Aetna Health Insurance Review 2024 (2024)

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Our Expert Take

Our Expert Take

We like Aetna’s excellent average rates for its Affordable Care Act plans, but the company also has the highest average silver plan deductible of the companies we analyzed. That means you may pay higher out-of-pocket costs for those excellent premiums.

Pros

  • Lowest average ACA plan premiums compared to other large health insurance companies.
  • Slightly better than average National Committee for Quality Assurance quality ratings.
  • Aetna is owned by CVS Health, which provides members a $25 allowance every three months to shop at CVS Health and a 20% discount on CVS Health brand products.

Cons

  • Higher than average silver plan deductibles.
  • Complaints to state departments of insurance higher than industry average.

Aetna Health Insurance Review 2024 (1)

Learn More

On Healthcare.com's Website

2.6

Aetna Health Insurance Review 2024 (2)

Our star ratings are based on a range of criteria and are determined solely by our editorial team. See our methodology for more information.

Provider network

More than 1 million providers

Average deductible for a silver plan

$8,375 a year

Table of Contents

  • About Aetna
  • Types of Health Insurance Offered by Aetna
  • Types of Plans Available from Aetna
  • Extra Benefits from Aetna
  • How Much Do Aetna Health Insurance Plans Cost?
  • How Aetna Health Insurance Premiums Compare to Other Companies
  • Methodology

Show more

About Aetna

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 Aetna across the U.S. The subsidiary of CVS Health Corp. has a network of 1 million health insurance providers across the U.S. that offer health care services to Aetna policyholders.

Aetna’s health plans are available in the health insurance marketplace in:

Arizona

Missouri

California

Ohio

Delaware

New Jersey

Florida

North Carolina

Georgia

Nevada

Illinois

Texas

Indiana

Utah

Kansas

Virgina

Maryland

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.

Aetna also offers:

  • Medicare
  • Medicaid
  • Dental insurance
  • Vision insurance
  • Supplemental insurance

Types of Plans Available from Aetna

Aetna offers two 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.

The company offers three metal tiers on the ACA marketplace: bronze, silver and gold. Insurers can offer bronze, silver, gold and platinum. 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.

Extra Benefits from Aetna

Aetna members get a $25 allowance every three months to shop at CVS Health and a 20% discount on CVS Health brand products. You can also get 24/7 virtual care visits and walk-in visits at over 1,000 MinuteClinic locations.

How Much Do Aetna Health Insurance Plans Cost?

Aetna health insurance plans cost $414 monthly on average for a 30-year-old with an ACA marketplace plan. Age is one cost factor for ACA plans. A 40-year-old pays $466 monthly on average while a 50-year-old spends $651 on average.

Average Aetna Health Insurance Cost by Age

Age of memberAverage monthly costs for a Aetna plan

Age 21

$365

Age 27

$382

Age 30

$414

Age 40

$466

Age 50

$651

Age 60

$990

Source: Healthcare.gov. Based on unsubsidized ACA plans.

The ACA marketplace divides plans by metal tier based on cost: bronze, silver, gold and platinum. Bronze and silver plans are the cheapest health plans with the lowest premiums. Those plans also have the highest out-of-pocket costs when you need healthcare. Platinum and gold plans have higher premiums but fewer out-of-pocket costs.

Bronze and silver plans are the most common type of plan, while platinum plans are fairly rare.

Average Aetna Costs by Metal Plan

Age of memberAverage monthly cost for a Aetna Bronze planAverage monthly cost for a Aetna Silver plan Average monthly cost for a Aetna Gold plan

Age 21

$295

$373

$418

Age 27

$310

$391

$438

Age 30

$335

$424

$474

Age 40

$378

$451

$534

Age 50

$528

$667

$747

Age 60

$802

$1,013

$1,135

Source: Healthcare.gov. Based on unsubsidized ACA plans. Aetna doesn’t offer many Platinum plans, so we didn’t include those averages.

How Aetna Health Insurance Premiums Compare to Other Companies

Aetna has the lowest average health insurance premiums of the major national insurers we analyzed.

Average Monthly Costs for ACA Marketplace Plan by Company

Age of memberAetnaBlue Cross Blue ShieldCignaUnitedHealthcare

Age 21

$365

$444

$390

$396

Age 27

$382

$468

$417

$415

Age 30

$414

$506

$449

$450

Age 40

$466

$569

$504

$506

Age 50

$651

$795

$705

$708

Age 60

$990

$1,206

$1,066

$1,076

Source: Healthcare.gov. Based on unsubsidized ACA plans.

HMOs: Average Monthly Health Insurance Costs

CompanyAge 30Age 40Age 50Age 60

Aetna

$414

$466

$651

$990

Ambetter

$417

$470

$657

$998

Blue Cross Blue Shield

$441

$497

$694

$1,055

Cigna

$436

$491

$686

$1,043

Kaiser Permanente

$400

$451

$630

$957

Oscar

$407

$458

$641

$974

UnitedHealthcare

$431

$486

$679

$1,032

Average costs are for unsubsidized plans.

EPOs: Average Monthly Health Insurance Costs

CompanyAge 30Age 40Age 50Age 60

Aetna

$413

$465

$650

$988

Ambetter

$432

$487

$680

$1,034

Blue Cross Blue Shield

$550

$617

$864

$1,307

Cigna

$459

$513

$720

$1,084

Kaiser Permanente

$383

$431

$602

$915

Oscar

$411

$463

$647

$983

UnitedHealthcare

$490

$552

$772

$1,172

Average costs are for unsubsidized plans.

Reviews & Ratings for Aetna Health Insurance

Complaints filed with state insurance departments against Aetna for individual health insurance are about twice as high as the industry average.

Aetna Health Insurance Review 2024 (3)

Other ratings for Aetna include:

  • Average National Committee for Quality Assurance rating: 3.3 out of 5 stars
  • AM Best financial strength: A (Excellent)

Aetna received slightly better than average NCQA marks among the companies we analyzed. Aetna had four health plans that received four out of five stars: PPO/EPO combined plans in Massachusetts, Pennsylvania, Rhode Island and Wisconsin.

AM Best affirmed Aetna’s 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.

Methodology

We used the following data to determine the best health insurance companies.

  • Complaints made to state insurance departments (30% of score): We used complaint data from the National Association of Insurance Commissioners.
  • Plan ratings from the National Committee for Quality Assurance (30% of score): The National Committee for Quality Assurance is an independent, nonprofit organization that accredits health plans and produces ratings based on specific metrics.
  • Average silver plan deductible (20% of score): The deductible is how much you have to pay for healthcare services in a year before the health plan begins picking up a portion of the costs.
  • 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).
  • Metal tier offerings (10% of score): We gave points to companies offering more metal tiers. The ACA marketplace has four metal tier levels.

Find The Best Health Insurance Companies Of 2024

Learn More

Information provided on Forbes Advisor is for educational purposes only. Your financial situation is unique and the products and services we review may not be right for your circ*mstances. We do not offer financial advice, advisory or brokerage services, nor do we recommend or advise individuals or to buy or sell particular stocks or securities. Performance information may have changed since the time of publication. Past performance is not indicative of future results.

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Aetna Health Insurance Review 2024 (2024)

FAQs

What is the star rating for Aetna in 2024? ›

WOONSOCKET, R.I., Oct. 13, 2023 — Aetna®, a CVS Health® company (NYSE: CVS), announced today that 87 percent of its Medicare Advantage (MA) members are in 2024 Medicare Advantage Prescription Drug (MAPD) plans that are rated 4 stars or higher (out of 5 stars) by the Centers for Medicare & Medicaid Services (CMS).

Does Aetna deny a lot of claims? ›

The payer denied 93 percent of the emergency room claims that California investigated, underscoring that surprise billing remains a relevant issue during the coronavirus pandemic.

Is Aetna good or bad? ›

Aetna is rated A (excellent) by AM Best, and has high ratings from several other financial ratings services. AM Best is a credit rating firm that assesses the creditworthiness of and/or reports on over 16,000 insurance companies worldwide.

What is the best health insurance company to go with? ›

  • Blue Cross Blue Shield. : Best all-around policies.
  • Oscar. : Excellent plan options.
  • Kaiser Permanente. : Lowest average deductible.
  • Cigna. : Excellent value.
  • Aetna. : Lowest premiums.
May 2, 2024

Why did Aetna lose a star rating? ›

The largest factor in the insurer's star ratings decline was a one-star decrease in the score for its National PPO Plan, which accounts for more than half of its MA membership. CVS said the decrease would likely reduce 2024 operating income for the insurance business by between $800 million and $1 billion.

What is Aetna's AM Best rating? ›

AM Best has affirmed the Financial Strength Rating (FSR) of A (Excellent) and the Long-Term Issuer Credit Ratings (Long-Term ICRs) of “a” (Excellent) of Aetna Life Insurance Company (ALIC) (Hartford, CT) and the other members of Aetna Health & Life Group, which are operating entities of Aetna Inc.

Is Aetna being investigated? ›

SACRAMENTO, Calif. — "I have directed the California Department of Insurance to open an investigation of allegations regarding Aetna's practices in denying claims and requests for prior authorization for care. The department is also investigating Aetna's utilization review process.

What is the class action lawsuit against Aetna? ›

The class action lawsuit alleged that Aetna's definition of infertility led to unequal insurance coverage treatment for LGBTQ+ couples. Heterosexual couples could receive coverage for infertility treatments if they said they were unable to become pregnant after six or 12 months of intercourse.

Which insurance company denies the most claims? ›

Claim denial rates by insurance company
CompanyClaim denials
UnitedHealthcare32%
Anthem23%
Aetna20%
CareSource20%
1 more row
May 15, 2024

Is Aetna better than UnitedHealthcare? ›

UHC is the largest Medicare Advantage provider, while Aetna has a greater percentage of highly rated plans. Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 18 years of experience writing about personal finance.

What is Aetna ranked? ›

By membership and revenue, Aetna is ranked third in the country for health insurance. Aetna has over 22 million members and receives annual revenues of over $60 billion. With revenue over 50 billion and membership over 14 million, Humana ranks number five of all U.S. health insurers.

What is Aetna known for? ›

(/ˈɛtnə/ ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit ...

Who is the #1 provider of health insurance in the US? ›

Kaiser Permanente is the largest health insurance company in the U.S., followed by two Blue Cross Blue Shield companies (Elevance Health and HCSC), according to S&P Global Market Intelligence.

Which health insurance is best now? ›

Top Health Insurance Companies with Claim Settlement Ratio (CSR) and Solvency Ratio for Year 2022-23
  • HDFC ERGO Health Insurance. ...
  • Reliance Health Insurance. ...
  • ICICI Lombard Health Insurance. ...
  • Liberty Health Insurance. ...
  • Kotak Mahindra Health Insurance. ...
  • Aditya Birla Health Insurance. ...
  • Care Health Insurance.

Where is Aetna on the Fortune 500 list? ›

Our annual ranking of America's largest corporations
4Aetna89
5Cigna130
6Coventry Health Care219
7Health Net221
8Amerigroup385
4 more rows

What is the proposed Medicare Advantage rate for 2024? ›

Since CMS is finalizing a phase in of the 2024 model, the 4.44% estimated MA risk score trend included in the 2024 Rate Announcement Fact Sheet is calculated using a blend of 67% of the MA risk score trend calculated with the current model (the 2020 model, 5.0% risk score trend) and 33% of the risk score trend ...

What are star ratings for Medicare? ›

Medicare uses a Star Rating System to measure how well Medicare Advantage and Part D plans perform. Medicare scores how well plans perform in several categories, including quality of care and customer service. Ratings range from one to five stars, with five being the highest and one being the lowest.

What is the difference between Aetna bronze and platinum? ›

The metal is used to signal how generous the plan coverage will be. The more valuable the metal is, the more the plan will pay for the coverage. Bronze represents the lowest level of coverage (except catastrophic plans, see below). Platinum represents the highest level of coverage.

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