The 2022 Aetna Health Insurance Review

Before we jump into our full health insurance review for Aetna, let’s take a look at the difference between health care insurance and Medicare. 

Health care insurance and Medicare are very different. It’s important to know how they compare so that you can make the best decision about your health cover.

U.S. Medicare Plans versus Private Health Insurance

If you have been shopping around for health cover, you may be wondering whether you should go with private health insurance instead of Medicare. 

Before you decide which is best suited to your needs, let’s look at how they compare.

Health Care Cover Options in the U.S.

Original Medicare is health insurance provided by the U.S. government for citizens of 65 years and older, and for younger people with certain medical conditions. 

It gives you medical treatment and services at public hospitals and approved medical facilities, some skilled nursing care options, as well as limited cover for home health care or end-of-life care at a hospice. 

Basic Medicare also includes cover for visits to the doctor and other health care providers when medically necessary. 

In short, it will cover some of your costs for some medical services and procedures based on an approved list.

The Medicare Advantage plans are offered by private companies that have made arrangements with the government’s Medicare program. 

• These plans include in-hospital cover and the other urgent and medically-necessary services that Original Medicare offers but get additional cover such as some vision, hearing and dental services.

• Some Advantage Plans may also cover some cover for nonprescription medications,  transportation to doctor visits and services that promote your health and wellness such as gym memberships.

• You may have to use doctors and medical facilities that fall in the plan’s network or pay extra if you do not.

With Medicare Advantage Plans you will not pay more than a certain amount out of your own pocket each year. 

If you reach the limit, you will not pay for treatments. The limits differ depending on the plan you choose.

Dependents

Keep in mind that Medicare is individual insurance and you can't add any dependents to your plan, whereas private health insurance plans do allow you to add dependents. 

Premiums and Costs

Private insurance companies calculate premiums based on factors such as your age, location, general health, and your lifestyle—like if you are a smoker.

The premiums of the government’s Medicare Plan, on the other hand, remain the same no matter how old you are or where you live. 

Medicare may also offer discounts to nonsmokers for making healthier lifestyle choices.

Benefits

You need to be aware that the Original Medicare program, otherwise known as Medicare Part A and Part B, has significant gaps in cover. 

For example, Medicare does not pay for prescription medication. The only way to add prescription cover is to take out additional insurance through a Medicare-approved private insurer at additional cost.

Now that we know the difference between health insurance and Medicare, let’s get into our review of Aetna Health Insurance.

Aetna Health: The Company

Aetna is a health insurance provider that has a long history in the U.S.

It has a strong track record in the health care funding industry, making it a solid choice for your health insurance.

Founded in 1853 in Hartford, Connecticut, Aetna provides health care insurance to U.S. citizens within the country, as well as those who live overseas. 

For more information on the company’s international plans and benefits, visit the Aetna International website.

Aetna is owned by CVS Health, which owns a broad network of pharmacies that manage prescription benefits for other companies. 

This means that if you choose a medical insurance plan with Aetna, you can get discounted medication from CVS’s pharmacy network.

With a focus on encouraging a healthy lifestyle, Aetna is actively involved in helping low-income communities improve their health through partly-funded health care programs. 

Since 1980, the Aetna Foundation has spent around $445 million to provide high-quality health care in poor communities.

Aetna Health Insurance Review - Pros and Cons

As the third-largest provider of health services and insurance in the U.S., Aetna is an insurance company that provides health cover to around 39 million Americans.

Benefits

There are some good reasons for choosing Aetna:

✅ One of the oldest health insurance providers in the U.S.

✅It has good customer service rankings.

✅Is a financially strong insurance company.

✅ It offers a wide range of health insurance plans to suit your needs.

✅ It offers many low-cost plans where you do not have to pay a deductible each year before your insurer starts paying toward your health care expenses.

✅ You can manage your plan with Aetna’s mobile app which allows you to find doctors, compare costs, view claims, track spending, and more.

✅ Aetna’s Attain app allows you to track and manage your fitness goals and activities. The app can be linked to your Apple Watch.

✅ It is easy to buy insurance through Aetna. Simplyrequest a quote and buy coverage online.

✅ You can choose a doctor, dentist, hospital, or other service provider from a wide range of options.

Limitations

The advantages of making use of Aetna far outweigh the downsides, but you need to be aware that:

❌ Customer service is available through email and telephone only.

Health Insurance Products offered by Aetna 

Aetna provides a wide range of health care plans to meet your needs. 

There are so many plans and options that it can be difficult to make a choice, so it is best to either visit the Aetna website or send an email to Help@PolicyScout.com for plan details.

Here are some of the plans and benefits on offer from Aetna:

• Medicare Advantage Plans 

Aetna offers five types of Medicare Advantage Policies.

These insurance plans offer the same coverage as Original Medicare, but often provide additional vision, hearing, and dental plans.

Aetna’s Medicare Advantage Plans can be taken without prescription drug coverage.

Many plans also include other benefits such as home-delivered meals after a hospital or skilled nursing facility stay, cover for over-the-counter items, and a 24-hour Nurse Line and Telehealth Service.

• Health Insurance: Affordable Health Care Individual and Family Plans

This medical insurance plan covers most doctor and hospital visits, prescription medicine, wellness care, and medical devices.

Aetna’s range of Affordable Health Care Act (ACA) plans give you access to the Aetna network of local doctors and hospitals. 

Every ACA plan covers 10 essential benefits which includes: 

• Prescription drugs.

• Pregnancy. 

• Maternity.

• Newborn care. 

• Pediatric services, including oral and vision care. 

• Mental health services.

• Emergency services. 

• Hospital cover.

• Rehabilitative services.

• Habilitative services and devices.

• Dental insurance

The Aetna Dental Direct Plan pays 100% for preventative dental care such as cleaning, oral exams, and routine X-rays. 

You can buy the Aetna Dental Direct Plan without the need to have medical or other insurance with Aetna.

The cover includes partial payment for the cost of fillings, crowns, root canals, and oral surgery, such as tooth extractions.

• Vision insurance

Covers routine checkups such as eye tests and contact lens fittings, as well as contact lenses, prescription lenses, and frames. 

You can see any provider you want—in or out of the Aetna network. But you’ll pay less and get more discounts and perks when you stay in the network.

• Supplemental Health Insurance Plans

The benefit of a Supplemental Plan is that you can receive direct cash payments to help pay for many expenses that medical insurance doesn’t cover, like copayments and coinsurance. 

You can also use the cash to pay for grocery and utility bills and other expenses.

• Prescription Drug Plans

Medicare Part D Plans are separate policies that pay toward prescription medication costs only and do not include other medical cover. It’s for people on the government’s Original Medicare or a Medicare Supplement Plan.

• Pharmacy coverage

Like medical insurance, pharmacy coverage pays to fill prescriptions in line with a specific list of drugs. 

The plans include services such as a 90-day supply of chronic medication and the medication can be mailed to your home for convenience.

• Medicaid Plans

Aetna-managed Medicaid plans across the country, including the Children's Health Insurance Plan (CHIP), are plans for people on Medicaid and Medicare, and long-term care programs.

Medicaid is for people who have limited assets, special needs, or a disability. 

If you qualify for Medicaid, it's offered at no or very low cost. Medicaid is open to low-income people of every age, provided they meet the criteria. 

It is run by state and local governments according to federal guidelines. To see if you qualify for your state's Medicaid or the Children's Health Insurance Plan, you can visit the government health care page.

For more information on Medicaid, please go visit http://www.medicaid.gov 

Source: Pexels

Understand Your Out-of-Pocket Expenses

When considering private health insurance, it’s important to understand what it will cost you. 

This means not only knowing what premium you will pay each month, but also what is not covered on your plan. 

Even if a health care service is covered, you can be expected to pay toward the cost of treatment.

If you are looking for a health care insurance plan, you may be confused by some of the terms that are used in the industry.

If you are puzzled by terms such as deductibles, co-payments, coinsurance, and so on, read on.

Co-payments

Co-payments, also known as co-pays, are typically set at a flat fee, but they may vary in amount based on the type of service. 

For instance, your plan may require a $20 co-payment for a visit to the doctor, but a higher copayment to visit a specialist or an emergency room.

You will pay the $20 when you visit your doctor and your insurer will pay the rest of the doctor’s account.

Deductibles

A deductible is a specified amount that you need to pay out of your pocket each year before the insurer will start paying for your health care expenses. 

If the deductible on your plan is $1,000, your insurer will only start paying for health care services once you have paid $1,000. 

Deductibles reset every year.

Not all plans have a deductible and cheaper plans will have larger deductibles. The cost of the deductible will depend on the specific insurance policy you choose with Aetna.

Coinsurance

As the term suggests, coinsurance is the portion of your medical expenses that you choose to “insure” yourself. The higher the percentage of coinsurance on a plan, the lower the premium will be.

For instance, if you choose a 20% coinsurance amount, you will pay 20% of the cost of each health service and your insurer will pay 80%.

You will start paying coinsurance only after you have paid for expenses up to the amount of your deductible each year.

Premiums

The premium is the monthly cost of joining a health care insurance plan. As with any type of insurance, if you fail to pay the premium each month, your insurance cover will stop and you will lose cover for your medical expenses.

Out-of-pocket limit

An out-of-pocket maximum is also known as an out-of-pocket limit, or cap. This is the maximum amount that you are expected to pay out of your pocket in a year.

When you have spent this out-of-pocket amount on deductibles, co-payments, and coinsurance in the year, your health insurance company will pay 100% for your health care services from that point onward until the end of that year. 

The next year, the deductibles, co-payments, co-insurance, and out-of-pocket maximums reset.

Free screenings

A health screen, also known as a routine checkup, is an important way to protect your health. 

During a health screening, the doctor or nurse will check your weight, waist circumference, height, blood pressure, and temperature, and also listen to your heart and lungs. 

These screenings allow for the early detection of preventable diseases such as diabetes and heart disease, and can be life-saving because treatment and/or lifestyle changes can start early. 

Aetna provides a wide range of screenings for adults, as well as vaccinations.

Why Choose Aetna Health

Aetna is one of the top health insurance companies in the U.S. Nearly one-third of all Americans are covered by Aetna health insurance policies. 

The company is large and well-established with an extensive network of health care providers. 

Aetna regularly receives excellent customer reviews. 

The company also has very positive financial ratings from independent companies. 

Let’s take a look at what these ratings are:

What Reviewers say about Aetna

A third-party review is based on customer reviews that are collected and verified by a consumer watch website that is not affiliated with the company being reviewed. 

J.D. Power

J.D. Power is an independent consumer research and data analytics company known for its customer satisfaction surveys across many industries, including insurance.

In its 2021 U.S. Medicare Advantage study, JD Power gave Aetna a score of 795 out of 1,000—which is only slightly below the average industry score of 806.

ConsumerAffairs

ConsumerAffairs is a private company that provides ratings based on real reviews from actual customers. 

According to the ConsumerAffairs website, Aetna was awarded 3.9 stars out of 5 stars for its customer service based on 455 reviews at the end of September 2022. 

NCQA

The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization. 

It assesses and rates plans each year based on their quality of patient care, how satisfied patients were with the care they’ve received, and the improvement efforts of plans.

Visit the NCQA website to view the 2022 NCQA's Health Plan Report and see how the Aetna health plans rank. Plans are rated between 1 and 5 stars with 5 stars being the top rating. 

Aetna plans range from 2.5 to 4 stars out of a possible 5.

The table below shows a sample of the ratings received for various U.S. Aetna offices:

source: NCQA

Is Aetna Financially Sound?

Financially, Aetna ranks among the country's top medical insurance companies.

Ratings agencies assess and measure the financial health of businesses, companies, and even countries. 

At least three ratings agencies have given Aetna a top rating for being financially strong and able to meet its financial commitments.

Credit rating agency AM Best gave Aetna an “Excellent” or “A” rating.

There is only one rating higher than A and that is A+.

Well-known ratings agency Fitch Ratings also gave Aetna an A rating, while Standard & Poor’s allocated it a BBB rating.

The ratings from Standard and Poor’s can be fairly complex, but what this rating means is that Aetna has shown adequate financial performance, but may be adversely affected by an economic downturn. 

How Does Aetna Compare to Other Health Insurance Companies?

There are many health care insurance plans and providers in the U.S. from which to choose, which makes a decision difficult.

To help you choose a health insurance company, we have included the National Association of Insurance Commissioners (NAIC) Complaint Index in our comparison table below.

The NAIC Index records the number of complaints against insurance companies each year. 

A lower percentage of complaints indicates that a company’s customer service is better than one with a higher percentage.

Aetna vs. UnitedHealthcare

Aetna vs. Cigna

Aetna vs. Humana

Summary of Review: Aetna Health Insurance

Well-known for its broad range of health plans and value-for-money products, Aetna is an excellent company, offering health insurance throughout all 50 states in the U.S., including Washington D.C.

As a global health insurance provider, Aetna also provides health care cover overseas to U.S. citizens. This makes Aetna a good option if you are looking to move to other countries in the future.

Aetna has a large network of health care providers and pharmacies in the U.S. and internationally. This means that it is able to support the health of its members wherever they are.

When it comes to customer service ratings, Aetna receives about the same number of customer complaints as the other top companies. 

From a financial point of view, Aetna health insurance is stable, which means it has the money to pay health care service providers on your behalf if you’re covered by them.

Proof of its strong finances is that Aetna receives good ratings from the world's leading financial ratings agencies. 

With a focus on uplifting low-income communities, Aetna aims to support people beyond its members. For members that care about supporting their communities, this makes Aetna a good choice. 

Aetna provides a wide range of health insurance services that includes health insurance, dental and vision insurance policies, Medicaid plans, pharmacy insurance, as well as employee health insurance products.

It also gives customers access to a large network of contracted pharmacies you can use to get your medication.

If you are shopping for a health care plan to cover your medical expenses, Aetna Health is worth considering.

Aetna Health Insurance: Frequently Asked Questions 

Does Aetna provide Dental Insurance?

Through the Aetna Dental Direct Plan, Aetna provides dental insurance that offers 100% preventative care with no out-of-pocket costs. Preventative care includes cleaning, oral exams, and routine X-rays.

Does Aetna offer Vision Insurance?

Aetna’s vision insurance plans cover routine eye exams and either one pair of eyeglasses, contact lenses, or prescription sunglasses. You are able to visit any optician and can make use of online shopping options for your vision needs.

Does Aetna provide Individual Health Insurance Plans?

An individual insurance plan is one that you purchase on your own, unlike plans which are offered to you via your employer.  

Aetna does provide individual health insurance plans which you can buy directly. If you are employed and your company has insurance with Aetna for its employees, you may already have health care cover this way.

Does Aetna offer Medicare Supplement Insurance?

Aetna’s health insurance offerings include medical, dental, vision, pharmacy, and behavioral health options. 

It offers both individual and group health insurance, including Medicare Advantage Plans, Medicare Prescription Drug Plans, and Medicare Supplement Insurance.

Does Aetna provide worldwide coverage?

Aetna is available across the globe. It has international offices in:

• Europe. 

• Asia Pacific.  

• Middle East. 

• United States. 

Does Aetna have a good reputation?

Aetna has an excellent reputation and has an average number of customer complaints compared to the other large health insurers. 

As its financial ratings are very good, you can rely on Aetna to meet its financial commitments.

Do You Need More Information or Help?

You can call PolicyScout at 1-888-912-2132 or send an email to Help@PolicyScout.com to get assistance from one of our trained consultants about your health insurance options.