Aetna's regular Medicare PPOs will be in 245 fewer counties in 2027

Aetna’s regular Medicare Advantage PPOs will be offered in 1,749 counties in 2027, down from 1,994 in 2026. That is a net loss of 245 counties, a Health and Tech Now analysis of CMS plan files shows.

The net figure hides more churn. 280 counties lose their regular Aetna PPO and 35 gain one. 1,714 keep one.

The count of states with a regular Aetna PPO falls from 43 to 39.

“Regular” means a CVS Health Aetna Medicare plan with plan type PPO and no special needs designation. A county counts if at least one such plan is offered there.

Four states with no regular Aetna PPO

California, Maryland, New Hampshire and Oregon have no regular Aetna PPO in 2027. Together they had 24 counties with one in 2026: 12 in California, 7 in Oregon, 3 in Maryland and 2 in New Hampshire.

In California the change is PPO only. Aetna still sells regular HMO plans in 13 California counties in 2027 and chronic condition HMOs in 9.

Where the footprint shrinks most

Illinois loses the most, going from 97 counties to 58. Alabama drops from 47 to 20 and South Dakota from 34 to 10. West Virginia goes from 55 to 33, Arkansas from 59 to 39, Louisiana from 38 to 18 and Colorado from 33 to 17.

Chronic condition HMOs grow

The same files show Aetna building out a different product. Its HMO C-SNPs are special needs plans for people with heart disease, heart failure or diabetes. They went from 6 plans in 2025 to 43 in 2026 and 72 in 2027. That is two years of growth, counted by unique contract and plan ID.

The footprint grew with them. These plans reached 18 counties in 2 states in 2025 and 234 counties in 17 states in 2026. In 2027 they reach 410 counties in 23 states.

What it means for you

Agents: pull your Aetna PPO clients in California, Maryland, New Hampshire and Oregon first. No regular Aetna PPO is offered in those states in 2027, and annual enrollment ends Dec. 7. Then check every county on your book against the 2027 plan list, because 280 counties lose a regular Aetna PPO.

Plan leaders: compare Aetna’s 410 chronic condition HMO counties with your own footprint. That is where Aetna now competes for members with heart failure, heart disease or diabetes.

Source: CMS CY2026 Landscape (Sep 2026) and CY2027 Landscape (Oct 2026 release, posted Oct 20, 2026), cms.gov. Aetna regular PPO means CVS Health Aetna Medicare plans with Plan Type PPO and no special needs designation. Counties served fell from 1,994 in 2026 to 1,749 in 2027, a net loss of 245 (280 counties lost, 35 added). No regular Aetna PPO is offered in California in 2027 (12 counties in 2026). Aetna chronic condition HMOs (HMO C-SNP) grew from 6 plans in 2025 (CMS CY2025 Landscape, Jun 2025) to 43 in 2026 and 72 in 2027.