Ambetter vs. Aetna / CVS Health

By the Florida Plan Finder Team · Licensed Florida Health Insurance Producer · Last Updated: May 25, 2026

If you are searching for an Aetna versus Ambetter comparison for 2026, there is an important fact to know first: Aetna / CVS Health exited the individual ACA marketplace nationwide — including Florida — at the end of 2025, affecting roughly one million members across 17 states. The company cited continued underperformance and recorded a $448 million premium deficiency reserve on its exchange business. So for the 2026 plan year, you cannot buy an Aetna individual marketplace plan in Florida.

Aetna is still very much active in Florida for employer/group health insurance and Medicare Advantage, so the realistic 2026 comparison is usually an Aetna employer plan versus a Ambetter individual marketplace plan — or, if your Aetna ACA plan ended, how Ambetter stacks up as a replacement. Ambetter, sold by Centene's Florida entity, carries one of the largest marketplace enrollments in the state but also one of 2026's steepest approved increases at 37.9%. This guide covers both.

Why Aetna Is Not a 2026 Florida Marketplace Option

Aetna / CVS Health exited the individual ACA exchanges: At the end of 2025 CVS Health withdrew Aetna from the individual ACA marketplace in all 17 states where it operated, including Florida, ending coverage for about one million members. CVS leadership cited continued underperformance of the exchange book and booked a $448 million premium deficiency reserve. Aetna had also briefly left the exchanges in 2017–2018 before returning in 2021.

Aetna still sells employer and Medicare coverage in Florida: The exit applies only to individual/family ACA plans. Aetna remains a major Florida carrier for employer/group health insurance and Medicare Advantage, which is why many Floridians still hold an Aetna card — just through work or Medicare, not the marketplace.

Ambetter from Centene (Celtic Insurance) on Florida's 2026 Marketplace

Low premiums and broad footprint: Ambetter is consistently among the lowest-cost options in Florida's most populous counties and has long carried one of the largest marketplace enrollments in the state. For subsidy-eligible shoppers who choose by price, Ambetter's Silver plans are frequently at or near the benchmark.

My Health Pays rewards: Ambetter members can earn My Health Pays reward dollars for completing a wellness visit, annual checkup, or health survey — funds that can offset premiums or be spent on everyday health items. It is one of the more generous wellness-incentive programs on the Florida exchange.

Centene scale and managed-care roots: Ambetter is backed by Centene, the country's largest Medicaid managed-care organization, which gives it deep experience serving lower-income and subsidy-eligible members transitioning between Medicaid and marketplace coverage.

Aetna Employer Coverage vs. a Ambetter Marketplace Plan

For most people the real 2026 decision is whether to keep an Aetna plan offered through an employer or buy a Ambetter plan on the marketplace. The pivot point is the subsidy: if your employer's Aetna coverage is deemed affordable under ACA rules, you generally cannot get a marketplace subsidy, which usually makes the employer plan cheaper. If you lack affordable employer coverage, a subsidized Ambetter marketplace plan may win on cost.

Ambetter manages cost through value-tiered networks that are broad in major metros but narrower than Florida Blue's. Its 37.9% approved increase for 2026 is among the highest in the state, so its historic price edge narrows in some counties — always confirm your doctors are in the specific Ambetter network for your plan.

2026 Premiums: Ambetter in Your County

Aetna no longer publishes individual marketplace premiums in Florida, so the figures below show approximate 2026 unsubsidized Silver premiums for Ambetter. Most enrollees pay far less after subsidies.

Approximate 2026 unsubsidized premiums for a 35-year-old non-smoker, before APTC subsidies. As a reference point, Florida regulators reported a 28-year-old in Duval County on a Silver plan going from about $149 to roughly $281 per month for 2026 after subsidy changes. Your actual cost depends on the benchmark Silver plan in your rating area.

Who Should Consider Ambetter

• Are subsidy-eligible and shopping primarily on price
• Live in a major metro where Ambetter is at or near the benchmark Silver
• Want to earn My Health Pays wellness rewards
• Are transitioning from Medicaid to a marketplace plan
• Do not have must-keep specialists outside Ambetter's value network

Who Should Keep Aetna Employer Coverage

• Have an Aetna plan through work that is affordable under ACA rules
• Would lose an employer contribution by dropping the group plan
• Have doctors who are in the Aetna employer network but not in marketplace networks
• Do not qualify for a marketplace subsidy because employer coverage is offered
• Are on Aetna Medicare Advantage, which is unaffected by the ACA exit