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Aetna Health Insurance Review

26 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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26 Customer Comments & Reviews

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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


drudd1726
7/30/2022
I had a mammogram they do not cover it because I got a 700 dollar bill. That's preventive health care or one would think. It's 80.00 to go to the eye doctor and you can go get glasses 2 pair and a free exam for 80.00.


R
ravin c
5/16/2022
Awful! First off, had the Wrong Name on my information so that should have been the first sign! they will charge you for ANYTHING they can & will get away with like X-Rays aren't covered! I was told that a Gynecologists are Specialist and so women will be charged pretty full charges for those visits, God forbid we have something going on with our woman area. Only Pediatrics, Family Practice & General medicine providers are the only ones that are pretty much covered by the insurance, anyone else is fair game & they can charge you full price! If you have other options for insurance go with them. I DO NOT RECOMMOMEND AETNA, NOT FOR MEDICAL OR DENTAL AS DENATL IS JUST AS BAD!!!!


linsey.hollingsworth
5/3/2022
Worst insurance I have ever had. They are constantly looking for reasons not to pay for things and I always get bills in addition to copays. I also stay in network and most of my stuff is preventative. I have had to call and argue with them several times and am over them. I will be switching to my husband's insurance asap. And I have the more expensive plan too.


T
TWIsh
2/7/2022
Aetna are a horrible company, they denied my MRI, which I qualify for, I saw mt doc on 12/20/21 for sciatic pain and given muscle relaxers to use with Ibuprofen, pain got worse and I saw him at his urgent care on 12/22/21 and given mythyprednisolone pack and Percocet and MRI ordered. Then I saw his ARNP at his urgent care on 12/27/21 when I had numbness in parts of leg, foot and toes. I then saw my doctor on 1/10 and he ordered MRI again, it was denied, I saw my doc again on 1/31/22, still have numbness in parts of leg, foot and toes, and get sciatic pain on and off in both legs now. Aetna feels this does not qualify for MRI, hell, you can google numbness in legs and feet and it all... Read More


C
Cheryl
1/4/2022
Worst Insurance we have ever had through our entire 33 years of marriage. They denied an MRI for my hip, took months to get one. They denied two different doctor’s requests for my son’s MRI of his shoulder. We couldn’t wait any longer, we needed answers for his shoulder pain, so we had to pay for the MRI out of pocket to get his MRI done. We paid $670.00 right before Christmas during inflation time and during pandemic, Aetna didn’t care, If you have a choice, stay away from this insurance,


ceh32792
9/3/2021
Very poor customer service. Representatives are nice but seem to have no idea or authority to resolve a problem. They seem to say whatever they believe, even if it is incorrect, in order to get the customer to end the conversation. I spoke to seven different reps this week and each of them gave me a different explanation and way to proceed. The issue is on their end, not mine, so I cannot resolve it. However, it is causing serious problems for me. They promised two return calls, within 48 hours, regarding medication and filing a grievance. The calls were never returned.


mcloota.nick
8/12/2021
Just wanted to let someone know that I have been treated with absolute disrespect from Aetna. I'm a pretty normal dude, and I submitted documents to them for reimbursement MULTIPLE TIMES (at least 3 per year) and have not been reimbursed. I go down a rabbit hole of emails and they continue to get more and more convoluted - then by the end they ask me to submit the same form I submitted in the very beginning. Currently, I'm at the stage of receiving radio silence. I will have to resort to calling - but wait times have exceeded 1.5 hours every time I've called. Horrible customer service is an understatement.


wcindi543
1/30/2021
Aetna outsourced customer service to India. The people are so nice and want to help but do not have the resources to solve problems. I have spent hours with the customer service representatives in India and they work so hard to provide answers. Their provider list is out of date and we cannot find a provider for diabetic shoes. 2021 Aetna Medicare Advantage is the worst company I have been associated with.



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