Aetna is a CVS Health company that offers a broad variety of insurance and employee benefits products including health insurance, dental insurance, behavioral health insurance, long-term care insurance and disability insurance. The company has its origin in the Aetna Fire Insurance Company of Hartford, Connecticut dating back to the 1800s, making it one of the oldest insurance companies around. Aetna is the third-largest health insurance provider in the country.
At one time, Aetna offered ACA-compliant health plans on the Marketplace, but it has discontinued doing so. However, Aetna still offers Medicare Advantage, Part D coverage and dental insurance plans.
Consumers can access Aetna Medicare products in most places throughout the country. Overall, Aetna has a strong reputation in the healthcare industry.
- People who are looking for affordable dental insurance plans
- People living on limited incomes
- People who appreciate rewards programs for fitness goals
- People whose first language is not English
- Dental discount plans potentially with prescription drug coverage
- Medicare Advantage Plans with $0 premiums in some cases
- Offers rewards for reaching fitness goals
- Does not work with independent agents
Aetna Medicare Ratings at a Glance
The rules for Medicare are complex, and it is common for people to be confused about how Medicare insurance works. Aetna strives to help consumers sort out the confusion about Medicare insurance.
Aetna has long offered a wide variety of health insurance plans, as well as dental and vision insurance plans. In 2018, the company sustained financial losses after offering health plans on the ACA Marketplace. Since then, it has discontinued offering plans on the Marketplace.
Nonetheless, Aetna still offers individual and group health insurance plans directly. Aetna also offers Medicare Advantage Plans, Medicare Part D coverage plans, dental insurance plans, dental discount plans, vision insurance plans and group disability plans.
|Coverage in All 50 States?||Yes|
|# of Plan Options||3 (HMO, PPO, and POS)|
Medicare Advantage Plans
Anyone who qualifies for Medicare can get a Medicare Advantage Plan through Aetna to cover the gaps in Medicare Parts A and B.
Aetna offers PPO, HMO and HMO-POS plans under Medicare Advantage. Out-of-network care costs more with PPO and HMO-POS plans, and customers are restricted to in-network medical providers for HMO plans unless it is an emergency.
Plan participants must have a primary care physician for HMO plans, and they must get a referral to see a specialist. Under HMO-POS plans, primary care physicians and referrals for specialists are sometimes required.
The maximum deductible for HMO-POS plans is significantly lower than for PPO and HMO plans.
All plans include access to dental, vision and hearing insurance coverage.
Part D Prescription Drug Plans
Medicare Part D is a prescription drug plan that is available as a standalone policy with Aetna. Customers have the option of three different plans under Medicare Part D, including the SilverScript SmartRX, SilverScript Choice and SilverScript Plus plans.
Plans are available with $0 deductibles and $1 copays. The SilverScript Plus plan provides the largest number of drugs and vitamins, Tier 1 and Tier 2 drugs in the coverage gap and savings on certain insulins.
Medicare Supplement Insurance
Aetna Medicare Supplement plans provide direct cash payments to supplement medical expenses that are not covered under other insurance plans, such as copays and coinsurance plans. Some coverages such as accident insurance, critical illness insurance and hospital indemnity plans also pay for household expenses, utility bills or grocery bills.
In addition to health insurance, Aetna offers Medicare Supplement plans with fixed benefits, dental coverage and vision coverage.
Aetna customers can reach someone in the customer service department by calling a toll-free number. The representative then transfers customers to the proper team to handle their call. General service representatives do not have access to specific policy information.
Unlike some of the other major health insurance companies that have representatives available around the clock, Aetna’s teams are only available between 8 a.m. and 6 p.m. EST.
Alternatively, Aetna customers may reach someone on the customer service team by sending a message online directly or by using the online customer portal.
Moreover, customers who prefer the online chat option can open a chat window on Aetna’s website to speak with a customer service representative.
On a positive note, the reviews for Aetna’s customer service department are generally favorable. Customers report the website is intuitive and user-friendly, making it easy to get the information they are looking for.
The NAIC index shows an above-average rating for customer complaints as proof of their good service. This means that Aetna receives significantly fewer complaints than its competitors. All other financial and customer service ratings are also very good, as the chart below indicates. Aetna is well-positioned to pay its claims now and in the future.
|AM Best Rating||A|
|NAIC Complaint Index||< 2|
|J.D. Power Rating||N/A|
Aetna services all 50 states, and depending on the state of residency, the amount insureds pay for their premiums depends on where they live and what type of coverage they purchased.
Overall, Aetna’s pricing is very good. The premiums for Aetna’s Medicare Advantage Plans start at $0 per month. For Medicare Part D, plan participants can expect to pay around $7 per month in most states.
Individuals who do not receive employer-sponsored dental coverage can purchase dental insurance at a reasonable rate. Aetna’s dental insurance plans cover up to 100% of the costs for preventative dental care and up to 80% of the costs for dental treatments and procedures. Something that sets Aetna apart from similar health insurance providers is it offers discounts on prescription drugs for dental care.
Another thing that sets Aetna apart from its competitors is its dental discount plans, which give patients a discount on dental services upfront.
Aetna’s dental insurance plans generally tend to be a bit pricier than other health insurers, but it offers good rates in comparison with the benefits it provides.
Applicants rank the overall quoting experience with Aetna very high. Insureds can apply for various Medicare insurance plans on Aetna’s website. The process is intuitive, fast and easy.
The Aetna Medicare Eagle plan is a PPO plan that is available to those who qualify for $0 monthly premiums with a $5,500 maximum out-of-pocket limit.
Aetna also offers two unique mobile apps that allow insureds to track their policy benefits and claims while they are out and about. The apps allow insureds to find medical providers who are in-network, view their plan details, access their ID cards and pay their claims.
Furthermore, insureds also have the capability to set up personalized health reminders to customize their health needs.
Applicants do not need to take a medical exam to access Aetna’s Medicare insurance programs.
Aetna’s most recent innovation is Attain by Aetna. This mobile app connects with the insured’s Apple Watch to allow them to set individualized health and fitness goals. Insureds have opportunities to earn rewards when they meet their exercise or dieting goals. The app also provides personalized recommendations for sleep, exercise and appointments. The Aetna Health app functions on the Android and Apple platforms. Nonetheless, Attain by Aetna is only available for Apple Watches.
Customers are generally happy with Aetna’s handling of insurance claims. Medical providers typically file claims on behalf of insureds.
Aetna claims to use generally accepted guidelines and policies in its approach to managing claims as well as the information detailed in the customer’s health plan.
Aetna’s approach to claims payments is to take a broad scope of an individual’s services, including hospital stays, tests, surgeries and other medical services. It will deny services for treatments it does not believe are medically necessary.
Like all other health insurance companies, Aetna provides its insureds with an Explanation of Benefits to describe what Aetna has paid and the reasons for denials. Aetna also responds to appeals for medical claims within 60 days.
Insureds will receive a refund for overpayments they made to medical service providers.
Aetna vs. Competitors
Even though Aetna does not offer health insurance plans on the Marketplace at this time, it is still considered a major player in the health insurance space. Its unique options and wide range of benefit options make it the right choice for many people.
Like some of its competitors, Aetna offers rewards programs for its customers who are working to improve their health. Aetna customers can earn gift cards and other rewards for reaching their health and exercise goals.
Another thing that sets Aetna apart from other medical insurance providers is that the company employs individuals who can help their customers in several different languages, including English, Spanish, Arabic, Italian, Chinese, German, Japanese, French, Russian, and more.
Finally, Aetna offers discounts on prescription drugs for its dental discount plans for just a few extra dollars per month, which is a popular feature among insureds, as it can save them a lot during the course of a year.
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In a review of Aetna’s Medicare insurance plans, Benzinga gives a four-star rating to Aetna for policy options, customer service and pricing. Aetna also earns five stars for its intuitive, easy-to-navigate online application and its cutting-edge mobile apps.
Aetna is not currently offering ACA health insurance plans, and it is unknown whether it may reenter the space in the future. In the interim, Aetna is a strong financial player that offers Medicare Advantage Plans, Medicare Supplement plans, Medicare Part D plans, dental insurance, vision insurance and dental discount plans.
Frequently Asked Questions
Does Aetna offer original Medicare?
Aetna does not offer original Medicare, but it does offer Medicare Advantage plans and Medicare Supplement plans. Medicare Advantage plans cover many of the medical services that original Medicare does not include.
Do you have to pay the premiums for Medicare Part B if you have a Medicare Advantage Plan through Aetna?
Yes. A Medicare Advantage Plan is equivalent to Medicare Part C coverage. You must pay the premium for Medicare Part B coverage along with your Medicare Advantage Plan premiums if there is a monthly fee.