Aetna Insurance Review for 2025 (+Costs & Options)

Our Aetna insurance review found that plans start at $560 and vary depending on age, gender, and lifestyle. Aetna offers medical, dental, vision, Medicaid, and Medicare options, along with wellness discounts and CVS Health integration.

Aetna Insurance Rating

Members benefit from a broad provider network and helpful digital tools, though some face higher deductibles and limited plan access. Overall, Aetna delivers strong coverage with added perks that go beyond basic insurance, making comparing plans and getting an insurance plan that works for you an essential step before enrolling.

Comparing Aetna Healthcare Insurance Rates

Aetna’s health insurance rates vary by age, gender, plan type, and lifestyle. An 18-year-old female pays about $345 a month, while a male of the same age pays $365. This small gap continues across age groups, with costs rising sharply over time—reaching $1,150 for women and $1,165 for men at age 65.

Compared to competitors, Aetna’s bronze plan averages $560 a month, cheaper than Blue Cross Blue Shield at $680 and Humana at $645. Its silver and gold plans, at $590 and $610, also stay below many rivals, making Aetna a cost-effective choice for tiered coverage.

Aetna vs. Top Competitors: Health Insurance Monthly Rates by Tier

Lifestyle also impacts pricing. Smokers pay much more, with ACA individual plans at $615 compared to $410 for non-smokers. Short-term health and supplemental coverage show similar increases, including $45 for critical illness coverage versus $30 for non-smokers.

Aetna Health Insurance Monthly Rates: Smoker vs. Non-Smoker

Aetna remains competitive, with lower entry-level pricing and better rates for healthier lifestyles, though costs rise significantly with age and smoking status, making health insurance finance an important factor when budgeting for long-term coverage.

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Aetna Rates by Coverage Type

Dental insurance is $22 per month and includes exams, cleanings, X-rays, and basic procedures. Vision coverage is $15 per month and provides annual eye exams, lenses, and a frame allowance. Medicaid has no premium for income-qualified individuals and families, covering doctor visits, hospital care, and prescriptions.

Aetna Insurance Monthly Rates by Coverage Type

Medicare also has no premium for seniors 65 and older or disabled individuals, offering hospital and medical coverage, drug plans, and extras like dental and vision. These options highlight how Aetna combines low-cost supplemental plans with essential government-backed coverage (Learn More: How the Human Eye Works).

Aetna Health Insurance Coverage Options

Aetna offers a wide range of coverage choices designed to meet different health needs, whether you’re looking for everyday care or more specialized support. Here’s a breakdown of the main options:

• Medical Coverage: Comprehensive health plans that include preventive care, doctor visits, hospital stays, prescriptions, and access to Aetna’s extensive provider network.
• Dental Insurance: Plans that cover routine exams, cleanings, X-rays, and standard procedures to help maintain oral health.
• Vision Insurance: Coverage for annual eye exams, prescription lenses, and allowances for frames or contacts.
• Medicaid Plans: State-supported programs managed by Aetna for income-qualified individuals and families, providing essential medical services and prescriptions.
• Medicare Plans: Options for seniors and eligible disabled individuals, including Medicare Advantage, Medicare Part D drug coverage, and supplemental benefits like dental and vision.

Together, these options give members flexibility to choose the right mix of benefits, from core medical coverage to specialized plans, while maintaining access to reliable care and nationwide support.

Aetna Copay, Deductible, & Premium Explained

This shows the differences between copays, deductibles, and premiums in Aetna health insurance. Copays are fixed amounts paid at the time of service, usually $0 to $50, and are predictable per visit. Deductibles are annual out-of-pocket costs before coverage begins, ranging from $0 to $500 in many Advantage plans, though some Aetna plans have none.

Aetna Copay, Deductible, & Premium Breakdown

Premiums are monthly payments required to keep coverage, typically $0 to over $100, depending on the plan and subsidies. Copays apply mostly to Medicare Advantage and Part D, deductibles appear in some Part C and D plans, and premiums apply across Parts B, C, and D.

Copays are the most predictable, deductibles vary by plan, and premiums remain the most consistent monthly expense, which is why understanding insurance deductibles is critical when deciding how much coverage truly fits your budget.

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Aetna Health Insurance Discounts

Aetna offers a variety of discount programs that give members savings on services and products outside of standard health coverage. These aren’t insurance benefits but added perks that can help lower costs and encourage healthier habits. Here are some of the key discounts available:

• Fitness & Gym Memberships: Members get reduced rates on gym memberships, home exercise equipment, and wellness programs through partners like GlobalFit and ChooseHealthy.
• Alternative Care Savings: Discounts apply to services such as chiropractic care, acupuncture, massage therapy, and nutritional counseling.
• Vision & Hearing Discounts: Members can save on eye exams, glasses, contact lenses, LASIK procedures, and hearing services, including exams, hearing aids, and batteries.
• Nutrition & Wellness Products: Aetna partners with vendors to provide savings on vitamins, supplements, and healthy living tools like fitness trackers.
• Lifestyle & Everyday Discounts: Additional perks extend to travel, entertainment, groceries, and even electronics through Aetna’s Vital Savings program.

Aetna’s discount programs help members cut costs on health and wellness while adding everyday value beyond medical coverage. These extras make it easier to stay healthy without overspending, which is the kind of benefit often highlighted in the complete guide to health insurance.

Aetna Medicaid Coverage & Benefits

This breaks down what Aetna Medicaid covers and who qualifies. It’s designed for low-income individuals and families who meet state requirements, though availability varies by state. Primary care, like doctor visits and checkups, is free, while specialist care is covered with a referral, depending on state rules.

Aetna Medicaid: Full Breakdown & Benefits

Hospital services include both inpatient and outpatient care, and prescription drugs are usually available with low or no copay. Preventive care, such as immunizations and wellness visits, is fully covered, and maternity services include prenatal, delivery, and postpartum care.

Vision and dental are included for children, with adult coverage depending on the state. Some plans also provide extra benefits like telehealth, transportation, and wellness programs, making it more comprehensive than just basic medical care.

Aetna Medicare Benefits & Coverage

Aetna Medicare is a managed care option built for low-income individuals and families who qualify under state guidelines, and the chart highlights what that coverage actually includes. Primary care visits and checkups are provided at no cost, while specialist care is available with a referral, though the process varies by state.

Aetna Medicare: Full Breakdown & Benefits

Hospital services, including both inpatient and outpatient care, are fully covered, and prescription drugs come with little to no copay. Preventive care—like immunizations, screenings, and wellness visits—is included, along with maternity services covering prenatal, delivery, and postpartum needs.

Vision and dental benefits are built in for children, while adult coverage depends on state rules. On top of that, many plans offer extra benefits such as telehealth, transportation, and wellness programs, making Aetna Medicaid a more complete support system than just basic medical coverage.

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Aetna Insurance Rates by State Comparison

Georgia’s Bronze plan is nearly identical to Florida’s, but Maine’s Bronze plan has some differences. The deductible in Maine is slightly lower at $6,400 compared to $6,550, and certain services require mandatory copays. A primary care visit costs $40 after meeting the deductible, while an urgent care visit costs $60.

Looking at the Silver plans, Maine has a $4,000 deductible compared to Florida’s $2,950. However, Maine’s copay rate is 20%, which is half of Florida’s 40 percent. Comparing these states shows how plan details and costs can shift depending on location.

Aetna Dental Coverage

Aetna’s dental coverage is structured to handle routine care while also providing support for more expensive procedures. The details can vary by state and plan, but here’s what members can typically expect:

• Preventive Care: Most Aetna dental plans cover two exams and cleanings per year at no cost when using an in-network provider. X-rays, including bitewings, are often included as part of preventive coverage, which helps detect issues early without extra charges.
• Basic Services: Coverage generally includes fillings for cavities, simple tooth extractions, and emergency dental treatment. Members usually pay a coinsurance percentage or a flat copay for these services, with lower costs in-network.
• Major Services: More complex treatments such as root canals, crowns, bridges, dentures, and oral surgery are covered but at a higher coinsurance rate. These services may also have waiting periods depending on the plan.
• Orthodontics: Select plans provide benefits for braces or clear aligners, often with a lifetime maximum benefit cap. This option can be especially valuable for families with children who may need orthodontic care.
• Network Savings: Aetna dental PPO plans give access to thousands of participating dentists nationwide. Members pay the least when using in-network providers since Aetna negotiates discounted rates, though out-of-network care is still available at higher costs.

Altogether, Aetna’s dental coverage is designed to make preventive care affordable while also giving members financial protection against the high costs of advanced dental procedures. It combines everyday coverage with broader support, making it practical for both individuals and families.

Aetna Insurance Plans

Aetna offers a wide range of insurance plans designed to meet the needs of individuals, families, seniors, and even people living abroad. From everyday health coverage to supplemental protection, Aetna structures its plans so members can find the right balance of affordability, flexibility, and comprehensive care. Below is a breakdown of the major types of Aetna insurance plans and what each one includes.

Individual & Family Health Plans

Aetna offers Affordable Care Act (ACA) marketplace plans in select states, giving individuals and families choices between Bronze, Silver, and Gold levels. Bronze plans carry lower monthly premiums but higher deductibles, while Gold plans cost more each month but provide lower out-of-pocket expenses when you use care. Silver plans fall in the middle and may qualify for cost-sharing reductions if your income meets federal guidelines. These plans typically cover essential health benefits such as doctor visits, hospital stays, preventive care, prescription drugs, and maternity services.

Employer-Sponsored Group Plans

Many employers use Aetna to provide health benefits to their workforce. These group plans can include medical, dental, vision, and pharmacy coverage, often bundled with wellness programs, mental health support, and telehealth services. Employers may choose plan structures like HMO, PPO, or high-deductible health plans (HDHPs) paired with Health Savings Accounts (HSAs). Aetna also offers business-specific solutions that include onsite health screenings, health coaching, and data-driven cost management to help companies lower expenses while keeping employees healthier.

Medicare Plans

For seniors and eligible individuals, Aetna provides several Medicare options. Medicare Advantage (Part C) combines hospital, medical, and sometimes prescription drug coverage, with many plans adding dental, vision, hearing, fitness programs, and telehealth.

Prescription Drug Plans (Part D) help cover medication costs and are available as stand-alone policies or bundled with Advantage plans. Aetna also sells Medicare Supplement (Medigap) insurance, which pays for deductibles, coinsurance, and copays not covered by Original Medicare. Availability and benefits vary by state.

Medicaid Plans

Through its division Aetna Better Health, the company administers Medicaid and Children’s Health Insurance Program (CHIP) benefits in multiple states. These plans cover low-income individuals, families, children, pregnant women, and people with disabilities. Services usually include primary and specialist care, hospital coverage, prescription drugs, preventive screenings, maternity care, and long-term care services. Some Aetna Medicaid plans also offer extras like transportation to medical appointments, telehealth visits, and wellness programs to make care more accessible.

Dental & Vision Plans

Aetna provides standalone dental coverage in certain states, with benefits for preventive services like exams, cleanings, and X-rays, as well as basic and major procedures such as fillings, crowns, and root canals. Some plans also include orthodontic coverage. Vision plans cover annual eye exams, glasses, contact lenses, and provide allowances for frames or lens enhancements. Members may also access discounts on elective services such as LASIK surgery through Aetna’s network providers.

Supplemental Plans

To help with expenses that standard health insurance doesn’t fully cover, Aetna offers supplemental options. These include hospital indemnity insurance, which provides a set cash benefit for hospital stays; critical illness coverage, which pays a lump sum if you’re diagnosed with certain conditions like cancer or a heart attack; and accident coverage, which helps with out-of-pocket costs after accidental injuries. These plans add financial protection and flexibility for unexpected medical situations.

Disability Plan

Provides income protection when you can’t work due to illness, injury, or pregnancy. Offered mainly through employers, these plans come in short-term and long-term options. Short-term disability typically covers a portion of your salary for weeks or months after a brief waiting period, while long-term disability extends benefits for a longer timeframe if you remain unable to work. Coverage is designed to help pay everyday expenses like housing, food, and bills while you recover. Some plans also include provisions such as premium waivers if you become disabled before a certain age, ensuring you keep coverage without paying additional costs.

Life Insurance Plans

Typically offered through employers rather than sold directly to individuals, giving employees financial protection for their families in case of death or serious injury. Coverage often includes group term life insurance with options like accidental death and personal loss (AD&PL), portability to continue coverage if you leave your job, and conversion features that let you switch to an individual policy when group coverage ends. Some plans also provide an accelerated death benefit, allowing you to access part of the payout if you’re diagnosed with a terminal illness, and premium waiver provisions so you don’t have to pay premiums if you become disabled. These options make Aetna’s life insurance a flexible way to secure long-term financial support alongside other workplace benefits.

International Plans

Aetna International specializes in coverage for people who live, work, or study abroad. These plans typically include access to global networks of hospitals and doctors, emergency medical evacuation, preventive care, chronic condition management, and coverage for routine and specialist care outside the U.S. They are designed for expatriates, international students, and globally mobile employees who need reliable healthcare access wherever they are.

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How to Save on Aetna Healthcare Insurance

Finding ways to cut healthcare costs is important, and Aetna offers several practical options to help members lower their overall expenses without sacrificing necessary care.

• Choose The Right Plan Level: Aetna’s Bronze, Silver, and Gold plans balance premiums and out-of-pocket costs differently. If you rarely visit doctors, a Bronze plan with lower monthly payments may save you money, while frequent healthcare needs may be cheaper overall with a Gold plan.
• Use In-Network Providers: Staying within Aetna’s network keeps costs down since these providers have negotiated lower rates. Out-of-network care can lead to significantly higher bills.
• Take Advantage of Wellness Discounts: Aetna members can access discounts on gym memberships, nutrition programs, chiropractic services, hearing aids, and even some alternative care like acupuncture and massage therapy.
• Consider Supplemental Coverage: Options like dental, vision, or hospital fixed benefits plans can be added for relatively low costs and may prevent high out-of-pocket bills for common services not covered by standard health insurance.
• Use Preventive Care Benefits: Aetna covers many preventive services at no cost when you see an in-network provider, including annual checkups, immunizations, and screenings. Regular preventive care reduces the risk of expensive health issues later.

Altogether, saving on Aetna healthcare insurance comes down to understanding your plan, using in-network care, and taking full advantage of included perks and preventive services. This approach helps keep costs predictable while giving you more value from your coverage.

Aetna Preferred Lab Network

Aetna’s Preferred Lab network is designed to help members save money and avoid surprise bills by steering lab work to contracted providers that offer discounted rates. If your doctor orders bloodwork, diagnostic testing, or other lab services, using an Aetna Preferred Lab means the claim is filed directly by the lab, and you typically pay only the copay or coinsurance tied to your plan.

Out-of-network labs can still process your tests, but costs are usually much higher since Aetna won’t cover the full amount. Members can check the Aetna provider search tool or call customer service to confirm whether a lab is preferred before testing. This setup ensures predictable pricing, smoother billing, and fewer denied claims, making it an important part of managing healthcare costs under Aetna coverage.

Behavioral Health Programs

Aetna also offers behavioral programs as part of its Aetna Integrated Primary Care Behavioral Health Programs. These programs support individuals with mental health needs. An integrated approach is used so both your primary care physician and your behavioral health clinician are on the same page about what’s going on with you medically and psychologically. To take advantage of this coverage, simply speak with your primary care physician for a referral to a behavioral health clinician.

When you’re under this program, you’ll start out with a minimum of three sessions with a licensed psychologist, licensed social worker, or licensed professional counselor. Your behavioral health clinician will then regularly report back to your primary care physician on your diagnosis, as well as on the solutions they’re currently implementing. This continues for as long as both your doctor and clinician see fit.

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Aetna Insurance Programs

Aetna goes beyond providing health coverage by offering a suite of programs and perks designed to support members’ wellness, simplify life during tough times, and help them access specialty care more easily. Here are some of the standouts:

• Wellness & Discount Programs: Aetna offers members access to significant savings through programs like Weight Management tools, fitness services, vision and hearing care discounts via EyeMed and Hearing Care Solutions, and even LASIK surgery savings with U.S. Laser Network or Qualsight. 
• Corporate Wellness (Aetna Health Connections): For employer-sponsored members, Aetna provides tailored workplace wellness programs. These include health coaching, mindfulness initiatives, women’s health programs, metabolic syndrome support, and accessible health advice via their “Informed Health Line”.
• Aetna Institutes: This program connects members with top-performing hospitals and clinics for specialized treatment. It includes Institutes of Excellence for care like transplants and pediatric heart surgery, and Institutes of Quality for areas like bariatric, cardiac, orthopedic, and behavioral health care. 
• Compassionate Care Program: When facing a serious illness, Aetna assigns a nurse case manager to support members and their families—helping coordinate care, manage benefits, plan advanced care, and tap into community and hospice resources. 
• Aetna Personal Health Solutions: These are targeted, condition-specific programs—often featuring apps and resources—that are offered at no extra cost to qualifying members. They focus on early intervention and managing emerging health issues. 

Together, these programs show that Aetna is focused on more than just basic health coverage. By combining wellness discounts, specialized care networks, condition-specific support, and compassionate services for serious illness, Aetna gives its members resources that help them stay healthier and manage care with less stress. It’s a way of making insurance feel more personal and supportive, not just a policy you pay for.

Aetna Insurance Reviews & Ratings

When you look at Aetna’s ratings across major agencies, you get a well-rounded view of how it performs in the market. J.D. Power scores Aetna 835 out of 1,000 for average customer satisfaction, which puts it in a competitive spot but not at the very top. The Better Business Bureau gives Aetna an A+ for business practices, showing strong reliability in how it operates.

Aetna Insurance Business Ratings and Consumer Reviews

Consumer Reports rates it 70 out of 100 for customer satisfaction, suggesting that while many members are happy, there’s room for improvement. On the regulatory side, the NAIC gives Aetna a score of 0.75, meaning it receives fewer complaints than the industry average—a good sign for policyholders.

Finally, AM Best rates Aetna an A for financial strength, which tells you the company is in a solid position to pay claims and remain stable long term. Together, these ratings reflect a company that is financially strong and generally well-regarded, though customer experiences can vary.

How to File an Insurance Claim With Aetna

Filing an insurance claim with Aetna is usually straightforward, but the process depends on whether you’re using an in-network or out-of-network provider. Here’s what members need to know:

• In-Network Providers File: If you see a doctor, hospital, or specialist that’s part of Aetna’s network, the provider automatically submits the claim. You won’t need to handle paperwork, though you should still review your Explanation of Benefits (EOB) to confirm accuracy.
• Out-of-Network Requires Member Filing: If you use an out-of-network provider, you’re responsible for filing the claim yourself. This means completing the correct claim form and submitting it directly to Aetna.
• Access Claim Forms Online: Aetna makes the necessary forms available on its website. You can log in to your member account to download medical, dental, or pharmacy claim forms specific to your plan.
• Submit Online or Mail: Completed forms can be uploaded through Aetna’s secure portal or mailed to the address listed on the form. Be sure to include all supporting documents, such as itemized bills and receipts.
• Track Claim Status: Once submitted, you can log into your account and use the Claims Center to check real-time status updates. Aetna also emails confirmations when claims are received.

Staying in-network is the easiest path since claims are filed for you automatically, saving time and reducing errors. If you do need to submit a claim yourself, Aetna’s digital tools, clear instructions, and Claims Center tracking keep the process manageable.

Having online access to forms and updates also helps you stay organized and avoid delays, which gives members confidence that their claims will be processed correctly and on time.

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Canceling Your Aetna Insurance Policy

Canceling an Aetna insurance policy depends on the type of coverage you have. If you’re enrolled in an individual health plan, you can cancel by calling the number on the back of your Aetna member ID card. For employer-sponsored coverage, cancellation must go through your HR department since they manage enrollment.

If you purchased your plan through a third-party broker or agent, you’ll need to contact them directly. Medicare Advantage and Part D prescription plans follow federal rules that generally require you to keep coverage for the full calendar year, so cancellations can only occur during the Annual Enrollment Period or if you qualify for a Special Enrollment Period. Understanding these differences ensures you follow the right process and avoid gaps in coverage or unexpected penalties.

Aetna Insurance Pros & Cons

Aetna has been in the health insurance business for over 160 years, and as part of CVS Health, it now reaches millions of members across the U.S. Like any insurer, it has strengths and weaknesses that matter depending on what kind of coverage you’re looking for. Here’s what stands out most:

Pros

• Strong Medicare Advantage Options: Aetna is one of the largest providers of Medicare Advantage plans, many of which come with $0 premiums, prescription drug coverage, and extras like dental, vision, hearing, fitness programs, and over-the-counter allowances. This makes them a popular choice for seniors who want more than what Original Medicare provides.
• Wide Provider Network: Members have access to a network of about 1.5 million health care professionals and more than 5,000 hospitals nationwide, plus MinuteClinic walk-in locations through CVS. This size and accessibility can make it easier to find in-network care close to home.
• Wellness and Member Perks: Beyond medical coverage, Aetna offers discounts on gym memberships, weight-loss programs, hearing aids, and even alternative therapies like acupuncture. These extras help members save money on preventive and lifestyle health needs.

Cons

• Customer Service Complaints: While some members report positive experiences, Aetna receives a high volume of complaints about denied claims, delays in processing, and difficulty reaching consistent support. Consumer Affairs ratings and NAIC complaint data show customer service as a weak point.
• Limited Availability for Some Products: Not all Aetna plans are offered in every state, particularly ACA marketplace and Medicaid options. That means your eligibility depends heavily on where you live, which can be frustrating if you like Aetna’s offerings but can’t access them in your area.

Aetna stands out for its strong Medicare Advantage presence, broad provider network, and valuable wellness perks. However, prospective members should weigh those benefits against the company’s uneven customer service reputation and the limited state availability of certain plans. If you’re considering Aetna, it’s worth checking both the plan options in your zip code and reviews from current members in your state.

One Reddit user shared that Aetna provided faster claims processing compared to Blue Cross Blue Shield of North Carolina, and they were more satisfied with Aetna’s coverage and pricing. This kind of feedback highlights how member experiences can differ and why it’s helpful to compare reviews before choosing a plan.

Deciding if Aetna Insurance Is the Best Fit for You

Our Aetna insurance review shows that the company remains a strong option for individuals, families, and seniors who want a mix of affordability and broad coverage. Aetna stands out with its wide network of providers, competitive Medicare Advantage plans, and supplemental offerings like dental, vision, and wellness programs.

However, members should weigh these advantages against drawbacks such as uneven customer service ratings and limited availability of certain plans in some states. For anyone considering Aetna, the key is to carefully compare plan details, costs, and benefits in your specific state to see if it matches your healthcare needs.

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