Aetna Vs. Premera: Comparing Health Insurance Providers

When it comes to health insurance, Aetna and Premera are two big names that often come up. Both provide comprehensive medical coverage to millions of Americans across the country.

However, there are some key differences between these two providers that are worth examining when choosing a plan for you or your family.

A Brief Comparison Table

Overview Of Aetna

Founded in 1853, Aetna is one of the oldest and largest health insurance companies in the United States. It offers a wide range of medical plans including HMO, PPO, POS and HDHP options. Some key facts about Aetna:

• Provides coverage to over 39 million members
• Offers individual, family, employer-sponsored and Medicare plans
• Has an extensive nationwide provider network with over 1.2 million doctors and healthcare facilities
• Received a rating of “A” (Excellent) from A.M. Best in 2022

• A large provider network so members have many options for doctors and hospitals
• Tools and resources to help members estimate costs and find providers
• Discounts and wellness programs such as gym memberships and quitting smoking
• Strong coverage for prescription drugs, mental health services and maternity care

• Higher premiums than some competitors for comparable coverage
• Prior authorizations required for some services before getting care
• Limited plan options in some rural or smaller metro areas

Overall though, Aetna offers solid medical insurance with good benefits for those needing comprehensive health coverage.

Overview Of Premera Blue Cross

Based in Washington state, Premera Blue Cross is the largest health insurer in the Pacific Northwest. It provides coverage in Washington, Oregon, and Alaska. Some quick facts on Premera:

• Covers over 2 million members
• Non-profit and independent licensee of the Blue Cross Blue Shield Association
• Offers individual, family, small group, and Medicare plans
• Has a strong reputation for customer satisfaction and service

Some of the advantages Premera is known for providing members include:

• A large regional network of doctors, hospitals and pharmacies
• Lower out-of-pocket costs than many competitors
• Programs to help members get and stay healthy
• Support in understanding benefits and managing healthcare expenses
• High marks for member experience and claims handling

Potential downsides to weigh with Premera:

• Primarily serves the Northwest region, less nationwide coverage
• May have gaps in rural area networks outside major cities
• Requires referrals for specialists with some HMO plans
• Select plans may limit options to network pharmacies

Premera is a great choice for those who live in the Northwest looking for localized service and competitive pricing. Just be aware that coverage can be more limited outside the Northwest region.

Comparing Plan Types

Both Aetna and Premera offer all the standard health insurance plan types – HMO, PPO, POS and HDHP. Here’s how the plans offered by each insurer compare:

HMO (Health Maintenance Organization)

• Aetna – Wide range of HMO options with copays for office visits and prescriptions
• Premera – Lower premiums but requires referrals to see specialists

• Aetna – More flexibility to see out-of-network doctors for higher costs
• Premera – Out-of-network coverage but higher deductibles and coinsurance

• Aetna – Combines HMO and PPO features with primacy care physician referrals
• Premera – Out-of-network coverage subject to deductible and copays

• Aetna – Compatible with HSAs and lower premiums but high out-of-pocket costs
• Premera – Also HSA eligible, deductibles from $1,500-$7,000 depending on plan

Both insurers offer full coverage across these common plan types. Choose based on your preferences for network flexibility, deductibles and premium costs.

Provider Network Coverage

One of the big considerations when choosing a health insurance provider is making sure your existing doctors are in-network. This allows you to maintain established relationships and minimize costs.

Aetna has one of the country’s largest provider networks with over 1.2 million participating physicians and facilities. This ensures most members have extensive choice and coverage across the nation.

Premera also has a large regional provider network, with over 38,000 doctors and 300 hospitals. However, it is more localized to the Pacific Northwest. Those living outside of Washington, Oregon or Alaska may find their selection of local providers more limited.

If keeping your current medical providers is a priority, be sure to check each company’s provider lookup tool to see if your doctors are in-network before selecting a plan. Those situated primarily in the Northwest will likely find robust coverage through Premera’s regional network.

Plan Costs And Value

Premiums, deductibles, copays…health insurance involves a myriad of costs. What really matters is the overall value you get for what you pay in premiums.

Aetna plans fall in the mid-range for premium pricing – not the absolute lowest or highest cost options on the market. You pay more upfront compared to some competitors, but get strong coverage and benefits in return.

Premera is known for lower premiums and out-of-pocket costs than many insurers for comparable plans. But again, this value is primarily within their Northwest network. Nationwide coverage with Premera comes at a higher relative cost.

For the premium dollars, Aetna provides robust coverage and provider choice across all 50 states. Premera offers outstanding regional value focused in the Northwest. Determine which aligns better based on your location and budget preferences.

Member Services And Satisfaction

How well an insurer delivers on member services influences the overall insurance experience. This includes handling claims quickly, answering questions, and resolving issues.

Aetna receives mixed reviews from members when it comes to customer service. Experiences vary greatly depending on the individual plan and circumstance. They generally earn higher marks for Medicare plans than individual market offerings.

Conversely, Premera repeatedly lands at or near the top for customer satisfaction surveys in the Northwest region. They excel on metrics like communication, claims handling, and providing a positive member experience.

While both companies offer 24/7 member support and online account services, Premera edges out Aetna when it comes to stellar member experiences. Aetna’s customer satisfaction appears more uneven across different plan types.

Health And Wellness Offerings

Most insurers provide tools and programs to help members improve health and wellbeing. This includes resources on healthy living, preventive care reminders, fitness center discounts, and more.

Aetna offers a thorough wellness program called Aetna Health Connections. Members get access to plans and resources matched to individual health needs and risks. Offerings range from pregnancy support to chronic disease management. Also watch this!

Hi! I am Melvin K. – the multifaceted maestro of the digital realm. From the worlds of cutting-edge technology and high-end fashion, I craft content that's as sleek as the gadgets I review.