Aetna vs. Blue Cross

At a Glance

Aetna vs. Blue Cross: Policy Types

Aetna and Blue Cross offer virtually the same types of coverage, including HMO, PPO, HSA, POS, FSA, and indemnity plans. Because Blue Cross and Aetna offer different policies in every state, the covered services and treatments will vary depending on where you live.

The major difference between these two providers is that Aetna doesn’t offer private individual or family plans. Currently, Aetna sells government-funded Medicare and Medicaid plans, as well as group health insurance, student health insurance through universities, and international insurance only. If you’re shopping for private individual coverage, Blue Cross offers a variety of policies with a range of coverage limits and deductibles.

In addition, Aetna and Blue Cross both offer vision and dental insurance. Aetna’s Dental Direct plan has no waiting period if you switch from a comparable plan. Blue Cross dental insurance does require a waiting period, but there are more plans to choose from.

You can get a Blue Cross dental insurance policy with a deductible as low as $25 and an annual maximum benefit up to $2,000. In most states, there are four Blue Cross dental plans available. With Aetna, most states have two plans available with a deductible of $50 and an annual maximum benefit between $1,000 and $1,250.

Aetna vs. Blue Cross: Cost 

The cost of health insurance is different for everyone. Your premium depends on the type of plan you choose, the coverage limit, the deductible, your age, your state, and the insurance company.

If you qualify for Medicare, you might be able to get free Medicare Part A coverage through Aetna, and some plans also come with a $0 deductible. However, you typically need to pay for Medicare Part B, which covers things like preventative care and ambulance rides. 

Because Blue Cross sells coverage through 34 independent local companies, the rates vary significantly based on where you live, as each state has different plans. To give you an idea of how much you might pay for Blue Cross coverage, we got sample quotes for a 50-year-old female in a few different states:

Both companies make it easy to get a personalized quote online. Just keep in mind that for Blue Cross, you have to visit your state’s website in order to get an accurate quote. As an alternative, you can apply through your state’s insurance marketplace to see what Blue Cross and Aetna plans are available with premium subsidies. 

Also, neither company advertises a discounted rate if you purchase a family or couples plan, but choosing a high-deductible policy can help you get a lower monthly premium.  

Aetna vs. Blue Cross: Coverage Limits

Whether you have health insurance through Aetna or Blue Cross, the out-of-pocket coverage limits will depend on the specific policy you buy.

For instance, Aetna’s Level 1 PPO plan has an annual maximum benefit of $15,000 for in-network care, and the Level 2 PPO plan has an annual maximum benefit of $25,000 for in-network care. There are also individual limits for various services and treatments.

With Blue Cross, the coverage limits depend on your state’s plans. In most states, Blue Cross offers Bronze, Silver, and Gold plans with varying out-of-pocket maximums and deductibles. We recommend visiting your state’s Blue Cross website to see the available plans and the amount of coverage they offer.

Aetna vs. Blue Cross: Availability

Aetna and Blue Cross both sell health insurance in all 50 states and Washington, D.C. However, specific plan types and coverage limits will vary depending on location. 

Aetna vs. Blue Cross: Policy Management

Aetna and Blue Cross have standard options for policy management. Both companies have an online member portal that allows you to see your policy information, view the status of claims, and make updates to your plan.

You can get in touch with customer service agents for Aetna and Blue Cross by calling their main phone numbers during business hours. Neither company offers 24/7 support or an online chat feature.

With Aetna and Blue Cross, one of the best ways to manage your policy is through the company’s mobile apps, which are free to download on iOS and Android devices.

Aetna’s app allows you to search for doctors, view your claims, see your plan details, get your ID cards, track your spending, pay approved claims, and even compare costs for medical visits and procedures.

Blue Cross has a different app for each state, and the app features vary. At a minimum, you can find an in-network doctor or urgent care facility, access your claims, download your ID cards, view your policy information, and check your deductible and HSA balance. In some states, the app also allows you to pay your bills, research drug prices, submit out-of-network claims, and get connected with the 24-hour nurse hotline. 

Aetna vs. Blue Cross: Policyholder Experience

Overall, Aetna and Blue Cross have some concerning reviews from current and past policyholders. For both companies, many customers have complained about billing issues, slow claim payouts, and denied claims. Aetna specifically has a number of negative reviews related to its customer support agents. 

We also came across ratings for Blue Cross and Aetna in J.D. Power’s 2020 U.S. Medicare Advantage Study, which ranks insurance companies that offer Medicare Advantage plans based on coverage and benefits, cost, customer service, and more. 

Aetna was rated below average for overall customer satisfaction in J.D. Power’s study, as was Blue Cross of Michigan, the only local Blue Cross company rated. J.D. Power does not publish a study for private individual health insurance companies. 

Aetna vs. Blue Cross: Enrollment Process

To enroll in an individual health insurance plan from Blue Cross, you’ll have to do so during the annual open enrollment period. However, you can also purchase coverage outside of open enrollment if you have experienced a qualifying life event. Examples include giving birth, getting married, losing employer-sponsored coverage, getting divorced, and moving to a new state.

If you apply for coverage because you have experienced a qualifying life event, Blue Cross will ask to see documentation verifying the event. So, for instance, if you had a baby, your child’s birth certificate would be sufficient. If you lost your job, you could provide a letter of termination from your previous insurance company. 

If you qualify for Medicare, you can purchase an Aetna plan during the specific Medicare open enrollment period, which is separate from the individual open enrollment period. If you already receive Social Security benefits, you won’t need to verify your eligibility. However, if you are not receiving retirement benefits, or if you qualify for Medicare due to a disability, you will likely need to provide some documentation that proves you qualify for coverage.

Aetna and Blue Cross both offer online quotes and, in some cases, you can purchase a policy through the website. We found the online experience for both companies to be pretty good, but some Blue Cross states have a more outdated website than others. 

Methodology

To review Aetna and Blue Cross, we focused on some of the most important factors to consider when comparing health insurance companies. For each provider, we looked at the policies available, the cost of coverage, the coverage limits for various plans, the policy management tools, the overall customer experience, and the enrollment process. We also paid attention to the network size and area of availability for both companies.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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