About Aetna Health Insurance
Aetna’s roots stretch all the way back to 1853, when the company was formed In Hartford, Connecticut. Nearly a century later in 1951, Aetna offered its first major medical coverage policies.
Aetna merged with U.S. Healthcare in the 1990s to become Aetna U.S. Healthcare, and within three years it was the nation’s largest provider of health benefits. CVS Health Corp. acquired Aetna in 2017.
Aetna provides services to about 39 million people across the U.S. Aetna’s network includes 1.8 million health professionals. This includes 828,000 primary care providers and specialists, 341,000 behavioral health providers and over 62,000 hospitals. It also includes more than 9,900 CVS Pharmacy retail locations, over 1,000 MinuteClinic locations and more than 1,900 CVS HealthHUB locations.
Types of Health Insurance Offered by Aetna
Aetna offers both group health insurance and individual health insurance. The company’s individual health insurance plans are branded as Aetna CVS Health Affordable Care Act (ACA) plans. ACA plans are available at HealthCare.gov.
Aetna also offers:
- Medicare
- Medicaid
- Dental insurance
- Vision insurance
- Supplemental insurance
Aetna Plans
Aetna offers three types of insurance plans on the health insurance marketplace:
- HMO: Patients with a health maintenance organization (HMO) plan typically only are covered for care from providers within the plan’s network. In most cases, you need a referral to see a specialist.
- EPO: Patients with an exclusive provider organization (EPO) plan are only covered if they use physicians, specialists or hospitals within the plan’s network. You typically don’t need a referral to see a specialist.
- PPO: Preferred provider organization (PPO) plans give you more flexibility but that comes with higher premiums than HMOs and EPOs. PPOs let members get out-of-network care, which costs more than going to in-network providers. PPOs also don’t require referrals to see specialists.
Aetna Coverage Tiers
The company offers three metal tiers on the ACA marketplace:
- Bronze
- Silver
- Gold
Insurers can offer bronze, silver, gold and platinum on the marketplace at HealthCare.gov. Bronze plans have the lowest premiums but the highest deductibles and out-of-pocket costs. Gold plans have the highest premiums but lowest out-of-pocket costs.
When shopping for a health plan, consider how much healthcare you’ll likely need and what you expect in the coming year. For instance, if you expect to need an expensive surgery and rehab in the coming year, you may want a lower deductible. If you don’t need healthcare often, a high-deductible plan like a bronze plan may be a better choice.
When Can You Buy an Aetna ACA Plan?
Open enrollment to buy a plan on the ACA marketplace is from Nov. 1 to Jan. 15 every year in most states. A handful of states have slightly different open enrollment periods.
During this time you can buy an ACA plan or make changes to current coverage. The only way to buy an ACA plan outside of open enrollment is if you have a qualifying life event for a special enrollment period. A qualifying life event includes changes like getting married, having a baby, moving to a new ZIP code or aging out of a parent’s plan when you turn 27.
Where Is Aetna Health Insurance Available on the ACA Marketplace?
States with Aetna ACA Marketplace Plans
Member Benefits from Aetna
Aetna offers multiple member benefits that go beyond standard health insurance.
How Much Do Aetna Health Insurance Plans Cost?
Aetna health insurance plans cost $594 monthly on average for an ACA marketplace plan, based on our analysis.
ACA plan costs vary by age, location, type of plan, metal tier and smoking status. Your health or gender don’t affect health insurance costs.
When looking for a health insurance marketplace plan, you should compare quotes from companies offering plans in your area. You can do that through the marketplace website. Cost is an important factor, but you should also consider the health insurance deductible, coinsurance and provider network when choosing a health plan.
Average Aetna Health Insurance Cost by Age
| Age of member | Average monthly costs for a Aetna plan |
|---|---|
| Age 21 | $396 |
| Age 27 | $419 |
| Age 30 | $452 |
| Age 40 | $508 |
| Age 50 | $711 |
| Age 60 | $1,078 |
Average Aetna Costs by Metal Plan
| Age of member | Average monthly cost for an Aetna bronze plan | Average monthly cost for an Aetna silver plan | Average monthly cost for an Aetna gold plan |
|---|---|---|---|
| Age 21 | $336 | $410 | $434 |
| Age 27 | $356 | $433 | $457 |
| Age 30 | $384 | $468 | $494 |
| Age 40 | $432 | $526 | $556 |
| Age 50 | $604 | $735 | $778 |
| Age 60 | $916 | $1,115 | $1,179 |
How Aetna Health Insurance Premiums Compare to Other Companies
Aetna Reviews and Complaints
Aetna has the lowest level of complaints made to state insurance departments for the companies we analyzed. The National Association of Insurance Commissioners collects complaint data from state insurance departments and calculates a ratio of complaints to the insurer’s size of business. The industry average is 1.00, and Aetna’s complaint ratio is only 0.15.
Other ratings for Aetna include:
- Average National Committee for Quality Assurance rating: 3.4 out of 5 stars
- AM Best financial strength: A (Excellent)
Aetna received about average NCQA marks among the companies we analyzed. Aetna has 10 commercial plans that received 4 out of 5 stars, 27 that got 3.5 out of 5 stars and 16 received 3 out of 5 stars.
AM Best gives Aetna an A (Excellent) financial strength rating. The rating company highlighted Aetna’s “balance sheet strength,” as well as its “strong operating performance, favorable business profile and appropriate enterprise risk management.
Compare the Best Health Insurance Companies
Methodology
We analyzed 96 data points about coverage and quality to identify the best health insurance companies. Our ratings are based on:
- Average premiums (30% of score): We took the average Affordable Care Act health insurance marketplace rates for the following ages: 21, 27, 30, 40, 50 and 60, and then came up with an overall average. Source: HealthCare.gov.
- Complaints made to state insurance departments (30% of score): We used complaint data from the National Association of Insurance Commissioners.
- Average silver plan deductible (20% of score): The deductible is how much you have to pay for healthcare in a year before the health plan begins picking up a portion of the costs. Companies with health plans that had low deductibles got more points. Source: HealthCare.gov.
- Breadth of health plans (10% of score): Health insurance companies may offer up to four types of plan benefit designs (PPO, HMO, EPO and POS). We gave companies that offered more types of plans more points. Source: HealthCare.gov.
- Metal tier offerings (10% of score): The ACA marketplace has four metal tier levels. We gave points to companies that offered more tier plan options. Source: HealthCare.gov.
Read more: How Forbes Advisor rates health insurance companies
Find The Best Health Insurance Companies Of 2024
Aetna Health Insurance Frequently Asked Questions (FAQs)
Is Aetna CVS the same as Aetna health?
Yes, Aetna CVS Health is the same as Aetna health. CVS purchased the insurance company in 2017 and offers marketplace health insurance plans in 17 states.
Does Aetna CVS Health have an app?
Yes, Aetna CVS Health has an app on Apple’s App Store and Google Play.
The app includes your ID card, benefit details, deductible tracking, claims information, provider network list, cost estimates and health reminders.
How much is Aetna Insurance for a single person?
Single coverage costs $594 monthly on average for an Aetna health insurance plan on the ACA marketplace at HealthCare.gov.
Age is one factor marketplace health insurers use to calculate health insurance costs. Other factors include the type of plan, metal tier, smoking status and your location. An ACA plan can’t take health or gender into account setting rates.
Your household income can also affect costs. Marketplace plans are the only ones eligible for cost-saving subsidies and premium tax credits depending on your household income.
Is Aetna a good insurance company?
Aetna is a good insurance company in our analysis, receiving 4.5 stars out of 5 stars in our best health insurance evaluation. Aetna received high marks for having a low complaint level and low average ACA premiums.
The company didn’t score as well on its average deductible for silver plans ($7,231), which was the highest of the companies we analyzed.
