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Aetna Health Insurance Review

24 Customer Comments & Reviews - see all comments
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Aetna is an insurance company that specializes in health care innovation, accountable care and consumer health.  The health and wellness company offers insurance services for small business health plans and pharmacy services.

What’s Included with Aetna?

  • Emergency care
  • Prescription drugs
  • Outpatient surgery
  • Hospitalization
  • Primary care
  • Diagnostic tests and imaging
  • Maternity care
  • Mental health, behavioural health, or substance abuse needs
  • Rehabilitation and habilitation services

Types of Health Insurance Plans

Businesses and Organizations

Yes

Individuals and Families

Yes

Short-Term Health Insurance

Not Stated

Other Plans Offered:

  • Student Insurance
  • International Insurance
  • Medicare Insurance

Plans Reviewed

Bronze Plan

  • No overall annual limit for specific covered services
  • Overall Deductibles: $6,850 per individual for in-network providers. Some office visits, urgent care, and preventive care services does not apply in this plan.
  • Out-of-pocket limit: $6,850 per individual for in-network providersOther covered services:
  • Chiropractic care

Silver Plan

  • Overall deductibles: $2,750 per person for participating providers which does not apply specific preventive care services, urgent care, and office visits.
  • No maximum annual limit for selected covered services
  • Out-of-pocket limit: $8,850 per individual for in-network providers
  • Other covered services: Chiropractic care

Gold Plan

  • Overall deductibles: $1,400 per individual for in-network providers. Prescription drugs, urgent care, office visits, and preventive care services do not apply.
  • Other deductibles: $250 for in-network providers (prescription drug expenses per member)
  • No annual limit on specific covered servicesOut-of-pocket limit: $5,000 per person for in-network providers
  • Other covered services: Chiropractic care

*Information stated above are for customers residing in the state of Florida

How Much Does It Save You?

 

Bronze

Silver

Gold

Services Offered

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

In-Network

(Your Cost)

Out-of-Network

(Your Cost)

Generic Drugs

0% co-insurance (both retail and mail order)

Not covered

Tier 1A: $5 co-pay for retail and $12.50 co-pay for mail order

 Tier 1: $15 co-pay for retail and $37.50 co-pay for mail order

Not covered

Tier 1A: $3 co-pay for retail and $7.50 co-pay for mail order

Tier 1: $10 co-pay for retail and $25 co-pay for mail order

Not covered

Specialty Drugs

0% co-insurance

Not covered

Preferred: 40% co-insurance

Non-preferred: 50% co-insurance

Not covered

Preferred: 40% co-insurance

Non-preferred: 50% co-insurance

Not covered

Outpatient Surgery

0% co-insurance

Not covered

40% co-insurance

Not covered

20% co-insurance

Not covered

Emergency Room Services and Medical Transportation

0% co-insurance

0% co-insurance

Room services: $500 co-pay per visit

Medical transportation: 40% co-insurance

Room services: $500 co-pay per visit

Medical transportation: 40% co-insurance

Room services: $250 co-pay per visit

Medical transportation: 20% co-insurance

Room services: $250 co-pay per visit

Medical transportation: 20% co-insurance

Urgent Care

$75 co-pay per visit

Not covered

$75 co-pay per visit

Not covered

$75 co-pay per visit

Not covered

Primary Care

$15 co-pay per visit

Not covered

$10 co-pay per visit

Not covered

$10 co-pay per visit

Not covered

Preventive Care Services

None

Not covered

None

Not covered

None

Not covered

Diagnostic Tests and Imaging

0% co-insurance

Not covered

40% co-insurance

Not covered

20% co-insurance

Not covered

Hospitalization

0% co-insurance

Not covered

40% co-insurance

Not covered

20% co-insurance

Not covered

*Information stated above are for customers residing in the state of Florida

Annual Maximum

Bronze

None

Silver

None

Gold

None

*Only on specific covered services

The Bottom Line

Aetna is one of the companies in our list that offers the least expensive plans. They provide several programs that works great for the different needs of their customers.

 

 

 

 


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24 Customer Comments & Reviews

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Kayla S
10/31/2023
In 2018 I underwent Genetic Testing because I have a family history full of cancer. I tested positive for the BRCA2 gene. In early 2019 I underwent a Hysterectomy...no issues. But in June of 2020 I had a medically necessary double Mastectomy with Reconstruction. I was assured by all three of my doctors...Dr King who provided the diagnosis, Dr Archer who performed the mastectomy, and Dr. O'Neil who performed the reconstruction...that because of the BRCA2 gene that reconstruction is covered by insurance. My decision to go ahead and have reconstruction performed was solely based on the fact that it would be covered by insurance. My insurer is Aetna. The doctors received all the necessary... Read More


muratatli61
8/14/2023
PLATINUM PLAN PPO , NOT COVERS MEDICINES, AND EMERGENCIES, WHEN YOU CALL THEM AFTER 2 HRS WAITING SOMEONE PICK UP THE PHONE FROM INDIA.. CANCEL IT DO NOT BOTHER THIS CROOCKS


fmwoodruff214
8/4/2023
They are not paying claims on "covered" preventative services, even after supposedly reviewing the claim. It appears to me that what they really cover is as little as possible. I have found they have several loop holes and rules that are not explained up front. Some providers are not accepting Aetna insurance, telling me that Aetna does not pay them agreed amounts. This company really is very bad.


tlipscomb59
7/14/2023
I have paid my premium each month since subscribing for aetnacvs health insurance in december 2022. In april i began getting past due notices. I went to my bank and printed statements showing that my payments had been deposited by aetna. I mailed these statements with a letter describing my issues. Aetna gave mo response. I continued making payments and have not receiived any billing notices till today (7-14-2023) when i was notified that my coverage was cancelled on 4-30-2023. I called customer service representative was very hard to understand and kept reciting the same policy over and over. Would not transfer me to a manager or accounting. What do i do?


davidmcnicholas11
7/6/2023
Aetna is slow to approve / respond to my doctors referrals & requests for MRI’s and the like…Aetna is riddled with hoops to jump through. They force you to follow their maze of bureaucracy. They are inflexible. Every time I need anything other than checkup appointments its like playing a game of whack-a-mole and building a ship in a bottle through a knothole at the same time. Too much friction and rigidity in all their processes. Their prescription rules, processes are miserable. I have a very unpredictable intense travel element to my job. My doctor has decided I need 6 month of prescriptions at a time due to travel. Aetna wont do it, or I have to make phone calls and get... Read More


mjones4193
5/6/2023
Good luck getting a claim paid if you submit it yourself. Their support line will drop it into the vortex of lost claims, never received claims, and "you'll need to resubmit" claims. They used to be a good company. AVOID IF YOU HAVE BETTER OPTIONS


R
Richard L
3/24/2023
I've been trying for a month to find an in network mental health provider. Everyone listed on Aetnas website that I have contacted does not accept Aetna. I've called "member services" several times and talked to people in the Philippines who promised to send me a list of options and then they sent screenshots of Aetnas website. There is no way to email aetna and clicking on "contact us" on their website sends you to an error page. I'm a poor person so I'm used to having terrible health insurance but this is by far the worst I've ever had. They don't cover anything and you don't even have a way to contact anyone other than the folks at the call center reading from a script.


K
Ken B
11/30/2022
I have a PPO plan through my company, and I broke my foot. The urgent care facility has tried three different orthoepic offices and they were told they do not except Aetna. All I can say is sounds and looks like Aetna is more worried about their share holds then the people and companies that pay into them.


S
Sharkbiteinc11
11/16/2022
Heed my warning! Stay away from this company! I became permanently disabled and this company refuses to pay out what I am owed. You can’t speak to a live person. Instead I have been bounced around by an automated system and the customer services line is disconnected. Now I have to go they my lawyer. I hope a court summons will make them do what they were supposed to do 4 years ago. You read that right, this has been a 4 year struggle! Here is am with severely damaged nerves all over my entire body and missing my right hand and I still have yet to be paid on my claim. Stay away from Aetna!!!!


mikeandmels
8/1/2022
They have the worst customer service they sent me to an oncology surgeon and then denied the claim. I have called for 2 and a half months to get this straightened out they said they would have an answer for me in 48 hour I filed a complaint was supposedly escalated 3 times and never once have they called me even after they said 'they would call at 2pm today 8/1/22 no call nothing. So here I get to sit with a tumor in my breast can't have it removed because the doctor that is in network and the one they give as the first choice is not covered. It's lies why do we even pay for. The worst insurance if I could give them zero stars that's what they deserve



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