Aetna: Marketplace Insurance Or Not?

Aetna is a health insurance company that offers plans for individuals and families. They are a subsidiary of CVS Health and provide access to their network of local doctors, specialists, and hospitals. Aetna offers a range of benefits, including $0 preventive care, $0 MinuteClinic visits, and $0 virtual care. They also provide a $100 annual allowance for over-the-counter CVS Health brand products and discounts on dental care through their Aetna Dental Direct plan. Aetna's plans are available on the individual insurance exchange marketplace in select counties across 17 states, including California, Florida, Georgia, Illinois, and Texas.

Aetna CVS Health insurance plans

The plans combine the quality coverage of Aetna with the convenience of CVS, offering affordable access to a broad range of health services. Members can access the following benefits:

• $0 preventive care
• $0 MinuteClinic visits
• $0 virtual care
• Up to $100 allowance for over-the-counter CVS Health brand products
• 20% off CVS Health brand items
• 24/7 virtual care
• Walk-in visits at over 1,000 MinuteClinic locations
• Pediatric services, including oral and vision care
• Maternity and newborn care
• Mental health and substance use disorder services
• Prescription drugs
• Wellness services and screenings at MinuteClinic locations
• Generic prescriptions for a $5 or less copay
• Access to the Aetna network of local doctors, specialists, and hospitals

Aetna Dental Direct plans

Benefits

• Affordable plans. Plan options start at $20.
• Choice of providers. You get access to a nationwide network with your choice of more than 445,000 dental providers.
• The coverage you need. You’re covered for fillings, crowns, root canals and more.
• Plan extras. Aetna Dental plans include access to CVS ExtraCare Plus membership, including a $10 monthly reward, free delivery and more.

Plan Options

• Aetna Dental Direct Preferred PPO – the highest level of coverage if you need more than routine dental care.
• Aetna Dental Direct Core PPO – the same as the Preferred plan with a lower premium, but you may pay more for services.
• Aetna Dental Direct Preventive PPO – budget-conscious coverage for routine care with the lowest monthly premium. Available in AZ, CA, FL and ME.

Costs

The monthly costs shown are examples of the lowest monthly rates. Your cost may vary based on the individual dental plan you choose and the number of people you insure. Once you choose a plan, check your plan documents for your covered services and benefit levels.

Other Options

If you're looking for an alternative to dental insurance, you can get instant savings off the cost of most dental services with the Aetna Vital Savings discount card.

Aetna Vital Savings Dental

The program offers savings on the following dental services:

• Cleanings
• X-rays
• Root canals
• Crowns
• Dentures
• Implants
• Braces
• Cosmetic work such as teeth whitening and veneers

In addition to dental services, the program also offers savings on vision care through the Vision One discount program.

The program has two payment options:

• Monthly payments starting at $7.99 per month
• Annual payments of $75 for the whole year

A one-time $20 startup fee is required for enrollment, and individuals can choose to add pharmacy discounts for an additional fee.

Aetna Better Health of Texas

• Preventative care, such as flu shots, at no cost.
• $25 of over-the-counter health supplies and products from CVS Health every month, at no extra cost.
• Medicaid coverage for kids, newborns, pregnant women, and some families.
• Medicaid coverage for kids and adults aged 20 or younger with disabilities.
• Coverage for families that earn too much money to use Medicaid but can't afford private health insurance.
• Coverage for mothers-to-be.
• 24-hour nurse line.
• Help lines for STAR, STAR Kids, and CHIP.
• Pharmacy benefits, mail-order medicine, and specialty medicine.
• Vision and dental care.
• Non-emergent medical transportation services.

In addition to the benefits offered by Aetna Better Health of Texas, members can also take advantage of the following benefits offered by CVS Health:

• Up to a $100 annual allowance for over-the-counter CVS Health brand products.
• 20% off CVS Health brand items with the barcode on the member's ID card.

Aetna ACA exchanges

Aetna CVS Health offers Affordable Care Act (ACA) individual and family health insurance plans in 17 states. These plans are available on the individual insurance exchange marketplace in select counties.

Aetna exited the ACA exchanges in 2018 following years of losses but returned to the exchanges at the beginning of 2022. In September 2022, Aetna announced that it would enter the ACA exchanges in four more states for the 2023 plan year: California, Delaware, Illinois, and New Jersey. This brought the total number of states with access to Aetna ACA exchange plans to 12.

Aetna ACA exchange plans are co-branded with CVS Health and offer access to Aetna's provider network, including local doctors, specialists, and hospitals, in tandem with walk-in visits at CVS MinuteClinics and on-demand virtual care. The plans cover a range of services, including pediatrics, emergency care, lab services, prescription drugs, and mental health care.

Aetna ACA exchange plans offer benefits such as $0 preventive care, $0 MinuteClinic visits, and $0 virtual care. Members also have access to a $100 annual allowance for over-the-counter CVS Health brand products and a 20% discount on CVS Health brand items.

Aetna's ACA exchange plans aim to provide quality, affordable healthcare with convenient access through virtual technology and in-person care.

Frequently asked questions