
Limitations and Considerations
Not all plans are available in every state or county. Alaska, Hawaii, and Vermont have limited commercial plan options. ACA Marketplace plans end in 2025, requiring members to switch insurers.
Medicaid coverage is state-specific, with only 16 states offering Aetna Better Health. Some plans have network restrictions, like HMOs requiring in-network providers. Verify your doctor’s status to avoid extra costs.
If your plan is discontinued, use the Special Enrollment Period (SEP) until February 28, 2026, to switch. Contact Aetna or Healthcare.gov for help. Rural areas may face fewer provider options.
Additional Benefits by State
Aetna’s Medicare plans offer extras like dental, vision, and OTC allowances. For example, Florida Medicaid plans include a $65 monthly OTC benefit. Medicare Eagle plans provide $0 copays for labs and colonoscopies in 43 states.
Some states, like New Jersey, offer tiered networks with lower costs for preferred providers. Check your state’s plan documents for unique benefits. Use Aetna’s website to explore extras like SilverSneakers.
Members in states with MinuteClinics, like Texas, get $0 copay vaccinations. Wellness programs, like smoking cessation, are available in most states. Confirm availability with your plan’s Summary of Benefits.
Summary
Aetna provides health insurance in 46 states and Washington, D.C. for Medicare Advantage, 16 states for Medicaid, and most states for commercial plans in 2025. ACA Marketplace plans cover 17 states until December 31, 2025, after which members must find new coverage. The pharmacy network includes over 70,000 locations, with CVS as a preferred provider. Use Aetna’s Plan Finder tool or call Member Services to verify coverage in your state. By staying in-network and exploring plan benefits, you can maximize Aetna’s offerings for your healthcare needs.
FAQ
What states does Aetna cover for Medicare Advantage?
Aetna covers 46 states and Washington, D.C. for Medicare Advantage in 2025. Plans include HMO, PPO, and D-SNPs across 2,269 counties. Check AetnaMedicare.com for local availability.
Does Aetna offer Medicaid plans in my state?
Aetna Better Health covers 16 states, like California, Florida, and Illinois. Visit AetnaBetterHealth.com and select your state for details. Coverage varies by state regulations.
Are ACA Marketplace plans available with Aetna in 2025?
Aetna offers ACA plans in 17 states until December 31, 2025. These include Arizona, Florida, and Texas. After 2025, members must switch to new insurers via Healthcare.gov.
How do I find Aetna’s in-network pharmacies in my state?
Use AetnaMedicare.com/FindProvider or the Aetna Health app to locate pharmacies. CVS is a preferred provider with lower copays. Call 1-855-338-7027 (TTY: 711) for help.
What happens if Aetna doesn’t offer my plan in 2026?
If your ACA plan ends, use the Open Enrollment period (November 1, 2025–mid-January 2026) to switch. A Special Enrollment Period extends to February 28, 2026. Contact Healthcare.gov for options.