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 treat rising health care costs as a central part of retirement planning, not an afterthought, by integrating realistic medical expense projections into their overall financial strategy early on.' — Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.
'Aetna employees who factor health care inflation into their long-term retirement plan can better maintain financial stability and flexibility throughout their later years.' — Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article, we will discuss:
-
The rising cost of health care in retirement and its impact on long-term outcomes for your finances.
-
Strategies Aetna employees can use to estimate and manage future medical expenses.
-
Smart ways to integrate health care planning into your overall retirement strategy.
You’ve been saving, working, and planning your retirement for decades. Yet many Aetna employees are still surprised by one expense that can quietly disrupt even the most careful plans: health care.
Even if your mortgage is paid, your pension elections are set, and your retirement travel mapped out, health care costs can alter your financial path if not taken into account early.
According to Wealth Enhancement financial adviser Kevin Won, CFP®, “Health care inflation is the hidden tax on retirement. People often budget carefully for living expenses and travel, but underestimate the long-term costs of health and longevity.”
The Price of Health Care in Retirement
Industry research shows the average 65-year-old couple may need roughly $345,000 to cover premiums, prescriptions, and out-of-pocket expenses in retirement—not including long-term care. 1 Depending on health and lifespan, total costs could reach higher amounts. For Aetna retirees, these expenses can reduce decades of pension and 401(k) savings if not addressed appropriately.
Between 1989 and 2019, prescription drug prices surged over 200%, and hospital care costs climbed about 450%, far outpacing general inflation. 2 This reinforces the need for Aetna employees to plan for the future cost of medical care well before retirement.
Why Estimating Health Care Costs Is So Difficult
Everyone’s retirement health story is different, but several key factors shape expenses:
Life Expectancy
Many Americans now live well into their 80s. For Aetna couples retiring at 65, there’s nearly a high chance at least one partner will live past 80
3
—meaning additional years of premiums and prescriptions.
Personal Health
Even retirees in good health will face costs for age-related procedures, such as joint replacements, dental, and vision care. As Won notes, “Being healthy gives you choices, but not immunity from medical costs.”
Location
Where you live after leaving Aetna can have a major impact. Medical procedures may vary by tens of thousands of dollars depending on the state or region.
Insurance Options
Medicare provides core coverage, but it doesn’t cover everything. Aetna retirees who transition from company health benefits should understand that dental, vision, and long-term care are excluded from Original Medicare (Parts A and B).
The Ongoing Trend of Medical Inflation
Medical costs continue to rise faster than general inflation. While new technology improves outcomes and longevity, it also increases expenses. For Aetna retirees living on fixed pensions, this trend can place pressure on household budgets over time.
Won cautions, “The challenge isn’t today’s prices—it’s tomorrow’s uncertainty. Retirees who base planning on current medical costs may face shortfalls in 10 to 15 years.”
Turning Concern into Control
You may not influence the health care system, but you can influence your preparation. Aetna employees can start by estimating their current expenses—including out-of-pocket costs, copays, and premiums—and using an annual health care inflation rate of 5–6% to model potential future needs.
Regularly review your insurance coverage, including any Aetna retiree medical benefits you qualify for, and adjust as plans and costs change. Flexibility is essential—having a buffer is better than facing a shortfall during retirement.
Smart Strategies for Paying Health Care Costs
1. Understand Medicare Coverage 4
-
Part A: Covers hospital stays, usually with no premiums but with deductibles.
-
Part B: Covers outpatient care with monthly premiums and copays.
-
Part D: Offers prescription coverage through private insurers.
-
Part C: (Medicare Advantage): May include dental and vision benefits.
2. Account for Long-Term Care
About 70% of retirees will need some form of long-term care.
5
Costs can range from $70,000 to $75,000 annually for assisted living.
6
Aetna retirees should consider long-term care insurance or hybrid life policies, since Medicare does not cover custodial care.
3. Use Health Savings Accounts (HSAs)
Employees enrolled in a high-deductible health plan can fund HSAs with triple tax benefits: tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses. After age 65, funds may be applied to Medicare premiums and dental or hearing costs.
4. Keep a Medical Emergency Fund
Set aside six to 12 months of medical expenses to handle dental implants, surgeries, or out-of-network care. This helps avoid liquidating investments during market downturns.
5. Balance Your Investments
Health care inflation often exceeds overall inflation. A mix of growth and income investments can help Aetna retirees preserve purchasing power and maintain cash flow for health needs.
6. Review Prescription Options
Compare prices between pharmacies, consider mail-order services, and choose generic medications when available to reduce costs.
7. Include Health Care in Your Income Strategy
Treat health care as a fixed expense in your retirement budget. “When health care becomes part of your income plan, it can stop being a source of fear,” says Won.
8. Stay Informed Without Overreacting
Laws and benefits change frequently. Focus on what you can control—your savings rate, coverage selections, and plan reviews.
Your Health and Finances Are Connected
A well thought-out health care strategy can support both your wealth and your peace of mind. Whether you’re still working at Aetna or approaching retirement, now is the time to strengthen your plan.
“This is the stage where your preparation pays off,” says Won. “We want health care to be part of your retirement story, not a surprise ending.”
How The Retirement Group Can Help
Health care planning doesn’t have to be overwhelming. The Retirement Group can assist Aetna employees in designing a customized retirement and health care strategy aligned with their goals and benefit options. To speak with a retirement planning consultant about your pension, 401(k), or health care choices, call (800) 900-5867.
Featured Video
Articles you may find interesting:
- Corporate Employees: 8 Factors When Choosing a Mutual Fund
- Use of Escrow Accounts: Divorce
- Medicare Open Enrollment for Corporate Employees: Cost Changes in 2024!
- Stages of Retirement for Corporate Employees
- 7 Things to Consider Before Leaving Your Company
- How Are Workers Impacted by Inflation & Rising Interest Rates?
- Lump-Sum vs Annuity and Rising Interest Rates
- Internal Revenue Code Section 409A (Governing Nonqualified Deferred Compensation Plans)
- Corporate Employees: Do NOT Believe These 6 Retirement Myths!
- 401K, Social Security, Pension – How to Maximize Your Options
- Have You Looked at Your 401(k) Plan Recently?
- 11 Questions You Should Ask Yourself When Planning for Retirement
- Worst Month of Layoffs In Over a Year!
- Corporate Employees: 8 Factors When Choosing a Mutual Fund
- Use of Escrow Accounts: Divorce
- Medicare Open Enrollment for Corporate Employees: Cost Changes in 2024!
- Stages of Retirement for Corporate Employees
- 7 Things to Consider Before Leaving Your Company
- How Are Workers Impacted by Inflation & Rising Interest Rates?
- Lump-Sum vs Annuity and Rising Interest Rates
- Internal Revenue Code Section 409A (Governing Nonqualified Deferred Compensation Plans)
- Corporate Employees: Do NOT Believe These 6 Retirement Myths!
- 401K, Social Security, Pension – How to Maximize Your Options
- Have You Looked at Your 401(k) Plan Recently?
- 11 Questions You Should Ask Yourself When Planning for Retirement
- Worst Month of Layoffs In Over a Year!
Sources:
-
1. Fidelity Investments. ' Fidelity Investments Releases 2025 Retiree Health Care Cost Estimate ,' July 30, 2025.
-
2. Rakshit, Shameek, Emma Wager, Paul Hughes-Cromwick, Cynthia Cox, and Krutika Amin. “How Does Medical Inflation Compare to Inflation in the Rest of the Economy?” Peterson-KFF Health System Tracker, 2 Aug. 2024, www.healthsystemtracker.org/brief/how-does-medical-inflation-compare-to-inflation-in-the-rest-of-the-economy/ .
-
3. Social Security Administration. ' Actuarial Life Table .' Period life table, 2022, as used in the 2025 Trustees Report.
-
4. Centers for Medicare & Medicaid Services. “What’s Not Covered?” Medicare.gov, 6 months ago (access date Oct. 30, 2025), www.medicare.gov/providers-services/original-medicare/not-covered .
-
5. Administration for Community Living. “How Much Care Will You Need?” U.S. Dept. of Health & Human Services, 18 Feb. 2020 (page updated), acl.gov/ltc/basic-needs/how-much-care-will-you-need.
-
6. Where you live matters. ' How Much Does Assisted Living Cost? ' May 13, 2025.
How does Aetna Inc.'s frozen pension plan affect employees' eligibility for benefits, and what specific criteria must current employees meet to qualify for any benefits from the Retirement Plan for Employees of Aetna Inc.?
Eligibility for Benefits: Aetna Inc.'s pension plan has been frozen since January 1, 2011, meaning no new pension credits are accruing. Employees who were participants before this date remain eligible for benefits but cannot accrue additional pension credits. To qualify for benefits, participants need to have been vested, which generally occurs after three years of service(PensionSPD).
In what ways can employees at Aetna Inc. transition their pension benefits if they leave the company, and what implications does this have for their tax liabilities and retirement planning?
Transitioning Pension Benefits: If employees leave Aetna, they can opt for a lump-sum distribution or an annuity. Employees can roll over their lump-sum payments into an IRA or other tax-qualified plans to avoid immediate taxes. However, direct rollovers must follow the tax-qualified plan's rules. If not rolled over, employees are subject to immediate tax and potential penalties(PensionSPD).
What steps should an Aetna Inc. employee take if they become disabled and wish to continue receiving pension benefits, and how does the company's policy on disability impact their future retirement options?
Disability and Pension Benefits: Employees who become totally disabled and qualify for long-term disability can continue participating in the pension plan until their disability benefits cease or employment is terminated. No additional pension benefits accrue after December 31, 2010, but participation continues under the plan until employment formally ends(PensionSPD).
Can you explain the implications of the plan amendment rights that Aetna Inc. retains, particularly concerning any potential changes in the pension benefits and what this could mean for employee planning?
Plan Amendment Rights: Aetna reserves the right to amend or terminate the pension plan at any time. If the plan is terminated, participants will still receive benefits accrued up to the date of termination, protected by ERISA. Any future changes could impact employees' planning and retirement options(PensionSPD).
How does the IRS's annual contribution limits for pension plans in 2024 interact with the provisions of the Retirement Plan for Employees of Aetna Inc., and what considerations should employees keep in mind when planning their retirement contributions?
IRS Contribution Limits: The IRS sets annual contribution limits for pension plans, including defined benefit plans. In 2024, employees should ensure that their pension contributions and tax planning strategies align with these limits and the provisions of Aetna's pension plan(PensionSPD).
What are the options available to Aetna Inc. employees regarding pension benefit withdrawal, and how can they strategically choose between a lump-sum distribution versus an annuity option?
Withdrawal Options: Aetna employees can choose between a lump-sum distribution or various annuity options when withdrawing pension benefits. The lump-sum option allows for immediate access to funds, while annuities provide monthly payments over time, offering a more stable income stream(PensionSPD).
How does Aetna Inc. ensure compliance with ERISA regulations concerning the rights of employees in the retirement plan, and what resources are available for employees to understand their rights and claims procedures?
ERISA Compliance: Aetna complies with ERISA regulations, ensuring employees' rights are protected. Resources are available through the Plan Administrator and myHR, providing information on claims procedures, plan rights, and how to file appeals if necessary(PensionSPD).
What documentation should employees of Aetna Inc. be aware of when applying for their pension benefits, and how can they ensure that they maximize their benefits based on their years of service?
Documentation for Benefits: Employees should retain service records and review their benefit statements to ensure they receive the maximum pension benefits. They can request additional documents and assistance through myHR to verify their years of service and other relevant criteria(PensionSPD).
How do changes in interest rates throughout the years affect the annuity payments that employees at Aetna Inc. might receive upon retirement, and what strategies can they consider to optimize their retirement income?
Impact of Interest Rates on Annuities: Interest rates significantly affect annuity payments. Higher interest rates increase the monthly annuity amount. Employees should consider the timing of their retirement, especially at the end of the year, when interest rates for the following year are announced(PensionSPD).
If employees want to learn more about their pension options or have inquiries regarding the Retirement Plan for Employees of Aetna Inc., what are the best channels to contact the company, and what specific resources does Aetna provide for assistance?
Contact for Pension Inquiries: Employees can contact myHR at 1-888-MY-HR-CVS (1-888-694-7287), selecting the pension menu option for assistance. Aetna also provides detailed resources through the myHR website, helping employees understand their pension options and benefits(PensionSPD).



-2.png?width=300&height=200&name=office-builing-main-lobby%20(52)-2.png)









.webp?width=300&height=200&name=office-builing-main-lobby%20(27).webp)