Aetna Insurance Company was established in 1850, growing from a small life insurance fund into a large company. In 1953, the company’s life and health divisions separated.
UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. The company created the first network senior health plan in 1979, after receiving the licensing for this type of business from Minnesota.
Aetna and United Healthcare play a large role in the private Medicare insurance market. Beneficiaries can now choose from various Medicare options, including Medicare Advantage plans, Medicare Part D prescription drug plans, and Medicare Supplement Insurance plans.
We will compare Aetna’s and United Healthcare’s coverage options according to their networks, plan availability, costs, and quality ratings.
Table of contents
Overview
Aetna and United Healthcare are two of America’s largest healthcare insurers, offering high-quality policies nationwide.
Comparing and contrasting each company’s statistics, plans, features, and qualities is important before committing to a contract.
Once you have read this article, you may choose to buy a policy from Aetna or United Healthcare or decide that neither company has what you need to maintain your or your family’s health.
In this article, we review the pros and cons of each healthcare provider. Aetna and United Healthcare are two major health insurance companies in the United States.
Each company offers individual, and group plans and each has seen both lawsuits and popular pushback related to dropping people from their policies and raising premium prices.
Both also took an active interest in shaping the landmark health care reform bill of 2010, and executives from both companies played a role in consulting with President Barack Obama, members of Congress, and other leaders in the field on the best way forward for health care in America.
As leaders in the field with two different business models, choosing between Aetna’s health insurance products and United Healthcare’s is not easy.
See Also: EPO vs PPO Health Insurance: Which one is better?
Pros and Cons of Aetna vs United Healthcare
Pros
- United vs Aetna
- One of the largest insurance with large network of providers Robust benefits and healthcare plan for Medicaid and medicare
- Excellent customer services
- They have plans for people who do not qualify for Medicare and Medicaid.
- Earn reward on the app for healthy action. User-friendly mobile app
- They are in partnership with ARRP
Cons
- Aetna vs United Healthcare
- No individual insurance plan Plans are more expensive
- No short-term insurance health option Higher rate of customer dissatisfaction
- Does not work with independent agent
- Difficult to buy except offered by an employer
What are the enrollment Processes like? Aetna vs United Healthcare
United Healthcare
UnitedHealth Group offers insurance through state exchanges.
The company provides information on the plans it offers on its website, which is located at https://www.healthcare.gov/
Aetna
Aetna is a health insurance provider available through employer plans in the United States and online.
It also offers private, Medicare Advantage, Medicaid, student, and international health insurance.
Suppose you purchase an individual or family plan directly from Aetna or a marketplace. In that case, you can also compare rates from several companies for ACA, short-term, and medical indemnity plans. Start your enrollment here.
You may want to see How Insurance Companies Pay Out Claims
How to File a Claim with Aetna and United Healthcare Insurance
Aetna
You may use a network provider or choose an out-of-network doctor for your treatment, but the network provider will submit network claims.
If you see an out-of-network provider, you must submit the claim yourself.
To do this, you must complete and submit a form to the plan, providing details of services rendered and charges due from the doctor or hospital.
Alternatively, you may submit a detailed description of services and charges incurred directly to the plan.
United Healthcare
United Health Group pays network providers directly. If an out-of-network provider bills you, you may contact UnitedHealth Group at 1 (800) 328-5979.
If you submit a claim for an out-of-network provider in the case of an emergency or if you were referred to that provider by United Health Group.
When filing a claim for out-of-network care, you must attach a written statement stating why an out-of-network provider provided the care.
Include the following information with your claim:
- The Policyholder’s name and address.
- The patient’s name and age.
- That number stated on your ID card.
- The name and address of the provider of the service(s).
- The name and address of any ordering Physician.
- A diagnosis from the Physician.
- An itemized bill from your provider that includes the Current Procedural Terminology (CPT) codes or a description of each charge.
- The date the Injury or Sickness began.
- A statement indicating either that you are or you are not, enrolled for coverage under any other health insurance plan or program. If you are enrolled for other coverage, you must include the name of the other carrier(s).
What are the types of plans offered by Aetna and United Healthcare insurance?
Aetna and UnitedHealthcare each sell the main types of Medicare Advantage plans.
They are:
- POS plans (Point-of-Service)
- HMO plans (Health Maintenance Organization)
- SNPs (Special Needs Plans)
- PPO plans (Preferred Provider Organization)
- Aetna does not offer Special Needs Plans for people who have chronic conditions.
- Furthermore, United Healthcare also sells Chronic Condition Special Needs Plans (C-SNP) and Institutional Special Needs Plans (I-SNP).
- C-SNPs are tailored specifically to beneficiaries with certain conditions, and United Healthcare’s plans include options for those with diabetes, chronic heart failure and cardiovascular disorders.
- I-SNPs are designed to meet the needs of beneficiaries under particular living circumstances.
In the case of United Healthcare, these include plans for those in assisted living homes and nursing homes. United Healthcare trumps Aetna in this category.
Network providers of Aetna and United healthcare
United Healthcare and Aetna both come with a large network of providers. United Healthcare has over 1.3 million healthcare professionals in its network, while Aetna claims approximately 1.2 million.
You shouldn’t have trouble finding a doctor, specialist, hospital, or pharmacy no matter which company you choose to do business with.
United Healthcare claims the largest market share of Medicare Advantage beneficiaries in the nation (26%) compared to Aetna, which claimed 11% of all Medicare Advantage beneficiaries in 2020 for the 4th-largest share.
Aetna Vs United healthcare group statistics comparison
Aetna
- 15.8 million policyholders
- Benefits through employers in all 50 states
- Administers Medicare and Medicaid in selected states
- 462,000 physicians and primary care doctors
- 4,716 hospitals
- A.M. Best rating of A
READ ALSO: Health Care Vs Private Insurance: What You Should Know
United Healthcare Group18 million policyholders
- Benefits through employers in all 50 states with 4 international markets
- 470,000 physicians and primary care doctors
- 4,500 hospitals
- A.M. Best rating of A
Conclusion
Although both companies offer the same types of plans, United Healthcare has a slightly larger network of healthcare providers. It provides an expanded menu of Medicare Advantage Plans, which may appeal to people with a diverse range of special medical needs.
At the same time, Aetna’s ratings for its Medicare plans are slightly better than United Healthcare’s, as are its drug coverage policies.
As you consider your options for Medicare, remember to research the various plan options in your area.
References
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