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Aetna Health Insurance Review

By Tamara Holmes and

Tamara Holmes HealthCare Writer

Tamara E. Holmes is a Washington, DC-based freelance journalist and content strategist who has been writing about topics pertaining to personal finance, health insurance, careers and small business for more than a decade.

Michael LaPick

Michael LaPick Healthcare Writer

Michael LaPick is a Healthcare/Medicare writer for HealthCare.com and its web properties.

Updated on January 7th, 2025

In this Article

Basics Types of Health Insurance Plans How Do You Enroll? How Do You File Claims? How is Aetna Rated? What Are Strengths and Weaknesses? Next Steps

We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.

Choosing the right health insurance carrier is essential for financial security and access to quality care. In this series, we take a look at health insurance carriers based on various criteria. Here is our Aetna Health Insurance Review.

Pros:

  • Established Reputation: Over 160 years in the insurance industry, indicating stability and reliability.
  • Nationwide and International Coverage: Available in all 50 states, Washington D.C., and internationally.
  • Comprehensive Network: Includes 1.2 million healthcare professionals, 700,000 doctors, and 5,700 hospitals.
  • Variety of Plans: Offers a wide range of coverage options, including individual, family, group, Medicare, Medicaid, student, and supplemental plans.
  • Preventive Care Benefits: Many plans include perks like gym memberships, yoga sessions, health coaching, and discounts on weight management programs.
  • 24-Hour Hotline: Round-the-clock assistance for health-related inquiries.

Cons:

  • Customer Service Issues: High complaint rates related to claim denials and delays, as reflected in a complaint index more than three times higher than the market average.
  • Low Customer Satisfaction from review rating sites such as Consumer Affairs, Trustpilot, and Better Business Bureau (BBB)
  • Complicated Claims Process: Certain procedures may require referrals, and claims need detailed documentation and adherence to submission timelines.

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Who Is Aetna?

Aetna is one of the most trustworthy health insurers. With more than 160 years of experience, Aetna offers health plans to fit a variety of needs and situations. 

Basics on Aetna

Since 1853, Hartford, Connecticut-based Aetna has offered healthcare benefits and services to individuals, employers, and healthcare professionals.5 In 2018, Aetna began to offer those services as a subsidiary of CVS Health.6 The health insurance giant offers plans across all 50 states and the District of Columbia.8 It also offers international policies for individuals who are living or working abroad.9  Approximately 39 million people received healthcare services through Aetna as of December 2024.10

Aetna also has a large provider network. The company’s global network encompasses approximately 1.2 million healthcare professionals, more than 700,000 specialists and primary care doctors, and more than 5,700 hospitals.11

What Types of Health Insurance Plans Does Aetna Offer?

Aetna offers a variety of different types of health coverage, including:

  • Individual plans to cover your own medical needs.12
  • Family plans to cover your medical needs as well as those of a partner or dependents.13
  • Group plans for employers to offer insurance as a benefit to their workers.14
  • Medicare plans and Aetna Medical Advantage Plans15 for individuals 65 and older or those who have a disability.16
  • Medicaid plans for individuals with limited assets, a disability, or special needs.17
  • Student health insurance plans for those in college in the United States or studying abroad.18
  • Supplemental plans that cover gaps in your primary health insurance to pay for costs associated with such events as critical illness, accidents, and hospital stays.19

What Are Member Benefits for Aetna?

In addition to offering medical services, Aetna provides a number of other preventive care benefits designed to help you stay healthy.

For example, some plans come with a gym membership, yoga and massage sessions, and health coaching to help you reach certain fitness goals.20

Other benefits include discounts on diet and weight management programs and a 24-hour hotline.21

How Do You Enroll in Coverage with Aetna?

If you decide Aetna is the insurance carrier for you, there are a number of ways to sign up for coverage.

You can start by clicking on “Shop for a Plan” from the upper left-hand corner of the company’s website, Aetna.com.22

You can also contact the company by calling 1-800-872-3862 to speak with someone who can help you.23

Aetna also works with agents and brokers so you can sign up for coverage by having a professional walk you through the options.24

As you explore what is available to you, make sure you check to see if you qualify for a current-year subsidy under the Affordable Care Act.  

How Do You File Claims with Aetna?

If a time comes when you need to file a claim, Aetna has a variety of ways to do so. According to the company, the most efficient way to file a claim is online.25 However, you can also file a claim via fax, email, or traditional mail, preferably within 180 days of the services you are filing a claim for.26 

There is certain information you want to make sure you have on hand before filing your claim:

  • Your member identification number and contact information27
  • A description of the medical service and the date it was completed28 
  • Copies of bills and receipts29
  • Information on the method you’d like to be reimbursed30
  • Bank account information if you choose to be reimbursed via Electronic Fund Transfer31

For certain procedures, such as chiropractic or homeopathic treatment, you may need to get a referral from a doctor or specialist before submitting a claim.32 

How is Aetna Rated?

When it comes to choosing an insurance company, it’s a good idea to make sure your insurer is financially stable. Checking the insurer’s financial ratings by third-party companies can offer peace of mind. 

A.M. Best awarded Aetna the Financial Strength Rating of an “A,” which is equivalent to Excellent, in August 2024.33 Aetna also received an impressive score of “A-” from FitchRatings.34

When it comes to customer satisfaction with Aetna, there may be some room for improvement. The National Association of Insurance Commissioners tracks complaints about insurance companies, and Aetna has a complaint index that is more than three times higher than expected in the market.35 The most common complaint was for the denial of a claim, followed by delays in the handling of the claims process.36

Several websites allow consumers to share their experiences with different companies.

  • Consumer Affairs: 89% of reviews rated Aetna 1-star (out of 1,376 reviews).
  • Trustpilot: 92% of 181 reviews rated Aetna 1-star, with an average score of 1.3/5.
  • Better Business Bureau: Average rating of 1.08/5 from 367 reviews, with 1,299 complaints in three years.

Next Steps

Choosing the best health insurance company is a subjective process that depends on your individual needs and priorities.  

If you’re thinking about buying health care coverage through Aetna, make sure the policy fits your personal needs and your pocketbook. For example, would you prefer an HMO or a PPO? Not only should you be able to afford your premium, but you need to be able to afford out-of-pocket expenses, too. That means making sure your copayments, coinsurance, prescription drugs, and any deductible fits within your budget. Finally, pay attention to the customer service you receive while signing up for your policy.

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc. 

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  34. Fitch Ratings “Fitch Affirms Aetna’s IFS at ‘A’; Outlook Stable” Press Release May 22, 2020 (accessed February 22, 2021).

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