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UnitedHealthcare vs Aetna Medicare Advantage 2027

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) — Last updated October 8, 2026

For 2027, both UnitedHealthcare and Aetna grew their plan counts slightly while cutting PPOs and adding Special Needs Plans. The difference is where they are pulling back.

UnitedHealthcare is the largest Medicare Advantage insurer; Aetna, part of CVS Health, is among the largest. Which is better depends on what each offers in your county.

See Aetna vs UnitedHealthcare Medigap.

✔ Licensed in all 50 states
✔ Based on CMS 2027 data
✔ Free plan comparison

Key Highlights

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UnitedHealthcare: 852 plans; leaving Wyoming.

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Aetna: 654 plans; leaving Maryland and New Hampshire.

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Both are cutting PPOs and adding SNPs.

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The national average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

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Annual Enrollment runs October 15 to December 7, 2026.

Compare plans and enroll online

UnitedHealthcare vs Aetna

2027 Change UnitedHealthcare Aetna
Total plans 852 (up from 846) 654 (up from 642)
PPO plans cut 34 20
Special Needs Plans added 40 29 C-SNPs
Counties losing standard plans About 140 123
State exits Wyoming Maryland, New Hampshire

Source: CMS 2027 landscape data as reported by Becker’s, October 1, 2026.

Benefits UnitedHealthcare and Aetna Plans May Offer

UnitedHealthcare and Aetna Plans May Include

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Hospital and medical coverage, the same as Original Medicare Part A and B

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Part D prescription drug coverage on most plans

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Routine dental, vision and hearing benefits

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Fitness programs and over-the-counter allowances

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Telehealth visits and care coordination programs

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A yearly out-of-pocket maximum on every plan

Not all plans offer all benefits. Benefits vary by plan and county and can change for 2027. Check each plan’s Evidence of Coverage before you enroll.

What Are Medicare Advantage Plans

What This Means for You

Key Takeaway

Compare actual plans in your ZIP code; both vary widely by county.

Watch for: if your plan is ending, you will get a non-renewal letter. Your coverage continues through December 31, 2026. If you do nothing, you return to Original Medicare without drug coverage.

Find & Compare Plans Online

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How to Choose Between Them

Factor UnitedHealthcare Plan Aetna Plan
Premium
Out-of-pocket maximum
Your doctors in network?
Drug costs
Star rating

Fill in for the plans in your county.

How Medicare Advantage Works

Medicare Advantage, also called Part C, is a way to get your Medicare benefits through a private insurance company approved by Medicare. The plan covers everything Original Medicare Part A and Part B cover, except hospice care, which Original Medicare still pays. Most plans also include Part D drug coverage, and many may add extras such as routine dental, vision and hearing benefits.

In exchange, UnitedHealthcare and Aetna plans generally use networks of doctors and hospitals, and may require referrals or prior authorization for some services. Every Medicare Advantage plan has a yearly out-of-pocket maximum for covered medical care, which Original Medicare does not have. You keep paying your Part B premium, plus your plan’s premium if it has one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Evaluating Insurance Providers

Pros and Cons of Medicare Advantage

Advantages

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Often a low or $0 premium

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A yearly out-of-pocket maximum

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Drug coverage usually included

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Many plans may include dental, vision and hearing benefits

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One card and one plan

Tradeoffs

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Networks; HMOs require in-network care except emergencies

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Prior authorization and referrals are common

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Copays add up if you use a lot of care

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Plans and networks can change every year

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Switching to Medigap later may require health questions

UnitedHealthcare and Aetna Drug Coverage for 2027

Most UnitedHealthcare and Aetna Medicare Advantage plans include Part D drug coverage. Each plan has its own formulary, drug tiers and pharmacy network, and plans commonly charge less at preferred pharmacies and through mail order. For 2027, any plan’s Part D deductible can be up to $700, and the out-of-pocket cap on covered drugs is $2,400.

Tier Typical Drugs Typical Cost
Tier 1 Preferred generics Lowest copay
Tier 2 Generics Low copay
Tier 3 Preferred brand-name drugs Moderate copay
Tier 4 Non-preferred drugs Higher copay or coinsurance
Tier 5 Specialty drugs Highest coinsurance

Tier structures vary by plan. Check each plan’s formulary.

Sometimes a drug you take is not on a plan’s 2027 formulary, or it carries a rule like prior authorization. You still have options:

If Your Drug Is Not Covered

1

Ask for a transition fill. In the first 90 days of a new plan year or a new plan, plans generally must give you a temporary supply of a drug you were already taking, so you have time to switch or request an exception.

2

Ask your doctor about alternatives. A covered drug in the same class may work as well and cost less.

3

Request a formulary or tiering exception. Your doctor submits a statement explaining why you need the drug or a lower copay. Plans must decide within set time limits.

4

Appeal a denial. If the plan says no, you can appeal, and there are several levels of review.

See steps to appeal a Medicare Part D denial.

If Your Plan Is Ending

If your UnitedHealthcare or Aetna plan will not be offered in your county for 2027, you should have received a non-renewal notice in early October. Your coverage does not stop right away: it continues through December 31, 2026, so you have time to choose.

If Your Plan Is Ending

1

Read the non-renewal letter. It confirms your plan is ending and explains your options.

2

List your doctors and drugs. You will need them to compare replacement plans.

3

Compare plans for 2027. Check networks, drug coverage and the out-of-pocket maximum, not just the premium.

4

Choose by December 31 for no gap. Enrolling during Annual Enrollment by December 7 gives you coverage on January 1, 2027.

5

Use your Special Enrollment Period if needed. People whose plans end generally can still make a choice through the end of February 2027.

If you do nothing: you return to Original Medicare on January 1, 2027, without drug coverage unless you choose a Part D plan. Going without drug coverage can lead to a late enrollment penalty.

Medigap rights: when your Medicare Advantage plan leaves your area, you generally have a guaranteed issue right to buy certain Medicare Supplement plans without health questions, up to 63 days after your coverage ends.

How to Compare UnitedHealthcare and Aetna Plans for 2027

How to Compare

1

Read your Annual Notice of Change. It lists every change to your current plan for 2027.

2

Check your doctors and hospitals. Confirm each provider is in the 2027 network, not just the 2026 one.

3

Check your prescriptions. Confirm each drug, its tier and any prior authorization or step therapy rules.

4

Compare total yearly cost. Add the premium, typical copays and drug costs, and look at the out-of-pocket maximum.

5

Check star ratings. Medicare rates plans from 1 to 5 stars on quality and service.

6

Enroll by December 7. Your new coverage starts January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, switch or drop a Medicare Advantage or Part D plan for January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 If you are in Medicare Advantage, switch to another plan or return to Original Medicare once
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Change plans after events like moving, losing other coverage or your plan leaving your area

Most people make changes during Annual Enrollment. If you are happy with your current plan, you do not have to do anything; it renews automatically. Still, read your Annual Notice of Change, because premiums, copays, networks and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. Benefits, networks and drug lists are designed around the members they serve, and many include care coordinators. For 2027, Special Needs Plans are one of the few areas where large insurers are adding plans, even as they cut PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; often very low costs and added benefits
Chronic Condition SNP (C-SNP) People with qualifying conditions such as diabetes, heart failure or chronic lung disease Doctors, drugs and programs built around the condition
Institutional SNP (I-SNP) People living in a nursing home or who need that level of care at home Care delivered where the member lives

Turning 65 in 2027

If you turn 65 in 2027, your Initial Enrollment Period lasts seven months: the three months before your birthday month, your birthday month and the three months after. Signing up during the first three months means your coverage starts on the first day of your birthday month.

Turning 65 Checklist

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Sign up for Part A and Part B, unless you have qualifying employer coverage and choose to delay Part B

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Decide between Medicare Advantage and Original Medicare with Medigap

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Join a drug plan, or a Medicare Advantage plan with drugs, to avoid a Part D late penalty

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If you choose Medigap, buy during your six-month Medigap Open Enrollment Period

Star Ratings

Medicare rates every Medicare Advantage and Part D plan from 1 to 5 stars each fall, based on things like preventive care, how well the plan manages chronic conditions, member complaints, customer service and drug pricing accuracy. The ratings are shown in Medicare Plan Finder.

Using Star Ratings

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A rating of 4 stars or higher is generally a good sign of quality and service

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Five-star plans have a special enrollment period, so you can switch into one once during the year

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New plans may not have a rating yet, which is not a bad sign by itself

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Ratings measure the plan overall, not how well it covers your specific doctors and drugs

Medicare Advantage or Medigap?

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; little or nothing on Plan G after the Part B deductible
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states after your Medigap Open Enrollment Period

Guaranteed issue: if your Medicare Advantage plan leaves your area, you generally can buy certain Medicare Supplement plans without health questions, until 63 days after your coverage ends.

Help Paying Medicare Costs

If your income and savings are limited, two programs can cut your Medicare costs sharply:

Medicare Savings Programs

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Run by your state Medicaid office

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Can pay your Part B premium, and sometimes deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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People in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Copays for doctors, specialists and hospital stays

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The out-of-pocket maximum

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Changes to your drug list, tiers and coverage rules

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Whether your doctors, hospitals and pharmacy are still in network

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Changes to dental, vision, hearing and other extras

Plans must send the Annual Notice of Change by September 30. It is the single most useful document you get each fall, because it tells you exactly how your plan changes on January 1.

Special Enrollment Periods

Outside the fall and early-year windows, you generally need a Special Enrollment Period to change plans. Common reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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You qualify for Extra Help or a Medicare Savings Program, or your Medicaid status changes

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You want to join a 5-star plan, once a year

Each Special Enrollment Period has its own time limit, so act as soon as the event happens.

Prior Authorization and Referrals

Most Medicare Advantage plans require prior authorization for some services, such as certain surgeries, advanced imaging, skilled nursing stays and some drugs. Your doctor usually requests it, but ask whether a planned service needs approval so a denial does not surprise you.

If a request is denied, you or your doctor can appeal. Medicare rules set deadlines for plans to decide, with faster deadlines when waiting could seriously harm your health.

Emergency, Urgent and Out-of-Area Care

Every Medicare Advantage plan covers emergency care and urgent care anywhere in the U.S., in or out of network, and you do not need prior approval for an emergency. Routine care away from home is a different story: HMOs generally do not cover it, while PPOs cover out-of-network care at a higher cost.

If you spend months away from home each year, ask each plan how it handles care in your second location. It is one of the most common reasons people switch plans mid-year.

Appeals and Complaints

If your plan denies a service, a drug or payment for care, you have the right to appeal. The plan’s denial notice explains how. There are several levels of appeal, starting with the plan and moving to independent reviewers.

For problems that are not about coverage, such as customer service or wait times, you can file a grievance with the plan. You can also contact 1-800-MEDICARE or your State Health Insurance Assistance Program for help.

The 2027 Part B Premium

The Part B premium is the one big number not released with the plans. CMS normally announces it in November. The 2026 Medicare Trustees Report projects a 2027 standard premium of about $209.50 a month and a deductible of about $292, up from $202.90 and $283 in 2026. You keep paying it with Medicare Advantage.

If You Miss December 7

If you miss the Annual Enrollment deadline, your current plan renews automatically for 2027, with the changes in your Annual Notice of Change. If you are in Medicare Advantage, you get one more chance from January 1 to March 31, 2027, to switch Medicare Advantage plans or return to Original Medicare and join a Part D plan.

Telehealth

Many Medicare Advantage plans may cover telehealth visits for some services, sometimes at a lower copay than an office visit. Telehealth is convenient for follow-ups and minor issues, but it does not replace confirming that your regular doctors are in network.

Your Medigap Open Enrollment Period in Detail

Your six-month Medigap Open Enrollment Period starts the first month you are both 65 or older and enrolled in Part B. It happens only once and cannot be restarted. During it, insurers must sell you any Medigap plan they offer in your state, at the same price as people in good health.

If you keep working past 65 with employer coverage and delay Part B, your Medigap Open Enrollment Period waits until you enroll in Part B. Enrolling in Part B early, when you do not need it, starts the clock and can waste this protection.

Switching From Medicare Advantage to Medigap

Step by Step

1

Check whether you have a guaranteed issue right. For example, your plan is ending or you are within your first year of Medicare Advantage.

2

If not, check your state’s rules. Some states give extra rights; most allow health questions.

3

Apply for Medigap before you leave Medicare Advantage. Make sure you are approved first.

4

Join a Part D plan. Medigap does not cover drugs.

5

Leave Medicare Advantage at the right time. During Annual Enrollment or the January to March window.

Medigap With Employer or Retiree Coverage

If you have coverage from a current employer, you may not need Medigap yet, and delaying Part B can preserve your Medigap Open Enrollment Period for later. Retiree coverage is different: it may work like a supplement, so compare it with Medigap before dropping it, because you may not be able to get retiree coverage back.

When employer or union coverage that pays after Medicare ends, you generally have a guaranteed issue right to buy certain Medigap plans.

Pre-Existing Condition Waiting Periods

If you buy Medigap during your open enrollment period or with a guaranteed issue right, you generally cannot be denied or charged more for health conditions. However, if you did not have creditable coverage before, an insurer may impose a waiting period of up to six months before covering costs for a pre-existing condition. Prior creditable coverage reduces or removes that waiting period.

The 30-Day Free Look Period

If you replace one Medigap policy with another, you generally get 30 days to decide whether to keep the new policy. Pay the premiums for both during that time, and do not cancel your old policy until you are sure about the new one.

How to Read a Medigap Quote

Check Each Quote For

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Plan letter, so you compare like with like

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Monthly premium and any first-year or enrollment discount

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Pricing method: community, issue-age or attained-age

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Household or payment discounts applied

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Effective date and any application conditions

If a quote includes an introductory discount, ask what the premium becomes after it ends.

Common Medigap Mistakes

Avoid These

1

Missing your open enrollment period. Later, health questions may apply.

2

Choosing on today’s price alone. Pricing method and rate history matter.

3

Forgetting Part D. The late penalty is permanent.

4

Dropping Medigap for Medicare Advantage without a plan to return. Getting back may require health questions.

5

Canceling a policy before a new one is approved. You could be left without coverage.

Medigap and Medicaid

If you have full Medicaid, you generally do not need Medigap, and insurers generally cannot sell you a policy that duplicates Medicaid benefits. If you qualify for a Medicare Savings Program, it may pay your Part B premium and, in some cases, deductibles and coinsurance; check whether a Medigap policy still adds value for you.

Getting Help

You do not have to compare plans alone, and you should not have to pay for help. These are the free options:

Free Help Comparing Plans

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Medicare Plan Finder on Medicare.gov, available any time

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1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week

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Your State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling

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A licensed insurance agent or broker, who can compare plans from several insurers at no cost to you

Before any call, have your Medicare card, your list of drugs and doses, your doctors and your preferred pharmacies ready. It turns a long conversation into a short one.

Bottom Line

The Bottom Line

UnitedHealthcare and Aetna both trim in different places for 2027. Compare actual plans during Annual Enrollment, October 15 to December 7, 2026.

Compare plans and enroll online

Frequently Asked Questions

➤ Which has more plans for 2027?

UnitedHealthcare has more Medicare Advantage plans for 2027, with 852 to Aetna’s 654. Aetna grew from 642 plans, while UnitedHealthcare grew from 846. What matters most is which plans are offered in your county, so compare both in Medicare Plan Finder with your ZIP code.

➤ Are both cutting PPOs?

Yes. UnitedHealthcare is cutting 34 PPOs and Aetna 20 for 2027. If you have a PPO from either company, read your Annual Notice of Change or non-renewal letter. If your plan is ending, coverage continues through December 31, 2026, and you can choose a new plan.

➤ Which states are they leaving?

UnitedHealthcare is leaving Wyoming, and Aetna is leaving Maryland and New Hampshire for 2027. UnitedHealthcare is also pulling plans from about 140 counties and Aetna from 123 counties. Check for a non-renewal letter if you live in an affected area.

➤ Which is better?

It depends on the plans in your county. Compare each company’s premium, out-of-pocket maximum, copays, drug costs and whether your doctors are in network. The better choice is the plan that covers your doctors and drugs at the lowest total yearly cost.

➤ When can I enroll in a Medicare Advantage plan for 2027?

Annual Enrollment runs October 15 to December 7, 2026, with coverage starting January 1, 2027. If you are already in Medicare Advantage, you can also make one change from January 1 to March 31, 2027.

➤ What happens if my Medicare Advantage plan is ending?

You will get a non-renewal notice, and your coverage continues through December 31, 2026. You can choose a new plan during Annual Enrollment or a Special Enrollment Period, and you generally have a guaranteed issue right to buy certain Medigap plans.

Have Questions?

Speak with a licensed insurance agent

1-855-398-0716

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-855-398-0716TTY 711

Mon-Fri: 8am-9pm ET

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