Oscar 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 Oscar 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 Oscar individual marketplace plan — or, if your Aetna ACA plan ended, how Oscar stacks up as a replacement. Oscar Health, built specifically for the ACA marketplace in 2012, posts one of Florida's lowest 2026 increases at 26.4% but sells only in select metro counties. 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.

Oscar Health on Florida's 2026 Marketplace

$0 telehealth and a leading app: Oscar offers $0 virtual visits 24/7 through its app for many common conditions — a standout for Bronze and high-deductible enrollees who would otherwise pay full price for office visits before meeting the deductible. Its app is consistently among the highest-rated in health insurance.

Dedicated Care Teams: Instead of a rotating call center, Oscar assigns each member a small Care Team of guides and a nurse who handle every interaction, creating continuity that traditional carriers rarely match.

Competitive metro pricing: In the counties where Oscar competes — primarily South Florida, Central Florida, and the Tampa Bay region — its Silver HMO plans are often among the lowest-cost, and its 26.4% approved increase for 2026 is one of the gentlest among Florida carriers.

Aetna Employer Coverage vs. a Oscar Marketplace Plan

For most people the real 2026 decision is whether to keep an Aetna plan offered through an employer or buy a Oscar 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 Oscar marketplace plan may win on cost.

Oscar's Florida networks are curated rather than comprehensive — selected hospitals and physician groups in the metros it serves, HMO-only, with no out-of-network coverage except emergencies. Because Oscar is not statewide, your first check is simply whether it is sold in your county at all.

2026 Premiums: Oscar in Your County

Aetna no longer publishes individual marketplace premiums in Florida, so the figures below show approximate 2026 unsubsidized Silver premiums for Oscar. 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 Oscar

• Are tech-comfortable and prefer managing coverage in an app
• Value $0 telehealth for routine and mental-health care
• Want a dedicated care team instead of a call center
• Live in a metro county where Oscar is offered
• Are younger and healthier without complex specialist needs

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