Medicare rules are complex, and it’s common for people to get confused about how Medicare works. Aetna is working to help consumers clear up confusion about health insurance.
Aetna has a long history of offering a wide variety of health insurance plans, as well as dental and vision insurance plans. In 2018, the company suffered financial losses after offering health plans on the ACA market. Since then, it has stopped offering plans in the market.
Nevertheless, Aetna still directly offers individual and group health insurance plans. 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|
|Number of plan options||3 (HMOs, PPOs and POSs)|
Medicare Advantage Plans
Anyone eligible for Medicare can get a Medicare Advantage plan through Aetna to cover Medicare Part A and Part B gaps.
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 limited to in-network medical providers for HMO plans, unless it’s 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 needed.
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 available as a standalone policy with Aetna. Customers have a choice 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 copayments. The SilverScript Plus plan provides the most medications and vitamins, Tier 1 and Tier 2 medications in the coverage gap, and savings on select insulins.
Medicare supplemental insurance
Aetna Medicare Supplement plans provide direct cash payments to supplement medical expenses not covered by other insurance plans, such as copays and coinsurance plans. Some coverages such as accident insurance, critical illness insurance, and hospital expense compensation 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 from customer service by calling a toll-free number. The representative then transfers customers to the appropriate 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 24 hours a day, Aetna teams are only available between 8 a.m. and 6 p.m. EST.
Alternatively, Aetna customers can contact a member of the customer service team by sending an online message directly or using the online customer portal.
Additionally, customers who prefer the online chat option can open a chat window on the Aetna website to speak with a customer service representative.
On a positive note, Aetna’s customer service reviews are generally favorable. Customers report that 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 far fewer complaints than its competitors. All other financial and customer service ratings are also very good, as shown in the table below. Aetna is well positioned to pay its receivables now and in the future.
|AM Highest rating||A|
|NAIC Complaint Index||< 2|
|Rating from Moody’s||Stable|
|Rated power JD||N / A|
Aetna serves all 50 states, and depending on the state of residence, how much policyholders pay for their premiums depends on where they live and what type of coverage they have purchased.
Overall, Aetna’s prices are very good. 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 have employer-sponsored dental coverage can purchase dental insurance at a reasonable rate. Aetna’s dental insurance plans cover up to 100% of the costs of preventive dental care and up to 80% of the costs of dental treatments and procedures. What sets Aetna apart from similar health insurance providers is that it offers discounts on prescription drugs for dental care.
Another thing that sets Aetna apart from its competitors is its dental discount plans, which offer patients a discount on dental services up front.
Aetna’s dental insurance plans generally tend to be a little more expensive than other health insurers, but they offer good rates relative to the benefits they provide.
Candidates rank the overall quote experience with Aetna very high. Policyholders can apply for various health insurance plans on Aetna’s website. The process is intuitive, quick and easy.
The Aetna Medicare Eagle plan is a PPO plan that is available to those who qualify for $0 monthly premiums with a maximum out-of-pocket limit of $5,500.
Aetna also offers two unique mobile apps that allow policyholders to track their policy’s benefits and claims while on the go. The apps allow policyholders to find medical providers who are part of the network, view their plan details, access their IDs and settle claims.
Additionally, policyholders also have the ability to set up personalized health reminders to personalize their health needs.
Applicants do not need to pass a medical exam to access Aetna’s health insurance programs.
Aetna’s most recent innovation is Attain by Aetna. This mobile app connects to the insured’s Apple Watch to allow them to set individualized health and fitness goals. Policyholders have the opportunity to earn rewards when they reach their exercise or diet goals. The app also provides personalized recommendations for sleep, exercise, and appointments. The Aetna Health app works on Android and Apple platforms. However, Attain by Aetna is only available for Apple Watches.
Customers are generally satisfied with Aetna’s handling of insurance claims. Medical providers typically file claims on behalf of policyholders.
Aetna claims to use generally accepted guidelines and policies in its approach to handling complaints as well as the information detailed in the customer’s health plan.
Aetna’s approach to claim payment is to consider a wide range of an individual’s services, including hospital stays, tests, surgeries and other medical services. He will refuse services for treatments that he does not deem medically necessary.
Like all other health insurance companies, Aetna provides its policyholders with an Explanation of Benefits to describe what Aetna has paid for and the reasons for denials. Aetna also responds to medical claims appeals within 60 days.
Policyholders will receive reimbursement for overpayments they have made to medical service providers.
Aetna versus competitors
Even though Aetna does not offer health insurance plans in the market at the moment, it is still considered a major player in the field of health insurance. 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 strive 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 people who can help their customers in several different languages, including English, Spanish, Arabic, Italian, Chinese, German, Japanese, French, Russian, etc.
Finally, Aetna offers prescription drug discounts for its dental discount plans for just a few extra dollars a month, which is a popular feature among policyholders as it can save them a lot over the course of a year.
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In a review of Aetna’s health insurance plans, Benzinga gives Aetna a four-star rating for policy options, customer service, and pricing. Aetna also gets five stars for its intuitive, easy-to-navigate online app and cutting-edge mobile apps.
Aetna doesn’t currently offer ACA health insurance plans, and it’s unclear if it might re-enter the space in the future. In the meantime, Aetna is a solid 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 health insurance?
Aetna does not offer Original Medicare, but it does offer Medicare Advantage plans and Medicare Supplement plans. Medicare Advantage plans cover many medical services that original Medicare does not.
Do you have to pay Medicare Part B premiums 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 with your Medicare Advantage plan premiums if there is a monthly fee.