Medicare Blog

how good is aetna hmo medicare

by Dr. Gaylord Lowe Published 2 years ago Updated 1 year ago
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NCQA rating: 2.5 to 4.5 stars
According to the National Committee for Quality Assurance, satisfaction ratings for Medicare plans issued by all Aetna divisions range from 2.5 to 4.5 stars, with more than 40 plans receiving high-performance ratings.
Jun 19, 2022

Full Answer

Does Aetna have a Medicare Advantage plan?

Depending on where you live, you may be able to enroll in one of the following types of Aetna Medicare Advantage plans: Aetna Medicare Advantage HMO (Health Maintenance Organization) plans may have lower costs than other types of Medicare Advantage plans because they use a contracted provider network to keep health-care expenses low.

Why is Aetna a good health insurance?

The Good

  • Company Ratings
  • Positive Reviews
  • Health Plan Variety
  • Additional Insurance Options
  • Helpful Member Resources
  • Large Provider Network
  • Customer Service

What are Medicare Advantage plans does Aetna offer?

As mentioned, Aetna Medicare Advantage plans may offer extra benefits not normally covered by Original Medicare, including prescription drug coverage and routine vision or dental benefits. If you’d like to learn more about Aetna Medicare plan options, visit the Aetna page to find coverage that may fit your needs.

Is Aetna better than United Healthcare?

Market share aside, the differences between UnitedHealthcare and Aetna Medicare plans are slim. UnitedHealthcare offers a more diverse lineup of Special Needs Medicare Advantage Plans and has a slightly larger network of health care providers. Aetna has slightly better quality ratings for its Medicare plans.

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How does Aetna Medicare rate?

Average star ratings: The Centers for Medicare & Medicaid Services gives Aetna's 2022 Medicare Advantage plans an average rating of 3.8 out of 5 stars. (The national average for all providers is 4.37.)

What is the highest rated Medicare plan?

List of Medicare Advantage plansCategoryCompanyRatingBest overallKaiser Permanente5.0Most popularAARP/UnitedHealthcare4.2Largest networkBlue Cross Blue Shield4.1Hassle-free prescriptionsHumana4.01 more row•Jun 22, 2022

Are Aetna benefits good?

Financially, Aetna ranks among the strongest health insurance providers. The company has received an A.M. Best Financial Strength Rating of A (excellent). This means the company is financially strong and has the ability to pay out claims in the future.

What is the best insurance company for Medicare?

Best Medicare Advantage Providers RatingsProviderForbes Health RatingsCoverage areaBlue Cross Blue Shield5.0Offers plans in 48 statesCigna4.5Offers plans in 26 states and Washington, D.C.United Healthcare4.0Offers plans in all 50 statesAetna3.5Offers plans in 44 states1 more row•Jun 8, 2022

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Which is better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Is Aetna a decent insurance?

Aetna is rated A (excellent) by AM Best, and has high ratings from several other financial ratings services. AM Best is a credit rating firm that assesses the creditworthiness of and/or reports on over 16,000 insurance companies worldwide.

Does Aetna cover all 50 states?

Aetna Health Insurance in California Aetna offers health insurance in all 50 states and in terms of membership is the third largest health insurer in the United States behind United Healthcare and Anthem Blue Cross. In California, Aetna ranks sixth in number of members among health insurance companies.

What type of insurance is Aetna Medicare?

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.

Does Aetna have a Medicare Supplement plan?

Aetna offers highly-rated policies for Medicare beneficiaries. Aetna Medicare policies range from Medicare Supplement plans (Medigap) and Medicare Advantage plans to Medicare Part D coverage and ancillary products.

Who is the largest Medicare Advantage provider?

UnitedHealthcare is the largest provider of Medicare Advantage plans and offers plans in nearly three-quarters of U.S. counties.

What are the negatives of a Medicare Advantage plan?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

What is the Aetna Medicare Advantage number?

to 8 p.m. EST, at 855-335-1407 (TTY: 711).

How many Medicare beneficiaries are in Aetna?

Overall, Aetna is the fifth-largest health insurer in the country, and it is the third-largest in terms of for-profit health plans. Nearly 2.7 million Medicare beneficiaries are enrolled in an Aetna Medicare Advantage plan, and the company added 210,000 new members for the 2021 plan year. Back to top.

How many states are Aetna plans available in?

Aetna expanded its Dual-Eligible Special Needs Plan to 27 states, and the Aetna Medicare Eagle plans — new Veteran-specific Medicare Advantage offerings in 2021 — are available in 41 states.

How much does Aetna cost in 2022?

Aetna offers three stand-alone Medicare prescription drug plans in 2022, with average monthly premiums that range from $7.08 to $68.97:

What is the Aetna premium for 2022?

Strong $0 premium offerings: In 2022, Aetna estimates that 84% of Medicare-eligible beneficiaries in the U.S. will have access to a $0-monthly-premium Aetna Medicare Advantage plan.

How much is Medicare Advantage 2022?

For 2022 Medicare Advantage plans with a premium, the monthly consolidated premium (including Part C and Part D) ranges from $10 to $217 [5]. For Dual-Eligible Special Needs Plans, or D-SNPs, monthly premiums range from $15 to $35.60 [6]. Aetna also offers low-premium stand-alone prescription drug plans nationwide, with an average monthly premium as low as $7.08 [7].

What is the cost of Aetna 2021?

Aetna offers three stand-alone prescription drug plans in 2021, with average monthly premiums that range from $7.15 to $69.52: SilverScript SmartRx: Average premium of $7.15. Offers Tier 1 generic drug coverage with a $0 deductible and $0 copays. This is the lowest-cost stand-alone drug plan nationwide.

How many members of Aetna are in Medicare Advantage?

While most of Aetna’s members are enrolled in employer-sponsored group health insurance plans, 2.7 million members enrolled in Aetna Medicare Advantage plans and 1 million people had an Aetna Medicare supplement plan as of September 30, 2020. 4 .

What is Aetna insurance?

Aetna is the fifth-largest health insurer in the U.S., with $55.4 billion in 2018 premium revenues and 5% of the overall health insurance market. 1 . Aetna offers Medicare Advantage, Prescription Drug, Supplement (Medigap) plans, and Special Needs plans for people who are dually eligible for Medicare and Medicaid.

How much is Medicare Advantage 2020?

Monthly premiums are the most obvious costs to consider, and many Medicare Advantage plans have low or $0-dollar premiums. Around 60% of Medicare Advantage Prescription Drug Plan enrollees paid no premium in 2020, and the average premium for all Medicare Advantage enrollees, including those with and without premiums, is $19 in 2022. 7 Aetna expanded its $0-premium Medicare Advantage offering in 2021 and plans even more benefits in 2022. 8

How many complaints did Aetna have in 2019?

For Medicare Supplement plans, Aetna’s complaint index was 4.87 in 2019 and 3.89 in 2018, with more than twice the likely complaints. 9  There were no complaints in 2017. Though complaints against Aetna rose over this period, the numbers are small and may not yet indicate a worsening trend.

How many stars does Aetna have?

Aetna’s Medicare Advantage plans range from 3 to 4.5 Stars; their Part D prescription plans range from 3 to 5 Stars. Aetna’s highest-ranking Part D plans are those in Georgia and Pennsylvania, both 5-Star plans. 7  Check Aetna’s Star Ratings in your county and for the plan you have or are considering.

What is NCQA in healthcare?

The National Committee for Quality Assurance (NCQA) is a leading health plan accreditation organization that assesses and rates health plans each year based on quality and customer satisfaction measures. In the 2019–2020 ratings, Aetna subsidiaries scored between 2.5 out of 5 for the Medicare-Medicaid plans, such as Aetna Better Health of Michigan and Aetna Better Health of Illinois, and 4.5 out of 5 for Aetna Health in Connecticut and Maine. 2

What are the extra benefits of Medicare Advantage?

Extra Benefits. Most Medicare Advantage plans offer extra benefits, such as fitness, dental, and vision benefits, as well as hearing aids, over-the-counter medications, and meal benefits. These benefits have become increasingly common. In 2020, 98% of Medicare Advantage plans also offered telehealth benefits.

What is the average rating for Aetna?

For 2020, Aetna Medicare Advantage Prescription Drug (MAPD) plans earned an overall weighted average rating of 4.3 out of 5 stars. The majority of Aetna Medicare plan members are in a plan rated 4.5 stars or higher out of 5 stars. 2.

Who can help you compare Aetna plans?

A licensed insurance agent can help you compare Aetna Medicare Advantage plans that may be available in your area.

How many people will be in Aetna in 2020?

Over 11 percent of all Medicare Advantage enrollees in 2020 are enrolled in an Aetna Medicare plan. This accounts for around 2.7 million Medicare Advantage plan beneficiaries. 4

How many stars does Medicare give?

According to Medicare.gov, the ratings range from one star (poor) to five stars (excellent).

Does Aetna offer Medicare Advantage?

Aetna offers several Medicare Advantage plan (also called Medicare Part C) options. If several Aetna Medicare Advantage plans are offered where you live, you can use the Medicare Star Ratings as an easy tool to help you compare plans.

Which states does Aetna not offer Medicare Advantage plans?

It is important to note that Aetna Medicare Advantage plans aren’t available in the following states: Alaska. Hawaii. Minnesota. Montana. North Dakota. Vermont. For everyone else, you’ll find at least some choice of Aetna Medicare Advantage plans in your state.

When did Aetna start offering Medicare Advantage?

Aetna has been in the Medicare market since 1966, and they started offering Medicare Advantage plans in 2010. Since then, Aetna has grown into one of the largest Medicare Advantage plan providers in the nation. Is a plan from Aetna right for you?

Is Aetna a Medicare Advantage?

As one of the top four largest Medicare Advantage plan providers in the United States, Aetna ranks pretty highly across the board . Aetna has relatively few customer complaints for a company its size, according to the National Association of Insurance Commissioners, and it also ranks fourth among insurance companies in the J.D. Power Medicare Customer Satisfaction Survey.

Is Aetna Medicare available in Alaska?

Aetna Medicare Advantage plans are sold in most states but aren’t available in Alaska, Hawaii, Minnesota, Montana, North Dakota, and Vermont. iStock. If you’re considering replacing your Medicare coverage with a Medicare Advantage plan, the list of plans and insurers can feel endless.

Is Aetna the best insurance?

In these states (among a few others), Aetna was rated as one of the best insurers in the state, according to U .S. News and World Report. *The exact premium you pay will depend on several factors, including where you live, your age, and your health.

Does Aetna have a preferred provider network?

Aetna has contracts with about 1.2 million providers. To put this in perspective, Cigna contracts with 1.5 million and UnitedHealthcare contracts with 1.3 million. Since your provider options will depend a great deal on your location, it is important to check out what providers in your area accept Aetna before you sign up for a plan.

Is Aetna Medicare good for seniors?

Aetna Medicare Advantage Plans: Great for Active Adults. More seniors than ever are adopting more active lifestyles, and with Aetna, your health insurance can keep up. If you like to travel, check out one of their “Explorer” plans.

What is Aetna health insurance?

What to Know about Aetna. Aetna is one of the nation’s oldest and leading healthcare insurance providers. The company was founded in 1853 and is headquartered in Hartford, Connecticut. Aetna was acquired by CVS Health Corp. in 2018, and is the third-largest provider of health insurance and services.

Why did Aetna stop offering health insurance?

The company stopped offering individual health insurance plans in 2018 due to revenue losses on the healthcare marketplace.

How to contact Aetna insurance?

Aetna Customer Service. To learn more about Aetna insurance products or to receive a quote, visit the Aetna website or call 1-800-US-AETNA (1-800-872-3862) between the hours of 7:00 a.m. and 7:00 p.m. ET. Members can contact Aetna in the following ways. Contact the Member Services phone number on your ID card.

How many employees does Aetna have?

Aetna has over 35,000 employees nationwide with revenue in excess of $35 billion. Aetna is rated A (excellent) by AM Best, and has high ratings from several other financial ratings services. AM Best is a credit rating firm that assesses the creditworthiness of and/or reports on over 16,000 insurance companies worldwide.

How does Aetna pay claims?

Claims are paid according to the benefits spelled out in your specific plan. After the provider submits the claim, Aetna will pay according to your plan. You’ll receive an explanation of benefits (EOB) describing what has been paid by Aetna, and what, if anything, you owe. You’ll receive a bill from your provider for any balance to be paid by you.

When was CVS Health acquired?

Founded in 1853. Acquired by CVS Health in 2018. Sells health insurance, Medicare Advantage plans and Medicare Supplement insurance, dental insurance, group life insurance, group disability insurance, and group vision insurance in all 50 states. The third-largest provider of health insurance and services. “A” (excellent) rating by AM Best.

Does Aetna work with independent insurance?

Does not work with independent insurance agents. Aetna Pros: Aetna is a well-established and financially strong company with high ratings from AM Best and numerous other financial ratings bureaus. Offers nationwide coverage, HSAs, and wellness programs with its health plans. Excellent customer service options via online account.

How Would Having Original Medicare Medigap And A Part D Plan Compare With My Employer

If you opt for Original Medicare plus a Part D Prescription Drug Plan and a Medigap supplement, the coverage is likely to be just as good as what you had previously from your employer. Depending on which Medigap supplement and Part D Prescription drug plan you choose, your out-of-pocket expenses could end up being very minimal.

Wellcare And Aetna Mobile Apps Options

The MyWellCare app allows you to keep track of your benefits, look for providers, and use it as a digital ID Card.

How Do Medicare Advantage Plans Provide Extra Benefits At A Reasonable Price

Medicare Advantage plans harness the power of care networks. These are groups of doctors and other health care professionals who contract with your plan. These networks help keep costs down. It also means your care may not be covered if you go outside your plans network. So before you sign up, make sure your favorite doctors are in a plans network.

Are The Ratings And Consumer Reviews Positive

Medicare star ratings vary by state, but the overall rating for 2021 is 4 out of 5 stars.

Aetna Vs Uhc: Medicare Part D And Medicare Supplement Plans

Medicare Part D plans provide coverage for prescription medications, which is not something typically covered by Medicare Part A or Part B .

Aetna Medicare Plan Options

Aetna offers a wide selection of HMO and PPO Medicare Advantage Plans. Coverage options vary by county, but if you live in a major city, you can typically choose between four to 10 plans. HMOs have lower copays and out-of-pocket expenses since most services are delivered by a network of contracted providers.

History Of The Company

The Aetna company has been around for a long time. Its a company that has traditionally sold insurance and other services. The main payers are employment-paid benefits or through Medicare. In 2008, the company became a subsidiary of CVS.

How do Medicare Advantage HMO-POS plans work?

Most of our HMO-POS plans provide you with flexibility to go to licensed dentists either in or out of our network for routine dental care. However, you may pay more for out-of-network care you receive.

Does a dental plan have RX coverage?

Yes. Yes, if plan has Rx coverage . Yes, if plan has Rx coverage. Dental, vision and hearing coverage. Yes. Yes, in most plans. Yes, in many plans. ER and urgent care coverage worldwide. Yes.

Does Aetna have a network?

With Aetna Medicare Advantage HMO-POS plans, you have a network of providers to use for medical care. Most of our HMO-POS plans require you to use a network provider for medical care. But there are options to go out of network for dental care. That gives you more choice and flexibility.

Does Aetna offer meals at home?

Meals-at-home program. (meals delivered to your home after a hospital stay) Yes, in many plans. Yes, in many plans. Yes, in many plans. Aetna Medicare Advantage plans at a glance. Our HMO-POS plans. Requires you to use a provider network. Varies by plan.

Is seeing out of network dental providers more expensive?

Varies by plan. Seeing out-of-network providers generally costs more. But most allow non- network dental providers.

Is there an OTC benefit for HMO?

Over-the-counter (OTC) benefit (get select OTC items at no charge) Yes. Meals-at-home program. (meals delivered to your home after a hospital stay) Yes, in many plans. Our HMO plans. Requires you to use a provider network.

Does Aetna offer Medicare Advantage?

Medicare Advantage plans for every need. In addition to HMO-POS plans, Aetna offers you other Medicare Advantage plan options — some with a $0 monthly plan premium. We can help you find a plan that’s right for you.

What is Aetna responsible for?

It is a pioneer in health care legislation and is responsible for making coverage of genetic testing and counseling an industry standard. Highly customizable selection of plans: Aetna allows consumers to pick and choose features such as the deductible amount, type of coverage and ability to choose a provider.

Is Aetna worth having insurance through?

Their copays and deductibles are terrible. They are a reflection of how broken the US insurance system is. It's pretty much not worth having insurance through them at all, you may as well just bankroll savings or switch providers instead of giving funds to these frauds.

Is Aetna Max Choice Gold deductible?

I have Aetna Max Choice Gold with a high deductible. The good thing is that Aetna is accepted most places. But all prescriptions and non-preventive office visits are subject to deductible which means you pay the whole contracted price of the prescription or visit instead of a copay or %.

What is HMO health care?

Our Health Maintenance Organization (HMO) benefits plans offer a nice choice of providers with the comfort of guided care to help members reach their best heath, at the best costs possible.

What is an HMO plan?

The HMO plan is ideal for employers in urban locations who want to offer simple, convenient care with fixed, predictable costs. Members must choose a PCP* to guide their treatment and coordinate all specialist care — which all takes place in a quality network to keep costs in check.

Is there a place like Aetna?

There’s no place like Aetna to find the plans, programs, services and administration you need to help keep your business strong and healthy.

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