At some point, everyone needs to have health insurance coverage.
A reality of life is that we get sick, we get hurt, or we simply age – and that in itself can bring on health issues.
However, the type of insurance coverage you need depends on a few factors, primarily your age, income, and your general state of health.
How you obtain your health coverage is important, as well.
For example, are you a small business owner looking to offer health insurance coverage to your employees? Or are you an individual or parent with a family needing to obtain coverage on your own? In addition, if you’re someone whose income qualifies you for Covered California, your options will be determined for you. And, as is increasingly the case, you may be a senior looking for a California Medicare plan.
The downside to all of this is that health insurance has become costly and complex. The upside is that you have professional resources like J. C. Lewis Insurance to guide you through the process.
Health Insurance: Getting Covered in California
While there are hundreds of health insurance providers in the United States, there are only a handful that provide services in the state of California.
And, overall, the top five health insurance companies serving California are:
- Anthem Blue Cross
- Kaiser Permanente
- United Health Care
In this article, we are going to place the spotlight on Aetna.
Aetna Health Insurance for California
Aetna is the third-largest insurance company in the United States in terms of members with over 22 million members nationwide. It ranks about #6 for market share, putting it solidly in the top then providers in the country.
According to an article from ValuePenguin,
“Aetna was acquired by CVS Health Corp. in 2018. CVS now operates the company and has been able to seamlessly integrate its provider networks with Aetna’s membership base. Founded in 1853, Aetna is the third-largest provider of health insurance and services. However, most of its membership comes from providing health insurance to employers and its employees in the private market. Since 2015, Aetna has removed itself from all Affordable Care Act marketplaces due to a loss in revenue.”
Aetna is not included as one of the health insurance companies currently available through the state’s health insurance exchange, or Covered California.
Although better known for its employer plans, Aetna does offer individual plans in California and their Bronze plans have often been some of the most affordable, according to reviewers.
According to the Aetna corporate website,
“Aetna offers health insurance, as well as dental, vision and other plans, to meet the needs of individuals and families, (and) employers.”
How Aetna Fares with Members
No company is perfect, and most health insurance providers seem to struggle with delivering quality care and customer service consistently. That being said, some organizations are significantly better than others, at least based on reviews and member feedback.
And Aetna appears to be among the better-rated organizations providing health insurance coverage for Californians.
For example, The Balance.com notes that,
“Aetna has an excellent reputation among members and is also one of the largest for-profit health insurers in the country. And, like UnitedHealthcare, Aetna also has an “A” (excellent) financial strength rating with AM Best Company.”
In addition, in the 2019 J.D. Power & Associates Commercial Member Health Plan Study, Aetna received five stars in overall customer satisfaction for the Delaware, West Virginia, and Washington D.C. areas.
Aetna offers affordable private health insurance plans for employers and individuals with options including:
- Preventive care
- Office visits
- Wellness programs
- Weight-loss programs
- Health coaching
- And other types of essential health care services
Some of the upsides of Aetna include their HSA plans, which members can use with high-deductible plans. However, the company’s website and apps only received a 3.5-star rating from Insure.com. Customer service might be an issue, as well, as only 75 percent of customers have indicated that they would recommend Aetna to a friend.
Rating Aetna’s HMO
A service provided for consumers by the State of California’s Office of the Patient Advocate (OPA) is their Health Care Quality Report Cards. These include a Health Plan Report Card for each provider doing business in the state of California.
Here are the results of the OPAs report card for Aetna Health of California, Inc. – HMO 2020-21 Edition:
- OVERALL QUALITY OF MEDICAL CARE Good
- Appropriate Use of Tests, Treatments and Procedures Very Good
- Asthma and Lung Disease Care Poor
- Diabetes Care Good
- Heart Care Fair
- Maternity Care Poor
- Behavioral and Mental Health Care Very Good
- Preventive Screenings Very Good
- Treating Adults Excellent
- Treating Children Fair
In addition, the state’s report card includes a patient rating scorecard:
- PATIENTS RATE OVERALL EXPERIENCE Good
- Getting Care Easily Poor
- Satisfaction with Plan Services Too few patients in sample to report
- Satisfaction with Plan Doctors Fair
While there are a few areas of concern based on these ratings, Aetna does manage to provide a good quality of medical care and a good patient experience overall.
Expert Guidance from a Local Company
JC Lewis Insurance, a family-owned firm of expert brokers based in Sonoma County, offers California health insurance plans only from the leading health insurance carriers licensed to do business in California.
Not only are we expert brokers, but we are also licensed and certified by each of these insurance carriers to offer coverage to individuals, families, and small group employers in addition to Medicare supplemental and prescription drug plans for seniors.
If you are self-employed, or your employer doesn’t provide health benefits, an individual or family plan may be the best option for you or you and your family.
And if you’re looking to purchase medical insurance for you and your family, you will likely have many questions and concerns. Bring your questions about health coverage insurance and you can be confident that JC Lewis Insurance Services will help you find the right solution.