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Aetna Health Insurance Company

As providers go, the Aetna Health Insurance Company is one of the most recognizable names in the industry. The organization is considered a leader as it offers dental, disability and prescription coverage in addition to its general health insurance, and touts a membership of over 19 million members in its medical plans alone. Of course, that does not mean that Aetna is the best health insurance company for your specific needs and health issues. Take few minutes to review some of Aetna’s plans and programs. Then use the free quote tool on this page to compare this provider with others before making a commitment to your health insurance investment.

Aetna’s History And Financial Stability

Aetna was started as an annuity fund that sold life insurance back in 1850. The name was inspired by a volcano in Sicily called Mt. Etna. It is the most active volcano in Europe and the name was taken to convey strength. Throughout the years, the company has offered a variety of insurance plans from farmer’s insurance to earthquake insurance for the great San Francisco earthquake of 1906. The payouts of $225 million completely decimated many insurers at that time. Clearly Aetna survived, thrived and in 2008 was selected the Most Admired Company in the health care industry by Fortune magazine.

There is definitely an advantage with going with an insurance provider with a national reputation and presence. You can be fairly certain that they are financially able to meet their commitments; although it’s also a good idea to check with a group like Moody’s or A.M. Best to see how they rate in your specific state. In 2008, Aetna had revenues of $31.6 billion with over 35,000 employees.

Aetna provides insurance products for companies that offer insurance to their employees, as well as those for individuals and families. While getting health insurance through work is seen as a great benefit, it’s not realistic for everyone. Also, many people find that they can better tailor a plan to their needs, and save money by not being pooled with higher risk participants and opting for an individual insurance plan.

If you are a small business employer, you can look into the Small Group Employer plans that will ensure anywhere from 2 to 50 employees. For private individuals and families, there are also a variety of options that vary from state to state. Aetna does not provide health insurance in all states, so getting a quote is the best place to start. You can also contact agents at the number above for help in determining which providers serve your specific state.

Aetna Member Services

One of the more popular member services provided by Aetna is an interactive website that provides information on prevention and specific diseases, tools to manage health and financial advice on managing your health care funds. Simply register online once you have a policy, and you will have access to some truly useful resources. In order to get plan specifics for your state you will need to get a rate quote. However, the services listed below are widely available.

Aetna Advantage plans are the name that covers a variety of benefit plans. Some offer dental coverage in combination with the plan. Maternity benefits are not currently offered in the majority of states at this point in time. However, complications related to pregnancy are, and newborns are covered automatically for 31 days, and can then be added to an existing policy.

The Advantage plans generally work by assigning a Primary Care Physician or PCP to help mange your plan. This person should act as your advocate as well as a primary care giver and advisor in case you need the help of a specialist. You may choose a pediatrician, general practitioner or an internist for this role.

Prescription drug benefits are a component of many of the Advantage plans. Some are based on a formulary method. This means that there is a list of preferred medications to help both you and your insurer manage costs. If there are specific medications that you know you need to have, it’s a good idea to find out if your proposed plan is subject to a formulary and, if so, if your desired medication is on it. If it’s not, the plan will not pay for it. Using generic drugs when you can is one way to save money on this or any other plan, as they cost less than name brand drugs.

Compare Aetna Health Insurance Quotes!

The first step to selecting a good insurance plan is to compare your options. For some folks, Aetna Health Insurance Company will offer services and benefits that suit their needs. For others, another provider will be a better match. Why not find out the answer for yourself? Go to the quote tool above, enter your zip code, and you will receive rate quotes from the best health insurance providers in your area. You can start now!

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25 reviews

  • Joseph Jones /
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    The Aetna network is top notch. It is rare that I ever come across a Doctor or Hospital that is not a part of the Aetna network. Very satisfied.

  • Jason Riley /
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    Aetna is a great company overall although I was disappointed to see that their coverage for mental health was not as much as I had hoped that it would be.

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    I have an Aetna PPO and haven’t had any problems. The co-pay is a bit high.

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    I have had Aetna for the past 18 months and never have had a problem with a claim. I would recommend them and they have a very large network where I don’t have a problem finding doctors.

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    I have used Aetna for many years now. We have a large family, have lived in various states and Aetna always provides good coverage for our area.

    Their customer service people are very helpful and claims are processed timely.

  • Patty Higgins /
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    Have found Aetna to be very strong in the market for the individuals who have one to two ailments wherein most others would rate and decline or rate and exclude.

  • Jonathan O /
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    When I went to the dermatologist I was very happy to see that my Dr was in network and Aetna paid the majority of my bill.

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    Aetna is the worst insurance I have ever experienced. It takes forever to get issues resolved and their customer service has no idea what they are talking about. Wrong statements to me or my doctors are common.

    If you have a choice stay away from Aetna. The worst part is the Aetna Mail Delivery Pharmacy. They are employing employees that cannot read. We got prescriptions back because they were not able to read it while our retail pharmacy filled it without questions or hesitations.

    Great Job Aetna! I hope you will get bankrupt or Obama find ways to get you out of business!

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    My company purchased a supplemental plan through Aetna/SRC. They have never paid a claim a per the policy provisions without numerous complaints and phone calls. They cite non-existing federal laws to explain why they have to pay the provider rather than the policy holder as stated in the policy. They flatly refuse to put this in writing and I’ve checked with the state to determine that there is no such law.

    I’ve submitted claims as many as 5 times before they admitted to receiving them. One phone call confirms they received it and a month later when I check on the status they claim to have no record of the claim.

    I would advise anyone planning to do business with this company to think twice. The plans and their provisions read really well but they make no effort to follow their own contracts.

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    Aetna fails to live up to the provisions of the private PPO contract they have with my company. Claims are routinely denied and the preventative health provision is a joke. If you call five times and speak with five different reps, you get five different answers.

    Their inefficient way of doing business leads to higher costs for them and for the consumer. Finding an in-network specialist in my area is often not possible. Aetna has chosen not to renew with several different specialists, meaning incurring the expense of traveling to another state for care.

    If you have any choice at all, stay away from Aetna. Opting out of employer-sponsored health plans in favor of a private plan, while more costly, is a better deal in the long run.

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    My company has had Aetna for 3 years. They are a very greedy company. Our insurance went up 22% this year and 30% last year. It’s amazing that the increase in cost just over what my tax credit should be. So they know they have you. It is a greedy, cut-throat industry and Aetna leads the pack.

    They walk a fine line when it comes to definitions. If they spent their money on improving costs instead of lobbying our congress maybe the prices would be more reasonable.

    The customer service reps have always been courteous.

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    WHAT A WASTE OF MONEY,TIME, & ENERGY !DO NOT MAKE THE MISTAKE OF CHOOSING AETNA !!!

    I am a very healthy young individual and have never had any medical condition or disease, but Aetna is just looking for an excuse for not to pay even for simple visits/ claims!

    If you wanna deal with their horrible- psycho and rude uncaring staff all the time, then choose Aetna. You usually find yourself even for long hours on the phone trying to prove that you paid your premium for example; They take money from your bank account in a minute you provide them with your card info, but they forget to place your payments on their broken system for months and this is why they charge you again and again over the same thing.

    If you consult with a doctor about a simple thing, Aetna puts this as a medical condition on your file. It doesn’t matter you visit even another doctor and s/he diagnoses you with no disease!

    This insurance company always relies on whatever makes more money for it. They easily rate up your premiums and of course they let you appeal to their decisions, but they deny your requests for sure even though you provide them with the supporting documents.

    DO NOT GET TRAPPED IN AETNA INSURANCE!!!

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    Aetna is the worst health insurance company I have ever had.

    They tell you that you are covered for exams, however when it comes time to pay the bill it comes out of your pocket time and time again. You would be better off flushing your money down the toilet and hoping for it to come back up then giving it to Aetna.

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    I bought Aetna bc my company doesn’t offer insurance & it seemed the most reasonable. I have a $2000 annual deductible which I keep in a savings account. But I didn’t realize it is $2000 for every member on my same policy number. This keeps us from getting basic care.

    I pay out the nose for my 3-year-old. If I could afford something else I would. I have been over billed and have to fight to get the bill fixed. Not the best in my book.

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    First, let me preface this by saying that I used to work at a health insurance broker’s office. No health insurance provider is a picnic, but Aetna was our second-to-last choice to quote for companies (only behind Coventry). After a later employer switch providers from UHC to Aetna, now I understand why.

    1. Everything is a hassle: contacting the company, dealing with customer service, faxing pre-approvals/pre-authorizations for everything just to be sure it was covered.

    2. Everything is a paperwork nightmare: they mail you duplicates or triplicates of every. service. you. ever. receive. If Aenta wants to save money, they can start by reducing the number of times they mail you a “THIS IS NOT A BILL” summary of services notice.

    3. Their plans were for mostly for sick people: expensive and provider choices were limited.

    4. A positive thing about them was with enough arguing and pre-authorization faxes, you can find out before you receive care whether or not they will cover your visit and thus whether or not you will get to eat that month.

  • jackie langford /
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    I’ve had Aetna health insurance for about 20 plus yrs. I got it through my jobs like General Dyn and Lockheed out of Abilene Tx it’s a PPO plan.

    I retired in 2005 the only thing is when I went on medicare it was only 73.00 a month and now it’s 160.00 a month for me and my wife of 52 yrs this last year it went up 20.00 dollars each for the last 3 yrs.

    The last of this month I will find out how they will go up if any this yr.I hate to leave Aetna but I can go to Humana for 98.00 a month a saving of 62.00-82.00 a month each for a total of 124.00-164.00 .Outside of the cost, they are great.

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    I am a part-time employee of Home Depot since August 2011 and participated in Aetna Health SRC Insurance plan offered by Home Depot for part- time employees.

    I enrolled in Aetna’s SRC $10,000 Maximum Plan for which I pay $120.00 per month for medical coverage. My enrollment indicated that I would have medical coverage up to $10,000 per calendar year in addition to whatever co-pays and deductibles were necessary.

    On December 8, 2011, I had outpatient surgery with Piedmont Hospital in Atlanta for a detached retina. Aetna only paid $1,000 for outpatient medical coverage. The bills totaled $20,000.

    In February 2012, I was rushed to the ER at Piedmont Fayette Hospital with acute kidney pain, which turned out to be a 6mm kidney stone (the doctor indicated this to be a very large stone, passable by very few people). The Hospital bill was $8000 for which Aetna only paid $600. Since my “insurance” plan only pays up to $1,000 for outpatient surgery, I was forced to pass the stone on my own.

    It was my belief that I had a $10,000 annual limit. I currently owe 30K in medical bills to hospitals, doctors, labs, etc. that Aetna refuse to pay. Aetna and the Home Depot falsely advertise the Aetna SRC plan as ‘MEDICAL INSURANCE’.

    When I signed with Aetna through Home Depot, I assumed I had medical coverage. I feel I have been taken advantage of by deceptive and misleading marketing practices by both Aetna and Home Depot in the purchase of Aetna Health Care SRC ‘Insurance’ that turned out to be nothing more than a discount program.

    Home Depot employs thousands of part-time employees throughout the US. Aetna is collecting billions of dollars annually from employee premium payments and disbursing almost nothing in medical claims, sticking the part-time employees with thousands of dollars in medical bills.

    I make $9.25/hour working 30 hours a week which amounts to $800 take home pay per month for which I support a family of four. How on earth does The Home Depot expect part-time employees to cough up 30K in medical bills?

    THIS IS NOT INSURANCE – IT’S A RIP-OFF PLAN!

  • Jeanette Supera /
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    Aetna changed my Medicare Part D plan WITHOUT prior notice. I found out when I went to pick up my scripts and was told that they did not cover until I met the $325.00 deductible.

    What I had signed up for was a tiered plan that had been costing 0 deductible. If I had known I would have changed Medicare Rx plans during the open time period.

    Why on earth would a person buy this high deductible plan with co-pays when for less than $2.00 a month more they could get a plan that is 0 deductible and 0 co-pay. And then, of course, when I called to complain their dispute department says they did mail out a notice. We all know how that story goes.

    So now I am STUCK with this crooked company until the next open enrollment period. I suggest that NO ONE sign up for ANY Aetna policy. They are more greedy and fraudulent than any other insurance company.

  • Paula LeVance /
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    Switched to AETNA 1/13 and was worst health care decision I ever made. The are denying meds. I put on my application and the self-testing device for coumadin therapy. I have AFIB. history of blood clots and a stroke. AWFUL.

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    Through AARP, I got Aetna’s Open Access health insurance in May 2012. Prior to Aetna, I was with Assurant Health since 2004. I switched to Aetna because of the lower premiums.

    My first claim (April 2013) with Aetna was denied payment. I spoke with Aetna and they said that they denied it because of how my doctor coded it as a “possible pre-existing condition.” I spoke with my doctor’s office and they did no such thing. I went back to Aetna and this time they asked if I had prior insurance. I said yes and gave them my policy number with Assurant. Their claims department gave me such a hard time. They were talking down to me. They were not helpful. After speaking with them, I wasn’t sure if they were going to pay the claim or not.

    I spoke with my doctor’s office again and told them about my conversations with Aetna. My doctor’s office said that Aetna was “hunting for pre-existing conditions” and that Aetna does this all the time. Doctor’s office said that I should get a Certificate of Creditable Coverage from my former insurance company, and send it to Aetna.

    If you’re considering switching to Aetna, be forewarned.

  • Unhappy /
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    I signed up for the 15K per year max benefit insurance through my IT recruiting company, which charged over $500 in monthly premiums. When I signed up, I made sure to ask if it covered maternity care, which I was assured it did at 70%.

    I thought that it sounded like a nice balance between premiums and coverage, so I signed up. BIG MISTAKE. The plan is closer to a discount plan than insurance. Bottom line, these plans are designed to sap people’s money, keeping them in a perpetual state of poor health.

    I went for a yearly physical & routine blood screen for which the plan only covered $100! There is no procedure in the western world that’s billed at $100. That’s over $550 out of pocket thank you.

    The final insult was my wife’s C-section & hospital stay, billed by the hospital at close to $20K. the “insurance” only covered $5K, citing that much of what the hospital billed as not covered by the plan. Now we are facing close to $15,000 in medical bills for the delivery, on top of the $1000 we already paid to the OB in the last 6 months.

    THIS PLAN IS A COMPLETE WASTE OF MONEY. In truth, it would have been cheaper to not have insurance at all and pay completely out of pocket, when you add up the monthly premiums, coinsurance, etc. We now have a private BCBS HSA plan and seems much better – and CHEAPER!

  • Ana Loera /
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    WORST INSURANCE EVER! AVOID!

    I require prenatal care, they do not cover anything, making me pay for all tests and visits out of my deductible, did not experience this with my previous insurance. What a costly mistake. Will NEVER use them again.

  • AETNA VICTIM /
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    AETNA is by far the most unethical organization on this planet. Due to the fact that they automatically deny all supposedly covered claims, I was forced to write and submit letters of appeal and more than enough supporting documentation from my physicians. AETNA would take up to 3 months to make a decision regarding a claim or appeal.

    In one incident, this caused me to exhaust my FMLA leave. Because of this, I was forced to take a leave of absence while waiting for AETNA to make a decision. In addition, they gave me and my physicians faulty advice – claiming that if I submitted a new claim using different ICD codes, my claim would be approved.

    In October 2013, I was employed and to my knowledge insured. Until AETNA retroactively cancelled my benefits in December 2013, and did not offer me COBRA until March 2013, after many requests. For years, I paid for top dollar for either their PPO or POS plans. In hindsight, I don’t know what I was paying for because they rarely covered anything! In fact, they just delayed my required medical care and tests, worsening my condition and health.

    After reviewing the medical record on three separate occasions, I felt that perhaps AETNA was denying my claims due to the high amount of inaccuracies. For example, claiming I was male and not female on some pages, incorrect recording of my age, and procedures I had done.

    On approximately 81 out of 89 pages there were substantial inaccuracies, the most outrageous – stating I had 3 stomach tumors removed, even documenting their size in cm – I have never had any sort of stomach procedure, tumor or surgery done! When I brought this to their attention and asked that the inaccuracies be corrected, they resent me the exact same report Verbatim- with the exact same inaccuracies.

    I attempted filing a report with the state board insurance, but AETNA kindly reminded them that they were exempt from such review for they were an ERISA plan, and also hinted that I was violating their “policy” stating that my medical report with my name and employee number on the top of each page in the header received from AETNA no less than 3 separate occasions was potentially someone else’s medical report- After numerous attempts and supporting documentation from my physicians to have my medical records corrected, I yet again received the aforementioned report along with a letter stating that after review AETNA found no inaccuracies.

    Needless to say, this was highly offensive, stressful, and ultimately led me to my resignation from my company. Fast forward to December 2014, I am receiving bills from my medical providers for procedures and tests dating back to October and November of last year.

    Apparently, AETNA is rescinding payments they made to these medical providers, claiming I was uninsured during that time. How on earth can this be possible?

  • Be careful /
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    Be careful with an Aetna Medicare Insurance Plan. They will not pay for outpatient surgery at a hospital until a $300 copay is met each time you go to the hospital for outpatient surgery.

    My mother went for outpatient physical therapy to have a wound taken care of. Each time we had to pay at least $300 for each visit. It would have been cheaper if we just had straight medicare with no advantage plan since Medicare would pay 80% of the bill. Just be careful and look at your Medicare Advantage Plans carefully.

    We had to pay $1000 under the Aetna Medicare Advantage Plan. With just medicare alone it would have been a lot cheaper at 80/20. Remember under an advantage plan the medicare 80/20 plan does not apply.

  • Jody Porter /
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    I will never get Aetna again!

    They refused to pay for a surgery for my 15-month-old son when my doctor was in network referred the surgeon. The facility was in network but the surgeon was not and they refused to pay. They are one of the most expensive providers and there customer service is horrible! My doctor also submitted an appeal on my behalf because they referred the surgeon and they still would not budge.

    They have terrible customer service and again the are very expensive. It has caused so much stress and I will tell everyone how awful my experience was!

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