Aetna Health Insurance Company – Overview

Aetna is one of the largest health insurance companies in the US.

Published September 13, 2019

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About

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.

See our comprehensive review here

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.

Learn more about prescription drug coverage.

Enrollment process

You can browse all plans on the Obamacare health insurance marketplace on healthcare.gov, 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 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.

Claims process

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.

Aetna review

Aetna provides a well-rounded suite of offerings, from relatively affordable major medical insurance to a suite of benefits including dental, disability and even international health insurance. In recent years, Aetna has also taken major steps to improve the customer experience, including a revamped website (that’s easier to navigate than most health insurer sites), a mobile app, and wellness resources. In November 2018, Aetna was acquired by CVS.

Basics & ratings

FoundedJD Power Rating# of PolicyholdersA.M. Best Rating
18532 out of 522.1 millionA

Overall score

We evaluated this health insurance company using publicly available data on patient care & satisfaction, customer service and costs (premiums) versus similar plans on the market.

Quality & SatisfactionAffordability
3 out of 54 out of 5

Other health insurance companies

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