Is Anthem the same as Blue Cross Blue Shield?

In 14 states, yes. Blue Cross Blue Shield is an association of independent local insurers rather than a single company, and Anthem's parent Elevance Health holds the Blue Cross and Blue Shield license in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. In those states the company trades as Anthem Blue Cross Blue Shield, or Anthem Blue Cross in California. Everywhere else, the Blue Cross plan is a different company entirely and has no connection to Anthem. This matters if you move, because your plan does not transfer to another state's Blue licensee.

What states does Anthem offer Medicare Advantage plans in?

Anthem offers Medicare Advantage plans in parts of 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. Availability is set county by county rather than statewide, so large portions of several of those states have no Anthem Medicare Advantage plans at all. If you live outside the 14, Anthem is not an option for you regardless of what you find advertised nationally.

Is Anthem cutting Medicare Advantage plans for 2027?

Anthem has not announced any Medicare Advantage plan or county exits for 2027. It made its cuts a year earlier, exiting selected plans and counties plus the standalone Part D market for 2026, which affected roughly 150,000 members. On Elevance Health's second-quarter 2026 earnings call the company said the 2026 actions were performing as expected and that 2027 bids were submitted with a focus on sustainable margin improvement, with no footprint reductions announced. That is not a guarantee your specific plan renews, since individual plan consolidations are only disclosed in the non-renewal notices carriers must send by October 1.

How good are Anthem's Medicare Advantage star ratings?

Mid-pack in absolute terms, but improving faster than almost anyone. For 2026, 53% of Elevance's Medicare Advantage members are in plans rated 4 stars or higher, up from roughly 40% the prior year. Over the same period Humana fell to about 20% and Aetna fell to about 81%, while UnitedHealthcare held above 77% and Kaiser stayed near 100%. Star ratings are assigned per contract rather than per carrier, so check the rating on the specific plan available in your county rather than relying on the company average. The 2027 ratings publish in October 2026.

Does Anthem Medicare Advantage include prescription drug coverage?

Most Anthem Medicare Advantage plans include Part D prescription coverage, and every special needs plan is required to. This is now the only route to drug coverage through Anthem, because the company exited the standalone Part D market entirely for the 2026 plan year. If you want an Anthem plan and you take prescriptions, the coverage has to come bundled inside the Medicare Advantage plan. Check that each of your medications appears on that specific plan's 2027 formulary and at what tier, since formularies are rebuilt annually.

MediBlue is Anthem's brand name for its Medicare Advantage plans. You will see it as MediBlue HMO, MediBlue PPO and variants such as MediBlue Access. It is a marketing name rather than a plan type, so two MediBlue plans in different counties can have completely different premiums, networks and benefits. Anthem also offers dual-eligible, chronic-condition and institutional special needs plans, which may or may not carry the MediBlue name depending on the market.

How much do Anthem Medicare Advantage plans cost in 2027?

Individual 2027 premiums and copays are not available yet. Plan-level data for every 2027 Medicare Advantage plan publishes October 1, 2026, and any specific 2027 Anthem premium quoted before that date is an estimate rather than a rate. What is confirmed is federal: the Part D out-of-pocket cap is $2,400, the maximum Part D deductible is $700, and the Medicare Advantage out-of-pocket maximum can reach $9,850 in network or $14,800 combined. Many Anthem plans carry a $0 monthly premium, but you continue paying your Part B premium regardless of which plan you choose.

What extra benefits do Anthem Medicare Advantage plans include?

Anthem names dental, vision and hearing coverage, monthly allowances for over-the-counter items and healthy foods, utility assistance allowances, and SilverSneakers fitness membership. Insulin is capped at $35 per month with no deductible applied. Depth varies enormously between plans and counties, and some benefits such as utility allowances are typically limited to special needs plans rather than offered across the board. Read the eligible-item lists and annual maximums rather than the headline figures, since that is where two plans advertising the same benefit differ most.

What will happen to Medicare Advantage in 2027?

The market is contracting rather than expanding. Roughly one in ten Medicare Advantage members is in a plan that will not be offered in 2027, with Humana alone exiting plans covering about 600,000 members. Carriers are concentrating on higher-rated, higher-margin plans because contracts at 4 stars and above earn bonus payments, and the effect falls hardest on rural counties where fewer carriers compete. Federally, the Part D out-of-pocket cap rises to $2,400 and the maximum deductible to $700. Anthem is one of the few large carriers with no announced 2027 reductions.

When can I enroll in an Anthem Medicare Advantage plan for 2027?

Annual Enrollment runs October 15 through December 7, 2026, for coverage beginning January 1, 2027. If you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period from January 1 to March 31, 2027 allows one further change. A Special Enrollment Period may apply if you move out of your plan's service area, become eligible for Medicaid or Extra Help, or your current plan is discontinued. If you are new to Medicare, your Initial Enrollment Period spans the three months before through the three months after the month you turn 65.

Aetna Medicare Advantage HMO 2027: Networks, Referrals and Costs

Reviewed by Russell Noga, Licensed Medicare Insurance Broker — Last updated August 8, 2026

Aetna is one of the major carriers offering Medicare Advantage HMO plans for 2027. This page covers how Aetna’s HMO plans typically work, what to expect for 2027, and how they compare to other carriers before you enroll.

For a full breakdown of how HMO plans work in general — network rules, referrals, and cost structure — see our complete 2027 Medicare Advantage guide.

Or compare other Aetna 2027 Medicare Advantage plans such as PPOs in your area by ZIP code to see real options now.

Compare Aetna Medicare plans and enroll online

About Aetna Medicare Advantage HMO Plans

Aetna, a CVS Health company, is one of the larger carriers offering Medicare Advantage plans nationwide, including HMO options in many counties. Aetna’s HMO plans generally require members to use a network of doctors and hospitals, coordinated through a primary care physician.

Like all Medicare Advantage plans, Aetna’s HMO plans must cover everything Original Medicare Part A and Part B cover, and often add supplemental benefits — though specific extras depend on the plan and your ZIP code.

How Aetna HMO Plans Work

Aetna Medicare Advantage HMO plans for 2027

With an Aetna HMO plan, you’ll typically choose a primary care physician (PCP) who coordinates your care and provides referrals to specialists within the network. Except for emergency or urgent care, staying in-network is generally required for coverage.

Many Aetna HMO plans bundle in Part D prescription drug coverage — if your plan includes it, you generally can’t also enroll in a stand-alone Part D plan.

What Aetna HMO Plans May Offer for 2027

Aetna Medicare Advantage benefits in 2027

Aetna Medicare Advantage Plans in 2027 have specific details — premiums, star ratings, and supplemental benefits — that are finalized by CMS and released publicly during the Annual Enrollment Period. Based on how Aetna has historically structured its HMO plans, 2027 offerings may include:

Prescription drug coverage bundled into many HMO plans
Dental, vision, and hearing benefits on select plans
Over-the-counter (OTC) allowances on select plans
Fitness program access (such as SilverSneakers) on select plans

Not all plans offer all benefits, and availability depends on your specific plan and service area. Confirm 2027 benefits directly with a licensed agent or the plan’s official Summary of Benefits before enrolling.

Aetna HMO Network & Provider Access

Aetna Medicare network and providers for 2027

Aetna’s HMO network size and specific participating doctors and hospitals vary by county.

Because HMO plans generally require in-network care except for emergencies, it’s especially important to confirm that your current doctors, specialists, and preferred hospital are in Aetna’s network before enrolling — and to recheck this each year, since network participation can change for 2027.

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What Might Aetna HMO Plans Cost in 2027?

cost for 2027 Medicare Advantage Plans from Aetna

Monthly premium: Aetna offers $0-premium HMO plans in many areas, but availability depends on your ZIP code — you’ll still pay your Medicare Part B premium

Deductibles & copays: vary by specific plan; confirm against the plan’s official Summary of Benefits

Out-of-pocket maximum: Aetna HMO plans, like all Medicare Advantage plans, cap your annual out-of-pocket spending

Extra benefits: dental, vision, hearing, and OTC allowances vary by specific plan and ZIP code

Is an Aetna HMO Plan Right for You?

An Aetna HMO plan tends to be worth considering if you:

Don’t mind coordinating care through a primary care physician
Want lower premiums and copays in exchange for staying in-network
Are interested in plans that may bundle dental, vision, and hearing benefits

If you’d rather see providers without referrals or want more out-of-network flexibility, a PPO plan — from Aetna or another carrier — may be a better fit. See our plan types comparison for more detail.

How to Enroll in an Aetna HMO Plan for 2027

Medicare advantage plan enrollment for 2027

You can enroll in or switch to an Aetna Medicare Advantage HMO plan during the Medicare Annual Enrollment Period, October 15 – December 7, 2026, for coverage effective January 1, 2027.

Compare Aetna Medicare plans and enroll online

Aetna Medicare Advantage HMO 2027 — Frequently Asked Questions

➤ Does Aetna offer $0 premium Medicare Advantage HMO plans for 2027?

Aetna offers $0-premium HMO plans in many areas, though availability depends on your specific ZIP code and county. You’ll still need to pay your Medicare Part B premium regardless of which plan you choose. Specific 2027 plan premiums and benefits publish October 1, 2026.

➤ Do I need a referral to see a specialist with an Aetna HMO plan?

Generally yes. Aetna HMO plans typically require a referral from your primary care physician to see a specialist, except in emergencies. If you’d prefer not to need referrals, a PPO plan may be a better fit.

➤ Does Aetna’s HMO plan include prescription drug coverage?

Many Aetna HMO plans bundle in Part D prescription drug coverage, but not all do. If your plan includes it, you generally can’t also enroll in a separate stand-alone Part D plan. Confirm coverage details for any specific plan before enrolling.

➤ How does Aetna’s HMO plan compare to other carriers’ HMO plans?

All Medicare Advantage HMO plans follow the same basic structure — network-based care coordinated through a primary doctor — but specific costs, networks, and extra benefits vary by carrier and ZIP code. Comparing plans side by side is the best way to see which carrier fits your situation.

➤ When can I enroll in an Aetna 2027 Medicare Advantage HMO plan?

You can enroll during the Annual Enrollment Period, October 15 – December 7, 2026, for coverage effective January 1, 2027. If you’re new to Medicare, you may also be able to enroll during your Initial Enrollment Period.

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ZRN Health & Financial Services, LLC, a Texas limited liability company

RussellNoga

Russell Noga is the founder of CompareMedicareAdvantage.org, and is a Medicare insurance broker licensed in all 50 states. He works with other licensed insurance agents and partners to keep plan information accurate and current for the 2027 Medicare Advantage enrollment season and beyond.

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Aetna Medicare Advantage HMO 2027: Networks, Referrals and Costs

Compare Aetna Medicare plans and enroll online

About Aetna Medicare Advantage HMO Plans

How Aetna HMO Plans Work

What Aetna HMO Plans May Offer for 2027

Aetna HMO Network & Provider Access

Find & Compare Plans Online

Speak with a licensed insurance agent

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What Might Aetna HMO Plans Cost in 2027?

Is an Aetna HMO Plan Right for You?

How to Enroll in an Aetna HMO Plan for 2027

Compare Aetna Medicare plans and enroll online

Aetna Medicare Advantage HMO 2027 — Frequently Asked Questions

Aetna Medicare Advantage HMO 2027 — Frequently Asked Questions

➤ Does Aetna offer $0 premium Medicare Advantage HMO plans for 2027?

➤ Do I need a referral to see a specialist with an Aetna HMO plan?

➤ Does Aetna’s HMO plan include prescription drug coverage?

➤ How does Aetna’s HMO plan compare to other carriers’ HMO plans?

➤ When can I enroll in an Aetna 2027 Medicare Advantage HMO plan?

Have Questions?

Speak with a licensed insurance agent

1-855-454-9051

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Find & Compare Plans Online

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1-855-454-9051TTY 711

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