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
| Category | Aetna | Premera |
| Coverage Area | National | Primarily Pacific Northwest |
| Plan Types Offered | HMO, PPO, POS, HDHP | HMO, PPO, POS, HDHP |
| Provider Network | Over 1.2 million providers nationwide | 300+ hospitals and 38,000 doctors in Northwest region |
| Premium Cost | Mid-range, not the highest or lowest | Typically lower than competitors in region |
| Deductibles | Vary based on plan, can be high for HDHP | Also vary, but tend to be lower than national insurers |
| Customer Service | Mixed reviews, varies by plan type | Top-rated for service in Northwest |
| Health & Wellness Programs | Aetna Health Connections | Premera Peak Performance |
| Recommended For | National coverage, Medicare Advantage | Pacific Northwest residents |
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
Some of the benefits Aetna is known for include:
- 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
On the downside, some drawbacks of Aetna can include:
- 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.
Also Read: Is Kaiser Permanente Better Than CareFirst?
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
PPO (Preferred Provider Organization)
- Aetna – More flexibility to see out-of-network doctors for higher costs
- Premera – Out-of-network coverage but higher deductibles and coinsurance
POS (Point of Service)
- Aetna – Combines HMO and PPO features with primacy care physician referrals
- Premera – Out-of-network coverage subject to deductible and copays
HDHP (High Deductible Health Plan)
- 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.
Also Read: Choose Between Kaiser And Premera.
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!
Premera also has a suite of wellness offerings under the Peak Performance program. This promotes preventive care, fitness, nutrition, and holistic health. Members can complete health assessments to get custom recommendations from Premera on health improvement plans and lifestyle changes.
Both Aetna and Premera have strong wellness programs. Aetna may cater a bit more to specific chronic conditions while Premera takes a more general healthy lifestyle approach. Programs are voluntary and help members optimize their health.
Frequently Asked Questions (FAQ)
Yes, Premera is considered one of the top-rated insurers in the Pacific Northwest region. They consistently earn excellent reviews for customer service, claims processing, and overall member satisfaction. Premera provides comprehensive medical coverage for good value, especially for those residing in Washington, Oregon or Alaska.
Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. While not the exact same entity as Blue Cross, Premera has the right to use the Blue Cross Blue Shield branding and network as an official licensee. So you get access to the Blue Cross network and benefits through Premera’s regional plans.
Overall yes, Aetna typically earns positive reviews as a nationally recognized leading insurance provider. They offer comprehensive plans with extensive benefits and provider networks. Reputation-wise, Aetna is stronger with certain plans like Medicare Advantage compared to individual marketplace offerings. But generally Aetna is known as a reputable insurer.
There is no one “best” medical insurance for everyone. The right insurance depends on your location, healthcare needs, budget, and plan preferences. Top insurers like Aetna and Premera deliver value and good coverage. Compare benefits, provider networks, and costs to find the optimal medical insurance for your circumstances.
Also Read: Choose Between Regence And Kaiser.
Conclusion
Based on this comparison, here are some recommendations on the best uses for Aetna and Premera health insurance plans:
- Aetna is ideal for those needing nationwide coverage and variety, especially retirees using Medicare Advantage plans. Their broad provider network and plan options make Aetna a flexible choice.
- Premera excels as a regional carrier in the Pacific Northwest. For Washington, Oregon and Alaska residents, Premera provides top-notch coverage for excellent value.
- Employees of large corporations offering Aetna group plans get a quality benefit with comprehensive provider choice. Sticking in-network provides affordability.
- For small business and individual coverage, Premera gives Northwest subscribers access to great local networks. Premiums are affordable relative to competitors.
In summary, Aetna is preferable for the flexibility and variety of a large national insurer. Premera dominates as the go-to regional coverage choice in the Northwest.
Evaluate your location, existing doctor relationships, and budget to determine which option may work better.
