2026 Aetna Medicare Advantage Plans: Premiums, Benefits, and Network Changes

Premiums may look steady, but don’t be fooled — the biggest shifts in 2026 Aetna Medicare Advantage plans are buried in network rules, drug costs, and benefit extras. With Aetna cutting nearly 10% of its offerings nationwide, including many PPO options, seniors face tough choices: keep their doctors, switch to an HMO, or risk higher out-of-pocket bills.

Skyline Benefit is an independent Medicare insurance broker helping seniors review Aetna’s 2026 lineup, confirm provider access, and compare alternatives — all at no extra cost. Here’s what you need to know before Medicare Open Enrollment ends.

Why Are 2026 Aetna Medicare Advantage Plans Being Cut?

Aetna is pulling back sharply in 2026, dropping 87 contracts across 34 states. PPOs are hit hardest, especially in rural areas where networks were already thin. The company cites rising medical and pharmacy costs, plus pressure from new federal rules, as reasons to consolidate its offerings.

How Much Will Aetna Plans Cost in 2026?

Most California Aetna plans remain at $0 monthly premium, but costs shift in the fine print:

• Primary care visits: $0 on many HMO options.
• Specialist visits: Copays ranging $25–$45 depending on plan.
• Hospital stays: Daily copays apply.
• Prescription deductible: Standard $615 Part D deductible, waived for Tier 1 & 2 generics.

Key takeaway: $0 premium ≠ $0 cost. Always compare MOOP (maximum out-of-pocket) before enrolling.

What’s Changing in Aetna’s 2026 Drug Coverage?

Drug benefits are more standardized this year:

• $0 generics (Tier 1 & 2) at preferred pharmacies.
• $2,100 annual cap on prescription out-of-pocket spending — once you hit it, covered drugs are free.
• Insulin at $35/month or less.
• Shingles, pneumonia, and flu vaccines at $0.

This cap is a game-changer for members with high drug needs.

What Do Aetna Networks Look Like in 2026?

This is where most people slip up.

• HMO Plans: In-network only for routine care. If your PCP or specialists aren’t in the 2026 directory, you’ll have to switch doctors.
• PPO Plans: Offer flexibility, but with strings attached. Out-of-network doctors can decline to treat you, and if they do see you, you’ll pay a higher cost-share. Always call ahead to confirm participation and pricing.

What Extra Perks Do 2026 Aetna Plans Include?

The 2026 summaries highlight extras seniors often overlook:

• Dental allowances for cleanings, fillings, and in some cases dentures/implants.
• Vision coverage including annual exams and eyewear.
• Hearing benefits with discounts on devices.
• OTC credit cards to use on health items and groceries.
• Worldwide emergency coverage, an increasingly valuable feature for traveling retirees.

These perks vary by county — Orange and LA plans differ in MOOP and allowances.

Which Aetna Plans Should You Watch Closely in 2026?

• Aetna HMO (OC & LA Counties): Strong value if your doctors are in-network.
• Aetna PPO (OC & LA Counties): Still available, but shrinking — may not survive future cuts.
• Special Needs Plans (SNPs): Richer coverage if you qualify for dual eligibility or chronic condition plans.

When Can You Enroll?

Medicare Open Enrollment runs Oct 15 – Dec 7, 2025. If you do nothing, your current Aetna plan renews automatically—but reviewing the 2026 changes ensures you don’t get stuck with surprise costs come January.

Need Help Comparing 2026 Aetna Medicare Advantage Plans?

Skyline Benefit is an independent Medicare insurance broker. We’ll help you check if your doctors and prescriptions are covered under Aetna’s 2026 lineup — and compare every major carrier so you know you’re getting the right fit at no extra cost.

Schedule a consultation today. Call us at: (714) 888-5112