Aetna vs Anthem Blue Cross. Which Health Insurance Is Better?

Medical health insurance is medical insurance, proper?

Not fairly.

Each well being protection supplier is completely different. So are the plans they provide and, to a sure extent, so is the standard of suppliers. For this reason comparisons are sometimes tough. And what makes comparisons much more problematic is that each buyer can also be completely different and has completely different wants or necessities in the case of healthcare and medical insurance protection.

So, after we method a subject corresponding to Aetna vs Blue Cross, you will need to remember that it’s not a lot a matter of “Which is healthier?” as “Which is healthier for me?”

Well being Insurance coverage as a Battle of the Titans

On one hand, the number of selections out there to employers and people seeking to purchase healthcare insurance coverage is a plus. Having the ability to match a supplier and a plan that most accurately fits one’s wants is definitely way more fascinating than a “one dimension matches all” well being plan.

Nevertheless, then again, the massive variety of selections may also be a bit overwhelming and complicated. And the way does one go about figuring out which suppliers are finest general? 

At present in California, there are a number of giant well being insurers working within the state and, amongst them, Aetna and Blue Cross, or Anthem Blue Cross as it’s recognized in California, are among the many high 5. 

Who Is Aetna?

Whereas Aetna is a nationwide medical insurance firm and affords insurance policies in each state, it doesn’t rank within the high ten suppliers when it comes to monetary dimension or membership.

In California, Aetna affords protection to employers within the small and huge group markets however is just not a part of the state’s well being market trade, Lined California, nonetheless. Nationally, Aetna has a superb popularity and has an AM Greatest “A” monetary energy ranking.

In 2018, Aetna was acquired by CVS Well being, however nonetheless gives employer well being plans in all 50 U.S. states. The Steadiness voted Aetna as “Greatest for Employer-Based mostly Plans” and famous that Aetna additionally affords reasonably priced non-public medical insurance choices and that members even have entry to HSA plans.

Moreover, The Steadiness evaluation goes on to state that,

“There’s a giant supplier community, so members will be capable to discover an Aetna-approved supplier irrespective of the a part of the nation they reside in. Community plan choices enable members to see an in-network physician or any licensed physician, though seeing ​a community physician will present the best financial savings. Aetna affords a number of varieties of supplier plans together with HMO, POS, PPO, EPO, and HDHP with HSA.”

Aetna additionally makes quite a few wellness applications out there to members that embrace gymnasium memberships, well being teaching, weight-loss applications, and extra.

For employers, Aetna group plans enable them to supply full, medium, and narrow-network HMO networks to their staff on the identical time. This can be a diploma of plan flexibility that’s uncommon within the California market.

A Have a look at Anthem Blue Cross 

In California, Blue Cross does enterprise as Anthem Blue Cross, which serves because the commerce title of Blue Cross of California. Because the second-largest medical insurance coverage supplier in the US by whole members, Blue Cross serves over 40 million members nationwide.

In California, Anthem Blue Cross gives protection for extra residents than every other medical insurance supplier within the state at over 8 million members. As well as, Blue Cross has been part of Lined California from the start of the state’s well being trade in 2014.

There are numerous coverage choices and Anthem Blue Cross affords HMO, PPO, EPO, and HSA plans for small teams, giant teams, and seniors.  Anthem insures extra PPO members in California than every other insurance coverage firm and their in depth PPO networks embrace most medical doctors and hospitals.

Aetna vs Blue Cross – How Do They Charge?

Based on the State of California, Workplace of the Affected person Advocate (OPA), for 2020-21, Aetna’s PPO plan ranked as “Truthful” general for the standard of medical care. 

Within the space of “Acceptable Use of Checks, Remedies and Procedures” and “Behavioral and Psychological Well being Care” they have been ranked as “Very Good”, and as “Good” for the “Preventive Screenings” class.

All different classes ranked by the OPA together with Bronchial asthma and Lung Illness Care, Diabetes Care, Coronary heart Care, and Maternity Care all acquired a “Truthful” rating.

A affected person’s ranking of their general expertise got here out as “Truthful” primarily based on the next indicators:

• Getting Care Simply: Poor
• Satisfaction with Plan Providers: Truthful
• Satisfaction with Plan Medical doctors: Good

Aetna’s HMO plan for a similar interval fared higher, with an general rating of “Good” with the identical classes of “Acceptable Use of Checks, Remedies and Procedures” and “Behavioral and Psychological Well being Care” each scoring “Very Good”, together with “Preventive Screenings.”

As well as, the class of Diabetes Care was thought-about “Good” versus simply “Truthful.”

Curiously, sufferers rated their general expertise with Aetna’s HMO as “Good” but scored the “Getting Care Simply” class as “Poor” and “Satisfaction with Plan Medical doctors” as simply “Truthful.” The class of “Satisfaction with Plan Providers” couldn’t be scored as there have been too few sufferers within the pattern to report.

• [Note: For a more in-depth look at how Anthem Blue Cross and Blue Shield of California fared in the OPA’s report card system, see this article.]

Yet one more supply for judging the general high quality of each these medical insurance suppliers is offered by the Nationwide Committee for High quality Assurance (NCQA).

Their web site, Well being Insurance coverage Rankings, ranks medical insurance plans primarily based on three broad classes of Buyer Satisfaction, Prevention, and Remedy. Right here is how they ranked Aetna vs Blue Cross:

Aetna HMO: 3.5 Total

• Buyer Satisfaction: N/A
• Prevention: 3.0
• Satisfaction: 3.0

Aetna PPO: 3.5 Total

• Buyer Satisfaction: 2.0
• Prevention: 2.5
• Satisfaction: 3.0

Blue Cross HMO: 3.5 Total

• Buyer Satisfaction: 2.0
• Prevention: 3.5
• Satisfaction: 3.0

Blue Cross PPO: 3.5 Total

• Buyer Satisfaction: 2.0
• Prevention: 3.0
• Satisfaction: 3.0
  

As we famous right here earlier, whereas the general high quality and popularity of any well being plan supplier is crucial, the ultimate resolution of which firm – and plan – to decide on rests on way over this. For this reason we strongly advocate making use of a educated and native useful resource like J.C. Lewis Insurance coverage to assist information you by the decision-making course of.

For Well being Insurance coverage in California, We Invite You to Go to J.C. Lewis Insurance coverage

We offer California medical insurance plans solely from the main medical insurance carriers licensed to do enterprise in California. In case you are purchasing for protection for your self or your staff, you should look no additional than J.C. Lewis Insurance coverage.

As a family-owned and operated California medical insurance agent situated in lovely Sonoma County, we specialise in medical insurance policy for small companies, people and households, and for folks with Medicare.

We’re professional brokers, and we’re additionally licensed and authorized by every insurance coverage provider. This permits us to supply protection to people, households, and small group employers, together with Medicare supplemental and prescription drug plans for seniors.

In case you are self-employed, or your employer doesn’t present well being advantages, a person or household plan could also be the best choice for you otherwise you and your loved ones.

And, if you’re seeking to buy medical insurance coverage protection for you or your loved ones, you’ll probably have many questions and issues. We invite you to contact us with these questions on well being protection insurance coverage and you may be assured that JC Lewis Insurance coverage Providers will enable you discover the proper answer.