Types of Aetna Insurance: Medicare, Commercial, and More

Author

Reads 765

Health Insurance Scrabble Tiles on Planner
Credit: pexels.com, Health Insurance Scrabble Tiles on Planner

Aetna offers a variety of insurance options to fit different needs and circumstances.

Medicare plans from Aetna are designed for individuals 65 and older, or those with disabilities.

Commercial insurance plans from Aetna are available to individuals and families who are not yet eligible for Medicare.

Aetna also offers group insurance plans for employers to provide coverage for their employees.

Types of Aetna Insurance

Aetna offers a variety of health insurance plans to meet the diverse needs of individuals, families, employers, and other groups. The specific plans available may vary depending on factors such as location and eligibility.

Here are some common types of Aetna plans:

  • Health Maintenance Organization (HMO) Plans: HMO plans typically require members to choose a primary care physician (PCP) and obtain referrals from the PCP to see specialists.
  • Preferred Provider Organization (PPO) Plans: PPO plans offer more flexibility in choosing healthcare providers, and members can see any healthcare provider but usually pay less when they use network providers.
  • Exclusive Provider Organization (EPO) Plans: EPO plans are similar to PPO plans but have more restrictions on out-of-network coverage.
  • High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs): HDHPs have higher deductibles than traditional health plans, but they often come with lower premiums.
  • Point of Service (POS) Plans: POS plans combine features of HMO and PPO plans, and members choose a primary care physician and can receive referrals for specialist care.
  • Medicare Advantage Plans: Aetna offers Medicare Advantage plans, also known as Medicare Part C, which provide all the benefits of Original Medicare (Parts A and B) plus additional benefits.
  • Medicare Supplement (Medigap) Plans: These plans help cover some of the out-of-pocket costs associated with Original Medicare.

These are just a few examples of the types of Aetna plans available, and it's essential for individuals to carefully review plan options and consider their healthcare needs and budget when selecting a health insurance plan.

Aetna Plans Available

Aetna offers a variety of health insurance plans to meet the diverse needs of individuals, families, employers, and other groups.

A Health Insurance Spelled on Scrabble Blocks on Top of a Notebook Planner
Credit: pexels.com, A Health Insurance Spelled on Scrabble Blocks on Top of a Notebook Planner

The specific plans available may vary depending on factors such as location and eligibility.

Aetna's plans include Health Maintenance Organization (HMO) Plans, which typically require members to choose a primary care physician (PCP) and obtain referrals from the PCP to see specialists.

These plans often have lower out-of-pocket costs but require members to use network providers for covered services.

Preferred Provider Organization (PPO) Plans offer more flexibility in choosing healthcare providers, allowing members to see any healthcare provider, but they usually pay less when they use network providers.

PPO plans typically do not require referrals to see specialists.

Exclusive Provider Organization (EPO) Plans are similar to PPO plans but have more restrictions on out-of-network coverage, requiring members to use network providers for all covered services, except in emergencies.

High Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs) have higher deductibles than traditional health plans, but they often come with lower premiums.

Members can pair an HDHP with an HSA, a tax-advantaged savings account used to pay for qualified medical expenses.

A Woman wearing Face Mask holding Insurance Policy
Credit: pexels.com, A Woman wearing Face Mask holding Insurance Policy

Point of Service (POS) Plans combine features of HMO and PPO plans, requiring members to choose a primary care physician and receive referrals for specialist care, but also allowing them to see out-of-network providers at a higher cost.

Medicare Advantage Plans, offered by Aetna, provide all the benefits of Original Medicare (Parts A and B) plus additional benefits such as prescription drug coverage (Part D) and vision or dental coverage.

Medicare Supplement (Medigap) Plans help cover some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance.

Here are some common types of Aetna plans:

  • HMO (Health Maintenance Organization) Plans
  • PPO (Preferred Provider Organization) Plans
  • EPO (Exclusive Provider Organization) Plans
  • HDHP (High Deductible Health Plan) with HSA (Health Savings Account)
  • POS (Point of Service) Plans
  • Medicare Advantage Plans
  • Medicare Supplement (Medigap) Plans

Commercial

Aetna offers a range of commercial insurance options, including PPO, HMO, and POS plans.

One notable provider is Aetna itself, offering PPO, HMO, and POS plans.

Anthem BC/BS also offers PPO and POS plans, while Anthem HealthKeepers provides HMO coverage.

CIGNA Healthcare of Virginia offers PPO, HMO, and POS plans, giving customers flexibility in their insurance choices.

Here are some of the commercial insurance providers listed:

  • Aetna (PPO, HMO, POS)
  • Anthem BC/BS (PPO, POS)
  • CIGNA Healthcare of Virginia (PPO, HMO, POS)
  • United HealthCare (PPO, HMO, POS)

Optima Health Plan also offers PPO, HMO, and POS plans, providing customers with a range of options to suit their needs.

Understanding Aetna Insurance Plans

Person Holding Insurance Policy Contract
Credit: pexels.com, Person Holding Insurance Policy Contract

Aetna offers a variety of health insurance plans to meet the diverse needs of individuals, families, employers, and other groups. The specific plans available may vary depending on factors such as location and eligibility.

HMO plans typically require members to choose a primary care physician (PCP) and obtain referrals from the PCP to see specialists. These plans often have lower out-of-pocket costs but require members to use network providers for covered services.

PPO plans offer more flexibility in choosing healthcare providers. Members can see any healthcare provider, but they usually pay less when they use network providers. PPO plans typically do not require referrals to see specialists.

EPO plans are similar to PPO plans but have more restrictions on out-of-network coverage. Members typically must use network providers for all covered services, except in emergencies.

HDHPs have higher deductibles than traditional health plans, but they often come with lower premiums. Members can pair an HDHP with an HSA, a tax-advantaged savings account used to pay for qualified medical expenses.

You might enjoy: Insurance Self Pay

A Doctor doing a Medical Examination on an Elderly Man at Home
Credit: pexels.com, A Doctor doing a Medical Examination on an Elderly Man at Home

POS plans combine features of HMO and PPO plans. Members choose a primary care physician and can receive referrals for specialist care, but they also have the option to see out-of-network providers at a higher cost.

Medicare Advantage plans provide all the benefits of Original Medicare (Parts A and B) plus additional benefits such as prescription drug coverage (Part D) and vision or dental coverage.

Medigap plans help cover some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance.

Aetna Insurance Plan Options

Aetna offers a variety of health insurance plans to meet diverse needs. These plans can be categorized into several types, each with its own set of features and benefits.

HMO plans require members to choose a primary care physician (PCP) and obtain referrals from the PCP to see specialists. These plans often have lower out-of-pocket costs but require members to use network providers for covered services.

Senior man consulting doctor online, holding medicine and glass indoors.
Credit: pexels.com, Senior man consulting doctor online, holding medicine and glass indoors.

PPO plans offer more flexibility in choosing healthcare providers. Members can see any healthcare provider, but they usually pay less when they use network providers. PPO plans typically do not require referrals to see specialists.

Aetna also offers Medicare Advantage plans, which provide all the benefits of Original Medicare (Parts A and B) plus additional benefits such as prescription drug coverage (Part D) and vision or dental coverage.

Here are some common types of Aetna plans:

  • HMO (Health Maintenance Organization) Plans
  • PPO (Preferred Provider Organization) Plans
  • EPO (Exclusive Provider Organization) Plans
  • POS (Point of Service) Plans
  • Medicare Advantage Plans
  • Medicare Supplement (Medigap) Plans

Medicare Advantage Plan Options

Aetna offers a range of Medicare Advantage plans that provide additional benefits beyond Original Medicare. These plans are designed to meet the diverse needs of individuals, and the specific plans available may vary depending on factors such as location and eligibility.

Medicare Advantage plans, also known as Medicare Part C, provide all the benefits of Original Medicare (Parts A and B) plus additional benefits like prescription drug coverage (Part D) and vision or dental coverage. This can be a good option for those who want more comprehensive coverage.

Expand your knowledge: Do I Need Both Fehb and Medicare

Senior adults stretching on yoga mats inside a gym, promoting health and fitness.
Credit: pexels.com, Senior adults stretching on yoga mats inside a gym, promoting health and fitness.

Aetna's Advantra Medicare Advantage plans offer the same basic coverage as Original Medicare, along with a wide range of other benefits. This may make them a good option for some people.

Here are some common features of Medicare Advantage plans offered by Aetna:

It's essential to carefully review plan options and consider your healthcare needs and budget when selecting a Medicare Advantage plan.

POS: Affordable Plan with Out-of-Network Coverage

A POS plan is a great option for those who want out-of-network coverage without breaking the bank. It's like an HMO, but with slightly higher premiums.

You'll typically need a referral from your primary care physician (PCP) to see a specialist, but this plan does cover out-of-network doctors. This is a big deal if you're managing a condition and your doctors aren't all in-network.

Donald, a 43-year-old divorced dad, is a great example of someone who benefits from a POS plan. He has type 1 diabetes and sees several specialists regularly, and he knows he's covered when he's visiting his girlfriend or son out of state.

Aetna Insurance Transformation

Medical Practitioners in Office
Credit: pexels.com, Medical Practitioners in Office

In 2010, Aetna Insurance underwent a significant transformation with the appointment of Mark Bertolini as its CEO, who led the company's shift towards a more consumer-centric approach.

Aetna's transformation was also marked by a major acquisition in 2011, when it bought Coventry Health Care for $5.6 billion, expanding its presence in the Medicare Advantage market.

Aetna's focus on prevention and wellness led to the launch of its "Wellness4Life" program in 2012, which provided members with personalized health advice and incentives to adopt healthy behaviors.

Aetna's transformation was also driven by a commitment to digital innovation, with the launch of its mobile app in 2013, which allowed members to manage their health and benefits on-the-go.

Aetna's Medicare Advantage plans have been particularly successful, with the company's 2013 acquisition of Coventry Health Care contributing to its strong market position in this area.

For another approach, see: What Is Insurance Types

Frequently Asked Questions

What is the difference between Aetna HMO and Aetna PPO?

Key differences between Aetna HMO and Aetna PPO plans include the need for a referral to see a specialist with HMO, whereas PPO allows direct specialist visits. Choosing between the two depends on your healthcare needs and preferences

How do I know what type of insurance I have with Aetna?

To find out what type of insurance you have with Aetna, visit your Aetna member website and log in with your member number from your ID card. You can also call the number on your ID card for assistance.

Is Aetna PPO a good insurance?

Aetna PPO is a good choice for those who need to see specialists or out-of-network doctors, offering low copays and coinsurance for in-network care. Consider this plan if you anticipate needing more healthcare services in the coming year.

Wilbur Huels

Senior Writer

Here is a 100-word author bio for Wilbur Huels: Wilbur Huels is a seasoned writer with a keen interest in finance and investing. With a strong background in research and analysis, he brings a unique perspective to his writing, making complex topics accessible to a wide range of readers. His articles have been featured in various publications, covering topics such as investment funds and their role in shaping the global financial landscape.

Love What You Read? Stay Updated!

Join our community for insights, tips, and more.