Aetna and its history
Aetna Inc., or Aetna, is a subsidiary of CVS Health company. It is a healthcare benefits company founded in 1853 and headquartered in Hartford, Connecticut. Aetna offers a range of traditional, voluntary, and customer-focused health insurance products and services. It also provides Medicaid health care management services, Medicare Advantage and Medicare supplement plans, and workers' compensation administrative services. It primarily serves employer groups, labor groups, college students, health care providers, part-time and hourly workers, individuals, health plans, government-sponsored plans, governmental units, and expatriates.
Pros and cons of Aetna Medicare Advantage plans
The Aetna medicare plans include various benefits, offer good value to customers, and are usually very well-rated. Aetna has unique and affordable prescription drug plans, and the Medicare Advantage plans also stand out in terms of their additional gap coverage.
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Some benefits and limitations of Aetna Medicare Advantage plans include the following:
Pros
- Lower Part D premiums: Aetna offers the SilverScript SmartSaver plan, a lower-cost prescription drug insurance plan with an average monthly premium of only $11.19.
- Additional gap coverage: Aetna's Medicare Advantage plan offers additional coverage during the gap period. Also, a few of Aetna's plans provide almost $0 copays during the coverage gap period.
- Extra benefits: Many of Aetna's Medicare Advantage plans provide additional benefits to the individual. These could include ER (Emergency Room) and urgent care coverage worldwide, over-the-counter benefits, fitness benefits, telehealth benefits, and meals from home after a nursing facility or hospital stay.
Cons
- Some regions have lower ratings: According to information published on Investopedia, Aetna's Medicare Advantage plans have a lower JD Power rating in some country regions.Â
- Medigap Plan G premiums are higher than average: Aetna's premium charges for its Medicare Supplement Plan G insurance plans may be higher than those of other insurance service providers.
What is coinsurance?
The part of the cost from the covered healthcare service that the patient has to pay, excluding the deductible, is called coinsurance. It is lower for the service you receive from an in-network provider than those from an out-of-network provider.Â
For example, visiting an in-network Aetna- Dentist near you costs $180, and your coinsurance is 20%. Then you have to pay 20% of $180, which equals $36. Therefore, $36 is your coinsurance and out-of-pocket expense for the visit, provided you've paid the deductible.
What is a grace period?
The grace period is a short, typically three-month window period after your monthly health insurance premium is due. To keep your health coverage, pay all owed premiums within this time.
The grace period is usually three months if both of the following apply:
- You have a Marketplace plan and use the premium tax credit.
- You have paid at least one month's premium during the benefit year.
Your grace period may differ if you do not use the premium tax credit. Contact your state Department of Insurance to learn the grace period rules in your state.
What is an EPO?
An EPO insurance plan is a type of managed care health insurance. EPO stands for exclusive provider organization, meaning you must receive care exclusively from healthcare providers contracted with the EPO. If you go outside the network, the EPO will not cover the costs.
Like other health plans that require you to use a provider network, EPOs will cover out-of-network care only in emergencies.
Insurance words and terms can be challenging to understand. People may also sometimes require more clarification on how insurance works for video visits. You can clarify your doubts with the help of Zocdoc's guide on common insurance terminologies and the application of insurance on video visits.
Dentists are certified doctors specializing in preventing, managing, and treating various ailments affecting the teeth, mouth, and gums. Dentists are skilled at extracting teeth, repairing cracked teeth, and whitening, filling, and bonding teeth. In addition, they can fill cavities, treat gum diseases such as gingivitis, and place crowns and veneers. One of the most crucial responsibilities of the dentist is to promote good oral hygiene and reduce the risks of oral diseases.Â
Dentists can even detect early symptoms in the mouth that indicate a health condition in a different body part. They can effectively recognize health cases that require immediate dental specialists' referral for optimum patient care and treatment.
What do dentists do?
Dentists also examine the tongue, salivary glands, the head and neck nervous system, and the head, neck, and jaw muscles. During a detailed dental examination, they check for swellings, lumps, ulcers, discolorations, and any other abnormalities in the oral cavity. Dentists can even perform appropriate diagnostic procedures like oral cancer screenings, biopsies, screenings of salivary gland functions, and diagnostic tests for infectious or chronic diseases.Â
Dentists can also perform surgical procedures on the oral cavity's soft tissues, bones, and teeth. They use modern equipment and the latest dental technology, such as X-ray machines, scalpels, drills, and other medical tools. Dentists wear protective gear, including safety glasses, masks, and gloves, while performing surgical procedures to prevent the spread of bacteria or germs.
What is dental insurance?
Dental insurance helps cover costs incurred for dental health and care. Since oral health plays an essential role in your overall well-being, having dental insurance can assist you in managing the expenses of dental care. Dental coverage is available in two ways:
- Health plans with dental coverage: Some marketplace health plans include dental coverage. You can identify these plans while comparing options. If a health plan includes dental coverage, the premium covers health and dental services.
- Separate dental plans: Sometimes, you can choose an individual dental plan. These plans are visible when browsing the marketplace. If you opt for a separate dental plan, you'll pay a separate premium in addition to the premium for your marketplace health plan.
Finding the best Aetna- Dentists near you in Houston
Locating the best dentist in Houston, Texas, could be a hassle. Zocdoc simplifies this process by letting you see the ideal in-network dentists through the website or app. You can select the condition or specialty, location, and insurance plan, and a list of doctors will appear.
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Each dentist on Zocdoc has a unique profile that includes their educational qualifications, board certifications, clinical interests, expertise, and languages spoken. You can also read verified patient reviews and user ratings.Â
You can also upload a photo of your medical insurance card to Zocdoc to find the right insurance plan. However, if you do not want to do this, you can enter your insurance information into your account by choosing your plan from the list.
These resources can help you select the best Aetna- Dentists near you that fit your unique requirements.Â
For any insurance-related queries, check out Zocdoc's patient help center.
All bookings on Zocdoc are easy, secure, and 100% free.
Statistics on health insurance coverage in Houston, Texas
According to data on the Aetna website, about 39 million people have enrolled in Aetna insurance products.Â
According to the 2022 data published by the Texas Department of Insurance, Aetna was Texas's sixth-largest accident and health insurance provider, with almost 4.73% market share and $2,728,396,377 in written premiums. In HMOs (Health Management Organizations) in Texas, Aetna had a market share of about 1.96% and about $1,240,076,688 in written premiums.Â
About 68.6% of adults in the 19-64 age group in Houston have health insurance coverage, lower than the Texas average of approximately 77.6% and the US average of roughly 88.7% coverage. Almost 76% of adults in Houston's 55-64 age group have health insurance. Health insurance coverage among women was higher than among men (71.6% and 65.6%, respectively), per the 2022 Houston State of Health data.
As per the data published by the Houston Public Media, almost 11.6% of children in Houston don't have health insurance, more than double the US average. At about 10.9%, Texas has the highest uninsured rate in the country compared to the US average of about 5.1%. Texas accounts for nearly 22% of all uninsured children in the United States.Â
Sources
WebMD
Maine Dental Association
Houston Public Media
Houston State of Health
Texas Department of Insurance
Investopedia
Aetna
Forbes
HealthCare.gov[1]
HealthCare.gov[2]
WebMD
VeryWell Health
