Aetna, Inc. was founded in 1853 as Aetna Life Insurance Company. With a name meant to invoke Mount Etna, a famous European volcano, Aetna eventually moved to offer health insurance, dental insurance, long-term care insurance, and long-term disability insurance.
Every health insurance plan is required to provide essential benefits, as defined by the Affordable Care Act. These essential benefits fall into ten categories of services:
The specific services offered within those categories may vary from state to state, but these categories represent the minimum that all health insurance plans are required to cover. No matter where you purchase your health insurance plan from – federal, state, or private marketplace – it must cover these ten essential benefits.
Plans may choose to cover additional services. State, federal, and private exchanges will give you the full list of the exact services each plan covers before you apply.
Aetna offers an app, called iTriage, just for Aetna members. This app allows them to keep track of symptoms, conditions, medications, and their favorite facilities. Available on both the web and mobile devices, this app helps Aetna members take control their health care.
Prescriptions & Drugs
Aetna provides coverage for both generic and brand name drugs. Depending on your plan, you may have a “two-tier” or a “five-tier” plan. These tiers decide how much you pay for a particular drug. Tier 1 is generic drugs, which you pay the least for; the tiers get more expensive as you go up the ladder. Depending on your plan, you may be able to purchase drugs not on your formulary for a higher price. To see if your Aetna plan covers a specific drug, use their Find a Medication Tool, or, if you’re not an Aetna member, you can look at example formularies.
PolicyGenius offers anonymous, no-obligation shopping of all marketplace health insurance plans, as well as “off-exchange” plans that you won’t find on Healthcare.gov or the state marketplaces. You can browse all plans, and sort and filter those plans based on your preferences and budget.
Once you’ve selected a health insurance plan, enrolling in that plan is easy. You fill out a short online form, then complete the final step with a quick enrollment phone call with a licensed agent. On that call, the licensed agent will verify your identity, double-check eligibility and answer any questions you may have. For certain insurers, who don’t permit private brokers (like PolicyGenius) to enroll customers, you’ll have to enroll directly with the insurer or on your state’s marketplace (these plans will be noted).
After you enroll in a health insurance plan, you will get your membership materials (including your member ID card) and the first premium bill directly from the health insurance company. You are responsible for paying the bill to ensure that your coverage goes into effect, and to keep current on those payments.
If you’re getting care in-network, your provider should submit your claim directly to Aetna for you. If they did not, or you’re submitting a claim for other care, you need to fill out this form and send it along with the original bill to the address on the back of your health insurance card.