Aetna Employees: Is It Time to Reevaluate Your Medicare Plan This Enrollment Season?

Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more

'Aetna employees should recognize that thoughtful Medicare decisions during annual enrollment can help align health care needs with long-term retirement goals, and taking the time to reassess options is essential,' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Aetna employees who take the time to review their Medicare options during annual enrollment can better align their health care choices with their personal retirement goals,' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. Key Medicare decisions that Aetna employees and retirees face during annual enrollment.

2. Common reasons to review and change Medicare plans.

3. How The Retirement Group can assist with Medicare and retirement planning.

Navigate Medicare Annual Enrollment with Confidence

From October 15 to December 7, Medicare’s Annual Enrollment Period (AEP) allows Aetna employees to enroll in, change, or discontinue Medicare Advantage (Part C) or Medicare Part D prescription drug plans. Any updates you make will take effect on January 1 of the following year.

Because Medicare plans may adjust provider networks, prescription drug lists, costs, and coverage every year, Aetna retirees should review their benefits during AEP.

Why Reviewing Your Medicare Plan Matters

You may hear recommendations from friends or see Medicare advertisements. What matters most is whether your plan:

• - Includes your preferred doctors, hospitals, and prescriptions

• - Fits your current health and financial needs

If your health situation has changed or costs have risen, it may be time to reassess your plan. AEP gives Aetna retirees the opportunity to make adjustments if you are no longer satisfied with your plan.

Common Reasons to Update Medicare Coverage

Aetna employees may consider changes if:

• - Your current plan has become too expensive

• - The plan does not support updated medical needs

• - Prescription drug costs have increased

• - Network doctors or specialists are hard to access

• - You want simpler coverage through a Medicare Advantage plan that may combine Parts A, B, and D

Review Annual Notices from Your Plan Provider

Each September, insurers send an Annual Notice of Change (ANOC) outlining updates for the coming year, including changes to costs, provider networks, or prescription coverage. If your plan becomes more restrictive or expensive, consider exploring alternatives during AEP.

Medicare Plan Options

Helpful Medicare Reminders

• - Medicare Part B covers many preventive services, including screenings, vaccines, and yearly wellness visits.

• - Part A covers medically necessary hospital stays, although deductibles and coinsurance may apply.

• - Provider-ordered lab tests are covered by Part B with no cost sharing; Medicare Advantage plans may have plan-specific rules.

• - Medigap changes may require medical underwriting unless you qualify for guaranteed issue rights.

  - Medicare provides individual coverage—there are no joint or family plans.

• - A lifetime Part D late enrollment penalty may apply if you go 63+ days without creditable prescription coverage.

• - If no action is taken during AEP, your current plan typically renews for the following year if it remains available.

Need Help Reviewing Your Options?

Making Medicare decisions each year is an important part of retirement planning for Aetna employees. Reviewing your plan can help determine if it still supports your health care needs and financial situation.

The Retirement Group can help you review your Medicare and retirement options. Call us at  (800) 900-5867  for assistance.

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Sources:

1. Medicare & You 2026. U.S. Department of Health & Human Services, 2025, pp. 62, 70–71, 79–81, 83–85. PDF file.

2. Pugh, Tony, et al.  “Medicare Open Enrollment: Compare Plans and Changes.”  AARP , updated 2025,  www.aarp.org/medicare/open-enrollment-action-plan/ .

3. Fidelity Viewpoints.  “Medicare Enrollment: Time to Change Plans?”  Fidelity Investments , 1 Oct. 2025,  www.fidelity.com/learning-center/personal-finance/retirement/medicare-enrollment-plans .

4. National Council on Aging (NCOA).  “ Understanding Medicare's Late Enrollment Penalties .”  National Council on Aging , 10 Apr. 2025.

5. Centers for Disease Control and Prevention (CDC).  “Adult Vaccination Insurance and Payment Resources.”  CDC , 9 Aug. 2024,  www.cdc.gov/vaccines-adults/hcp/adult-payment-insurance-resources/index.html .