Aetna 2026 Medicare Advantage plans deliver access to affordable, personalized care

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Oct 01, 2025, 07:00 ET

Providing access to affordable care
- $0 copays on Tier 1 drugs & covered vaccines at in-network pharmacies^1,
- $0 copay for colonoscopies and mammograms at in-network providers
- $0 copay for annual Healthy Home Visit from a licensed Signify Health clinician
- Continued investment in technology, tools and teams that support our members
Commitment to supporting unique member needs — those living with chronic conditions and individuals dually eligible for both Medicare and Medicaid
Leveraging the strength of the CVS Health family of companies to deliver differentiated member experiences

WOONSOCKET, R.I., Oct. 1, 2025 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), today announced our 2026 Medicare Advantage (MA) products with benefits and programs reflecting the diverse needs of our members. With decades of experience serving Medicare beneficiaries, Aetna is serious about continuing to innovate and bring together the resources to support members' health wherever they are.

For 2026, Aetna will offer Medicare Advantage Prescription Drug plans in 43 states plus Washington, D.C., accessible by 57 million Medicare-eligible beneficiaries.² Our other offerings include Special Needs Plans (SNPs), MA-only, prescription drug plans (PDP), and Medicare Supplement and ancillary products.

"We've built our plans around what matters most to our members — access, simplicity and care that meets them where they are," said Jeff Fernandez, president of Aetna Medicare. "Backed by CVS Health and our care delivery partners, we are committed to supporting our members at every point in their health care journey, whether it's in the doctor's office, at home or at the pharmacy."

Choices for affordable access to quality care
Aetna remains focused on providing reliable Medicare Advantage plans that prioritize affordable access to high-quality care. Our members also benefit from strong provider networks with providers who share our member-centric, quality-focused mission — because better health starts with trusted connections and continuity in care. Highlights for 2026 include:

Maintained essential benefits: Aetna offers a plan with a $0 monthly plan premium in every county where plans are available, and all plans have $0 copays for Tier 1 drugs at in-network pharmacies¹ and include dental, vision and hearing benefits plus a SilverSneakers® fitness membership.³ We estimate 82% of the Medicare-eligible beneficiaries will have access to a $0 monthly premium Aetna MA plan.⁴
Aetna Medicare Extra Benefits Card: The Extra Benefits Card, powered by OTC Health Solutions®, a CVS Health company, offers a simplified experience with one card for all card-based benefits. Eligible members can use their allowance on certain services and products at CVS® stores. Members in certain plans can also use the card at over 70,000 additional participating locations.
$0 cost-shares on essential preventive services : To ensure critical preventive services are affordable, we offer certain in-network services at no additional cost to the member, including $0 copays for annual physicals, colonoscopies, mammograms and routine eye and hearing exams and, for some plans, $0 copays for primary care visits and labs.
Expanded High-Value Provider Incentive Program: Aetna teams up with high-value primary care providers who specialize in caring for Medicare members. Members in eligible plans who choose a high-value PCP will receive additional funds on their Aetna Medicare Extra Benefits Card and, with certain plans, reduced cost-shares on certain services, such as $10 in-network specialist/podiatry visit copays and $0 routine behavioral health visits.
Simplified plan names: We know choosing a plan can be confusing. We've simplified our plan names to make it easier for consumers to choose the right plan for their health.

Benefits for whole-person care

Supporting our members' whole health means seeing the full picture. That's why all our MA plans include supplemental benefits like dental, vision, hearing and fitness — because good health goes beyond the doctor's office. Highlights for 2026 include:

Dental, vision & hearing: All our plans include dental, eyewear and hearing aid benefits with $0 routine hearing and eye exams in network.
SilverSneakers®: We continue to offer a SilverSneakers fitness membership to all individual MA members at no additional cost.³ Through SilverSneakers, members have access to thousands of gyms, exercise programs at community centers and parks, and other resources, including mental enrichment, nutrition workshops and well-being classes.
Healthy Home Visits through Signify Health®: All MA plans will offer an annual Healthy Home Visit from a licensed Signify Health clinician at no additional cost. From the comfort of their home, members can receive a comprehensive health assessment and an evaluation of their home environment to identify fall risks and social support needs. This visit complements the primary care visit, helping to improve care coordination and keep members healthy.
CVS Health® Resources For Living® (RFL®): In 2026 the CVS Health RFL program is also available to Dual Eligible Special Needs Plans (D-SNPs) and Chronic Condition Special Needs Plans (C-SNPs).⁵ RFL provides support for physical and mental health needs such as loneliness and connecting members with community resources, such as local transportation, housing, food programs and caregiver support.
Over-the-counter (OTC) benefit: The OTC benefit provides an allowance to purchase eligible health and wellness products like aspirin and bandages in store, online or by phone and is powered by OTC Health Solutions®, a CVS Health company. Members can use this benefit at participating locations like CVS Pharmacy®.

Deepening our commitment to Special Needs Plans
Aetna is committed to supporting members with unique health and coverage needs through our Special Needs Plans. For eligible members, these plans provide additional targeted benefits to support their care and help them live healthier, more empowered lives.

C-SNP: These plans are for members with a qualifying chronic condition including diabetes, chronic heart failure and certain other cardiovascular conditions and provide additional benefits to help them manage their condition. In 2026, Aetna is expanding its C-SNP footprint to 18 states, including 16 new states. These plans offer $0 copays for primary care and certain specialists related to eligible chronic conditions, as well as an Extra Benefits Card, dental, vision and hearing.
D-SNP: These plans are for people who qualify for both Medicare and Medicaid, providing tailored coverage to support their health needs. In 2026, we're expanding D-SNPs to 119 new counties. All D-SNP members will receive a monthly allowance on an Extra Benefits Card for approved over-the-counter products.⁶ Members with an eligible condition can use the allowance on additional spending categories including healthy foods, personal care products, transportation and utilities.

Affordable, accessible prescription drug coverage:

We're helping members get the medications they need at prices they can afford. Whether through our stand-alone SilverScript® prescription drug plans (PDPs) or integrated MAPD plans, Aetna Medicare Part D offerings — backed by CVS Health — are designed to deliver value, improve access and support better health outcomes. Changes and highlights include:

$2,100 out-of-pocket maximum: Members will have an annual out-of-pocket maximum of $2,100 for covered prescription drugs.
Medicare Prescription Payment Plan: New and previously opted-in members can manage the costs of their prescription drugs by spreading them across the year through monthly payments interest-free. There is no cost to join.
$0 dollar coverage across plan types:
- MAPD: Over 98% of our 2.1 million existing General Enrollment MAPD members will have $0 dollar coverage on Tier 1 and Tier 2 drugs up to 100-day supply at preferred pharmacies.^{7, 8}
- D-SNP: All D-SNP members will qualify for $0 Tier 1 drug copays and Aetna offers D-SNPs with $0 Tier 2 drug copays for up to a 100-day supply at in-network pharmacies.⁸ Low Income Subsidy (LIS) copays will apply for remaining generic and brand formulary drugs.
- C-SNP: C-SNP members will enjoy $0 Tier 1 drug copays on a sizable list of Tier 1 drugs or generic drugs used to treat their chronic conditions at in-network pharmacies. Our Tier 1 for this plan includes most commonly used generic drugs essential for managing chronic conditions such as heart disease, blood pressure, cholesterol and diabetes.
- $0 copay on covered vaccines: Many adult vaccines will be available to members with a $0 copay at in-network pharmacies.⁹
Pharmacy network: Members will have access to a broad pharmacy network including CVS®, Walgreens, Walmart, and grocers such as Kroger, Albertsons and H-E-B.
Affordable stand-alone prescription drug plan coverage: Our SilverScript® Choice plans will offer $0 monthly plan premiums to members receiving full Extra Help in 18 states. For other members, SilverScript Choice premiums will range from $14.70 to $116. These plans have simplified benefits and members don't have to use preferred pharmacies to get the lowest cost-sharing. Aetna offers prescription drug plans with reduced cost sharing, including $0 Tier 1 drug copays and no more than $2 Tier 1 drug copays.

Visit AetnaMedicare.com to learn more about our 2026 Aetna Medicare plans. Or call 1-844-588-0041 (TTY: 711), 7 days a week, 8 AM to 8 PM. The Medicare Annual Enrollment Period runs from October 15 through December 7, 2025. A licensed agent may answer your call.

About CVS Health

CVS Health is a leading health solutions company building a world of health around every consumer, wherever they are. As of June 30, 2025, the Company had approximately 9,000 retail pharmacy locations, more than 1,000 walk-in and primary care medical clinics, a leading pharmacy benefits manager with approximately 87 million plan members, and a dedicated senior pharmacy care business serving more than 800,000 patients per year. The Company also serves an estimated more than 37 million people through traditional, voluntary and consumer-directed health insurance products and related services, including highly rated Medicare Advantage offerings and a leading standalone Medicare Part D prescription drug plan. The Company's integrated model uses personalized, technology driven services to connect people to simply better health, increasing access to quality care, delivering better outcomes, and lowering overall costs.

About Aetna

Aetna, a CVS Health business, serves more than 37 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our D-SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area. The formulary /or pharmacy network may change at any time. You will receive notice when necessary. The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in <Suburban Arizona, Urban Kansas, Urban Missouri, Rural Michigan, Rural Nebraska, Rural North Dakota, Suburban West Virginia and Suburban Puerto Rico>. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-833-278-3928 (TTY: 711) or consult the online pharmacy directory. Other pharmacies and providers are available in our network. Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. {Multiple condition disclaimer (Extra Supports Wallet only, non HHP (multiple conditions))} The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include but are not limited to: hypertension, hyperlipidemia, diabetes, cardiovascular disorders, and chronic lung disorders. Eligibility is determined by whether you have a chronic condition associated with the benefit(s). Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility. {C-SNP (ESW and ESW + HVP (CHF, diabetes, cardio disorders))} The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include certain cardiovascular disorders, congestive heart failure, and diabetes. Eligibility is determined by whether you have a chronic condition associated with the benefit(s). Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility.

To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

SilverScript is a Prescription Drug Plan with a Medicare contract marketed through Aetna Medicare. Enrollment in SilverScript depends on contract renewal.

Aetna, CVS Pharmacy, CVS Caremark and Signify Health are part of the CVS Health family of companies.

¹General enrollment MAPD plan members have $0 copays on Tier 1 drugs at preferred pharmacies.

²This number includes the Aetna joint venture in Minnesota (with Allina Health).

³The SilverSneakers benefit that is included is the SilverSneakers basic membership. SilverSneakers is not available for Institutional Special Needs Plan (I-SNP) members.

⁴ Centers for Medicare & Medicaid Services (CMS) Enrollment data, July 2025.

⁵RFL is not available for members with Aetna Part D (prescription only) plans, Institutional Special Needs Plans (I-SNPs) or Medicare Supplement plans.

⁶All D-SNP members will receive a monthly OTC Wallet allowance on an Extra Benefits Card to purchase OTC items. If members have a qualifying chronic condition, their OTC Wallet will upgrade to an Extra Supports Wallet and get additional spending categories to help pay for healthy foods, personal care products, transportation and utilities, as well as OTC items.

⁷Due to legislation in Arkansas, effective January 1, 2026, you may not be able to utilize the following services within the state of Arkansas, unless a court takes action: CVS® retail, CVS Caremark® Mail Service Pharmacy, CVS Specialty® and Omnicare® long-term pharmacies.

⁸FOR 100-DAY SUPPLY: Not all medications are dispensable in 100-day supply due to unbreakable package sizing (e.g., inhalers), or as a result of being a controlled substance.

⁹ Adult vaccines recommended by the Advisory Committee on Immunization Practices will be available to members with a $0 copay at in-network pharmacies.

Resources For Living is the brand name used for products and services offered through the Aetna group of subsidiary companies.

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Media contact

Phil Blando
[email protected]

Investor contact

Larry McGrath
800-201-0938
[email protected]

SOURCE CVS Health