Aetna Health Inc.: History, Contacts, Benefits, Brokers, Services, Claims, AM Best Ratings and Reviews

Aetna Health, Inc., headquartered in Pennsylvania, offers a range of plans and services to individuals, employers, and healthcare providers.

 

As a subsidiary of CVS Health, a leading healthcare innovation company.

This article examines various aspects of Aetna, including its history, contact details, membership login, reviews, and both the advantages and disadvantages associated with the company.

Profile of Aetna Health, Inc.

Category	Details
Name	Aetna Health, Inc.
Type	Subsidiary of CVS Health
Industry	Health care
Founded	1853
Headquarters	Hartford, CT, USA
Products and services	Health insurance and related services, such as medical, pharmacy, dental, behavioral health, group life, disability, and health care management
Customers	Individuals, employers, health care professionals, producers, governmental units, government-sponsored plans, labor groups, and expatriates
Financial strength rating	A (Excellent) by AM Best
BBB rating	A+ by Better Business Bureau
Customer satisfaction rating	1.5 out of 5 stars by Consumer Affairs
Website	Aetna.com
Careers	Aetna careers website
Partner program	Aetna partner program

Aetna Health Inc. History

Established in 1853 in Hartford, Connecticut, Aetna started as a life insurance company before diversifying into multiple insurance sectors, including fire, accident, and health.

Taking a significant step into the managed healthcare market, the company introduced its first health maintenance organization (HMO) in 1975.

The year 1996 marked a pivotal moment for Aetna as it merged with U.S. Healthcare, a leading HMO company, evolving into Aetna U.S. Healthcare.

In 2017, CVS Health’s acquisition of Aetna resulted in the formation of a healthcare powerhouse that seamlessly integrates pharmacy, retail, and insurance services.

Aetna Health Inc. Contact Information

Aetna operates with different addresses and phone numbers for varied inquiries.

Category	Details
Corporate address	151 Farmington Avenue, Hartford, CT 06156, USA
Contact center	1-800-US-AETNA (1-800-872-3862) (TTY: 711)
Membership services	Phone numbers vary based on the plan and coverage
Social media platforms	Twitter, Facebook, LinkedIn, and YouTube

 

How to Access Your Health and Benefits Information Online with Aetna Health, Inc.

As a member of Aetna Health Inc., you have the convenience and security of accessing your health and benefits information through a secure member website or the Aetna Health app on your mobile devices.

These online platforms allow you to:

• View your health plan benefits and summaries
• Check the status of your claims and see your Explanation of Benefits (EOB)
• Find doctors, hospitals, and other healthcare providers in your network
• Estimate the cost of health care services and compare quality ratings
• Manage your prescriptions and order refills
• Access wellness programs and resources
• Contact customer service and get answers to your questions

To access the member website, you must create a username and password through registration on the site.

Alternatively, you can sign in without a password using your member ID and date of birth, which you can locate on your ID card or in your enrollment materials.

For the Aetna Health app, download it from the [App Store] or [Google Play], follow the instructions to set up your account, and use the same username and password as the member website.

Alternatively, sign in without a password using your member ID and date of birth.

By logging in to either the member website or the Aetna Health app, you implicitly agree to adhere to Aetna Health Inc.’s Terms of Use and Privacy Policy.

Aetna Health, Inc. Agents and Brokers

Aetna Health, Inc. stands as a prominent health insurance provider in the United States, boasting a vast network comprising over 1.2 million healthcare professionals, including 690,000 primary care doctors and specialists.

Aetna extends its offerings to agents and brokers seeking to expand their business and deliver quality coverage to clients.

As an Aetna agent or broker, you can access the following benefits:

1. Competitive compensation: Aetna provides commissions and bonuses based on your performance and the product type you sell. Recognition and rewards are also attainable through Aetna’s Producer World program, acknowledging your accomplishments.
2. Tools and support: Aetna equips you with online resources and training to facilitate the sale and service of its products. The Producer World portal offers access to product details, quotes, enrollment, billing, claims, and more. A dedicated producer service center is available for any inquiries or issues.
3. Diverse product portfolio: Aetna’s array of health plans caters to diverse customer needs, including individuals, families, small and large groups, Medicare and Medicaid beneficiaries, and federal employees. The health plans encompass various options such as HMO, PPO, POS, EPO, HDHP, and HSA, along with dental, vision, pharmacy, behavioral health, and wellness benefits.

To become an Aetna agent or broker, start the application online through Aetna’s Producer World website.

Submit your essential information and business details, finish Aetna’s contracting and certification process, and start selling Aetna products, enjoying the advantages of partnering with a top health insurer in the nation.

How to File and Track Your Claims with Aetna Health, Inc.

Typically, if you receive healthcare services from a provider within your network, there is usually no requirement for you to submit a claim to Aetna Health, Inc.

The provider will handle the claim submission on your behalf, and Aetna will directly compensate the provider based on your plan benefits.

Your responsibility at the time of service is limited to paying your copay, coinsurance, or deductible, as indicated on your ID card or in your enrollment materials.

However, there are some situations where you may need to file a claim yourself, such as:

• You receive services from an out-of-network provider who does not submit claims to Aetna
• You receive services outside the United States or its territories
• You have other insurance that is primary to your Aetna plan
• You have a dispute or an appeal regarding a claim

In such instances, you are required to make an upfront payment to the provider and subsequently submit a claim form to Aetna for reimbursement.

The claim form is accessible on the member website or the Aetna Health app, or you can obtain one by contacting customer service.

The completion of the claim form necessitates providing the following information:

• Your name, address, member ID, and date of birth
• The name, address, and tax ID of the provider
• The date and place of service
• The diagnosis and procedure codes
• The amount charged and paid
• The reason for the claim
• Any other insurance information, if applicable

Attach original bills, receipts, and other documents (referral, prescription, etc.) to the claim form. Copy them before mailing or faxing them to Aetna.

Submit within 180 days.

Track claim status, view EOB, and get alerts on the website or app.

Contact customer service or file a dispute or appeal if needed.

Aetna Health Inc. Headquarters

Aetna Health Inc. is a healthcare company offering diverse health and benefits products and services to its members.

Depending on the plan type and coverage, Aetna designates various claim headquarters where members can submit claims for reimbursement.

Here are some of the claim headquarters for different plan types:

• For medical benefit claim submissions, the address is PO BOX 981204 EL Paso, TX 79998-12041.
• For claim resubmissions, the address is PO Box 982970 El Paso, TX 79998-29701.
• Aetna Student Health and Medicare Plans require submissions to PO Box 191106 El Paso, TX, 79998-11061.
• For Aetna Voluntary and Limited Benefits Plans, the address is PO Box 14079 Lexington, KY 40512-40791.

Aetna’s corporate address is 151 Farmington Avenue Hartford, CT 06156 USA2. You can contact Aetna regarding claims at 1-800-US-AETNA (1-800-872-3862) (TTY: 711).

While Aetna may accept claims at any address, it is recommended to confirm the payor ID and address with the clearinghouse.

To monitor your claim’s status, access your Explanation of Benefits (EOB), and receive email or text alerts, visit the member website or the Aetna Health app.

Additional details on how to file and track claims with Aetna can be found on their website3 or by reaching out to their customer service.

What Aetna Health Inc. Offers to Its Members and Customers

Aetna Health Inc. is a healthcare company dedicated to enhancing the health and well-being of its members and customers by offering a range of services and products.

Among the services and products provided by Aetna are:

1. Health Plans: Aetna provides diverse health plans, including HMO, PPO, POS, EPO, HDHP, and indemnity plans. These plans cover a wide array of healthcare services, such as preventive care, hospitalization, surgery, emergency care, and more. Additionally, Aetna offers Medicare and Medicaid plans for eligible individuals.
2. Health Expense Funds: Aetna offers health expense funds, such as health savings accounts (HSAs), health reimbursement arrangements (HRAs), and flexible spending accounts (FSAs), providing members with tax-advantaged options to save money for qualified medical expenses.
3. Pharmacy Plans: Aetna’s pharmacy plans cover prescription drugs, encompassing generic, brand-name, and specialty drugs. Members benefit from access to a network of pharmacies, mail-order delivery, and online tools for convenience.
4. Behavioral Health Plans: Aetna’s behavioral health plans encompass mental health and substance abuse services, including counseling, therapy, medication management, and inpatient/outpatient care. Aetna also offers resources and programs supporting emotional well-being, such as online self-assessments, webinars, and coaching.
5. Health and Wellness Programs: Aetna provides health and wellness programs designed to help members enhance their health and lifestyle. These programs include wellness coaching, disease management, care management, maternity programs, and wellness discounts. Online tools and apps like Aetna Health, Aetna Mobile, and Attain by Aetna assist members in managing their health, and benefits, tracking activities, and earning rewards.

These services and products collectively contribute to Aetna Health Inc.’s commitment to its members and customers.

Further information is available on the Aetna website or by contacting Aetna customer service.

How to Join and Grow with Aetna Health Inc.

Aetna Health Inc. is dedicated to fostering a healthier world for its members, customers, employees, and communities.

Offering diverse career opportunities in areas like customer service, sales, clinical, technology, and finance, Aetna encourages individuals to apply their skills and passions to make a positive impact.

As an Aetna employee, you’ll experience a supportive and inclusive work environment, competitive compensation, and benefits, along with opportunities for learning, development, and recognition.

Engage in social impact through the athenaGives program, supporting causes like health equity, education, and environmental sustainability.

Explore current job openings on the Aetna careers website, where you can learn about the company culture, values, and diversity.

Apply online by creating a profile, uploading your resume, and submitting your application.

Sign up for job alerts to stay informed about new opportunities aligning with your interests.

Aetna Health Inc. actively seeks talented individuals who share its vision of creating a healthier world.

How Aetna Health Inc. Performs in Terms of

Financial Strength and Customer Satisfaction

Aetna Health Inc. provides a variety of health and benefits products and services.

Assessing a healthcare company’s performance involves considering its financial strength rating and customer reviews.

A financial strength rating evaluates the company’s ability to meet obligations like claims and benefits payments, with Aetna holding an A (Excellent) rating from AM Best.

Additionally, Aetna has an A+ rating from the Better Business Bureau, indicating trustworthiness.

However, customer reviews cite issues like claim denials, billing, network limitations, and customer service, with an average rating of 1.5 out of 5 stars on Consumer Affairs based on 1,082 reviews in the past year.

Consumer Affairs reports an average rating of 1.5 out of 5 stars, based on 1,082 reviews in the past year, with common complaints including:

• Aetna denied claims for medically necessary services or treatments, such as surgery, therapy, or medication, without a valid reason or explanation.
• Aetna charged incorrect or excessive fees, such as copays, deductibles, or premiums, or failed to process refunds or adjustments.
• Aetna had a limited network of providers, especially for specialty care, or changed the network without notice, resulting in higher out-of-pocket costs or loss of coverage.
• Aetna had poor customer service, such as long wait times, rude or unhelpful representatives, or lack of communication or follow-up.

These are some of the factors that affect the performance of Aetna Health Inc. in terms of financial strength and customer satisfaction.

You can find more information about Aetna’s ratings and reviews on their website or by contacting their customer service.

Advantages and disadvantages of Aetna Health, Inc.

Some of the benefits of choosing Aetna Health Inc. as your health insurance provider are:

Benefits

• Affordable premiums: Aetna’s monthly fees for ACA plans are lower than the national average, saving you money on health care costs.
• Quality ratings: Aetna’s health plans are rated above average by NCQA, a reputable organization that evaluates health insurers based on their performance and customer satisfaction.
• Large network: Aetna has a wide range of health care providers that accept its insurance, giving you more options and convenience when seeking medical care.
• CVS Health partnership: Aetna is part of CVS Health, a leading healthcare company that offers integrated services, digital tools, and personalized support to its members.
• Flexible plans: Aetna has various health plans that cater to different needs and preferences, such as HMO, PPO, POS, EPO, HDHP, and HSA options, as well as dental, vision, pharmacy, behavioral health, and wellness benefits.

Limitations

• Elevated deductibles: Aetna’s silver plans have deductibles surpassing the national average, necessitating higher out-of-pocket payments before insurance coverage activates.
• Increased complaints: Aetna receives more complaints than the national median from state insurance departments, indicating heightened customer dissatisfaction with its services.
• Limited ACA plans: Aetna offers fewer ACA plans compared to most health insurers, resulting in fewer options for health insurance that align with the ACA or Obamacare.
• Complex claim process: Aetna employs a convoluted claim process, potentially leading to challenges and delays in receiving reimbursement for medical expenses.
• Subpar customer service: Aetna’s customer service is deemed inadequate, suggesting potential difficulties and frustrations when seeking assistance or information from the company