Find out if Aetna health insurance meets your needs.
Aetna provides a range of coverage options for older adults and those who meet income restrictions, but it only sells individual and family plans through employers.
Overall rating: 4.8
Aetna is among the most significant health insurance providers in the nation, selling policies in all 50 states and contracting with more than a million health care professionals. While it doesn’t sell individual or family plans, it has coverage options for university students, older adults, and those qualifying for Medicaid. Keep reading to learn more about this provider.
|Coverage area||All 50 states|
|A.M. Best rating||A+|
|NCQA rating||4.5 to 2.5|
|What we like about Aetna health insurance plans:||The drawbacks of Aetna health insurance plans:|
Aetna offers a variety of health insurance plans that may meet your health needs and budget:
Aetna only offers plans through employers, so you can’t purchase individual or family plans through the company or the federal marketplace. However, it does offer several other plan options to meet your needs.
Aetna offers a range of Medicare Advantage Plans for qualifying individuals, which are another way for older adults and those with qualifying disabilities to get Original Medicare benefits. Along with Part A and Part B coverage, MA plans, such as those sold by Aetna, also provide prescription drugs and vision and dental care coverage.
Aetna also sells three Medicare prescription drug plans. These plans can be added to your Original Medicare plan, or certain MA Plans to help you control out-of-pocket medication costs.
Medicaid is free or affordable health insurance that’s jointly funded by the state and federal government. Each state has its own Medicaid program, so benefits and eligibility vary depending on where you live. Aetna manages plans nationwide for those aged 18 and under who qualify for the Children’s Health Insurance Plan (CHIP), Medicaid, and long-term care insurance.
Family health insurance plans don’t always provide coverage for university students, leaving uninsured individuals at risk of financial hardship if they experience a serious injury or illness. Aetna provides university-based health insurance through higher learning institutions all across the country, helping young adults find affordable coverage when their family’s health insurance coverage isn’t an option.
If your health insurance plan requires the use of in-network providers, living abroad can feel like a gamble. Aetna provides award-winning health insurance plans for U.S. citizens living outside the country for a short time. Varying levels of coverage are available, including coverage for emergency medical evacuation and repatriation.
Finding the right health insurance plan requires research. You’ll need to consider whether a company has the coverage you need at an affordable rate and additional factors, such as financial stability, other customers’ experiences with the claims process, and how far your money goes with one insurer compared to another. These can help you evaluate how easy the company is to work with when filing a claim.
|Financial strength rating: 5||Customer satisfaction rating: 4.8||Value rating: 4.8||Coverage rating: 4.8|
Enrolling in a plan from a company that lacks financial stability can make filing a routine claim a headache. Aetna’s financial strength is calculated based on A.M. Best’s rating that considers the soundness of financial decisions, continuous losses versus revenue, and the number of policyholders.
To measure Aetna’s overall customer satisfaction, we look at how happy existing customers are with their coverage and claims-filing experience by looking at three third-party agencies: the Better Business Bureau, National Committee for Quality Assurance, and Consumer Reports.
Aetna has an A+ rating on BBB. In the last three years, it closed 648 customer complaints, most of which were related to problems with not getting covered services paid for and billing or collections issues.
The NCQA gives ratings ranging from 2.5 to 4.0 for Aetna’s plans. Most plans rate as mid-performing across the three categories, including consumer satisfaction, prevention, and treatment.
Consumer Affairs gives Aetna 3.9 out of 5 stars based on 2,289 customer ratings.
Aetna’s value rating measures the affordability of its plans compared to other insurance companies. This rating considers Aetna’s monthly plan premiums, along with annual deductibles, annual out-of-pocket maximum limits, what you pay to see a doctor or specialist, and copays or coinsurance for obtaining emergency care. Considering an insurance company’s value rating can help you get the most for your money.
While low monthly premiums may be enough to entice thrifty customers to sign up for policies, they don’t save you money if the plan doesn’t include the coverage you need for routine or emergency care. Aetna’s coverage rating considers factors such as the number of health providers in the plan’s network, how many plan types are available, and the scope of coverage.
Tammy Burns is an experienced health insurance advisor. She earned her nursing degree in 1990 from Jacksonville State University, obtained her insurance billing and coding certification in 1995, and holds a health and life insurance license in Alabama, Georgia, Iowa, Mississippi, and Tennessee. Burns is Affordable Care Act (ACA)-certified for health insurance and other ancillary, life, and annuity products. She maintains an active nursing license and practices private-duty nursing.
Burns’ background as a nurse, insurance biller and coder, and insurance consultant includes infectious disease, oncology, gynecology, phlebotomy, post operative, family medicine, geriatrics, home health, hospice, human resources, management, billing, coding, claims, fixed annuities, group and individual health and life products, and Medicare. She’s always been driven by a desire to help people, spending more than 25 years as a practicing nurse in hospitals, private doctors’ offices, home health, and hospice. As a nurse, Burns supported patients filing insurance claims with Medicare, Medicaid, and private insurance companies as well as responding to billing questions from confused patients.
Seeing firsthand how unsuspecting patients are frequently confused by an overly complex system they don’t understand led Burns to become an insurance agent and health care consultant, now helping people understand the medical system. Since becoming an insurance agent in 2013, she has worked with some of the largest and most reputable insurance carriers and agencies in the nation, and she has built a large and loyal clientele by way of her commitment to transparency and personalized service.