Aetna vs Anthem: What Is The Difference?

Every health insurance provider is unique. So are the plans they offer, and to some extent, so is the provider quality. This is why making comparisons is so tough. What makes comparisons even more difficult is that each consumer is unique, with unique demands and expectations in terms of healthcare and health insurance coverage.

In this post, we’ll compare Aetna Health insurance and Anthem Health Insurance. We’ll also establish the basic difference between these two.
Make sure you read through this post to the end, as it’ll be very helpful and informative.

Medical care and services, such as wellness examinations, X-rays, prescription prescriptions, and procedures, are covered by health insurance. The majority of Americans receive health insurance via their work, but you can also get coverage through your state’s insurance marketplace or through a private provider on your own. When evaluating health insurance providers, take into account things like policy types, coverage limits, cost, and network size.

Let’s start by reviewing each company.

Table of contents

About Aetna

Aetna Insurance Company established a fund to market life insurance in 1850. Aetna’s life and health insurance divisions were split off in 1953. Eliphalet A. Bulkeley was the company’s first president. The name “Aetna” was inspired by an 11,000-foot volcano in Sicily, Italy, that was also Europe’s most active volcano.

Aetna provides coverage to employers in the small and large group markets in California, although it is not a part of the state’s health exchange, Covered California. They have a stellar national reputation and an AM Best “A” financial strength rating.

In 2018, Aetna was acquired by CVS Health. In spite of the acquisition, it continued to offer employer health plans in all 50 states. Aetna was named “Best for Employer-Based Plans” by The Balance, which also mentioned that Aetna offers reasonable private health insurance options and that members have access to HSA plans.

Despite the fact that Aetna is a nationwide health insurance provider with coverage in every state, it does not rank among the top ten in terms of financial size or membership.

Aetna currently provides Medicare, Medicaid, student health insurance, and overseas coverage. They provide individual and family policies through eHealth, which compares costs for Affordable Care Act plans, short-term plans, and medical indemnity plans from multiple firms. They sell government-funded Medicare and Medicaid plans, as well as group health insurance, university-based student health insurance, and overseas insurance alone.

On the flipside, Aetna does not offer private individual or family policies, which is the main distinction between Aetna and Anthem.

Aetna is a health insurance plan that is provided through participating companies. You can also request many free quotations from Aetna, the health insurance marketplace, or buy an individual or family plan directly from them.

Aetna Mobile Apps Options

You may use the Aetna Health app to select a doctor in your neighborhood and get pricing estimates for various treatments. You can also check your benefits, account balances, and claim status. The app is compatible with both iOS and Android devices. 29.3k iOS Aetna Mobile App users gave the app a 4.5 rating, while 2,316 Android Aetna Mobile App users gave the app a 3.4 rating.

READ ALSO: Health Care Vs Private Insurance: What You Should Know

Cost of Healthcare Insurance With Aetna

The cost of health insurance varies from person to person. The type of plan you choose, the coverage limit, the deductible, your age, your state, and the insurance company all influence your premium.

If you qualify for Medicare, Aetna may be able to provide you with free Medicare Part A coverage, with certain plans including a $0 deductible. However, Medicare Part B, which covers items like preventative care and ambulance rides, is usually an out-of-pocket expense.

How To File A Claim With Aetna

Your claims will be submitted by a network doctor or hospital if you utilize one. You must submit the claim yourself if you visit an out-of-network provider. A completed claim form or alternate documents must be faxed or mailed to the address below. Provide a description of services, a bill of costs from the provider, and any medical documentation you received from your provider instead of sending a claim form.

About Anthem

WellPoint Health Networks Inc and Anthem, Inc. joined in 2004 to form the country’s largest health-benefits provider. WellPoint Inc. changed its name to Anthem, Inc. in 2014. Anthem’s businesses provide healthcare plans and ancillary services such as dentistry, vision, behavioral health, life and disability insurance, long-term care insurance, and flexible spending accounts. 

Anthem is the 33rd largest company in the Fortune 500, with over 40 million subscribers. The headquarters of Anthem Inc. is in Indianapolis, Indiana. It is a Blue Cross and Blue Shield Association independent licensee that serves residents of California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin, as well as members of specialty plans in other states.

SEE ALSO: 10 Best Cheap Dental Insurance Companies in 2023

Anthem Enrollment Process

Anthem can be found on the health insurance exchange, or you can acquire multiple free quotes online. Each state operates its own market. Click here for details on how to start.

Anthem Mobile Apps Options

Only policyholders in five states can use the Anthem Medicaid app. Indiana, Kentucky, Nevada, Wisconsin, and Virginia are all states in the United States. Users can use the app to identify doctors, hospitals, and pharmacies, as well as view claims, pay bills, and manage medications. Anthem Mobile App has a 2.2 rating on iOS by 42 users while it has a 2.9 rating on android devices by 101 users.

How To File An Anthem Claim

Because each type of benefit plan is different, make sure you utilize the claim form provided by your benefit plan. Your doctor’s office will need to provide you with procedure codes. Fill out the papers as soon as possible. If necessary, include pre-approval.

Aetna vs. Anthem: Plan Comparison 

Aetna and Anthem both provide all three types of Medicare plans: Medicare Advantage, Medicare Supplement, and Part D prescription medication insurance. They also sell Special Needs Plans (SNPs), which are Medicare Advantage plans designed for people who have certain medical needs.

You may want to see How Insurance Companies Pay Out Claims

Rankings in the industry

Financial rating companies give both corporations good marks. However, Anthem’s rating (A) is somewhat better than Aetna’s (B) (BBB). These rankings reflect Standard & Poor’s assessment of a company’s ability to satisfy its financial obligations in the future. In summary, both Aetna and Anthem are expected to be able to pay their debts.

Aetna is the third-largest health insurance company in the United States. The company’s massive size allows it to provide a large number of in-network provider options. Anthem, which is the second-largest health insurance firm in the country, is even bigger than Aetna.

According to Anthem, one out of every eight Americans is covered by one of its associated plans.

Aetna serves a greater number of Medicare beneficiaries than Anthem. Aetna Medicare plans cover 2.2 million people, whereas Anthem Medicare plans on the other hand cover 1.9 million.

General Comparison: Overview

Aetna was founded in 1853, while Anthem, on the other hand, was founded in 2004. So, if you’re using years of the establishment to judge these healthcare companies, Aetna has higher credibility.

These two companies have an A+ BBB rating which shows that they both have high ratings.

In the NAIC complaint index, Aetna has 6.27 individual health insurance, while Anthem has 0.30% individual health insurance. Aetna and Anthem have a 4.53% and 6.3% market share percentage, respectively. They both have excellent financial strengths.

One good thing about Aetna is that Aetna is one of the largest insurance companies, with a wide provider network, while Anthem Inc. is one of the country’s top health insurance companies, with over 40 million members. Also, Anthem Inc. is a well-capitalized health-insurance company.

The downside about these companies is that Aetna Insurance is difficult to obtain unless it is provided by an employer. In 2014, Anthem was chastised for refusing to fund the hospitalization of a man with stage 4 malignancies. After a public uproar, Anthem agreed to pay for coverage.

Anthem was penalized in 2017 for not responding to concerns in a timely manner.


Your decision between Aetna vs. Anthem will depend upon the type of health plan that you hope to buy. This comparison is to help you make a better insurance choice. We really hope this article helps your search.


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