Aetna
Aetna is a diversified health insurance subsidiary of CVS Health serving 37 million members across Medicare, Medicaid, commercial, and individual markets in all U.S. states through employer sales, broker networks, and CVS pharmacy distribution.
- Company typePublic
- Founded1850
- HeadquartersHartford, United States
- Headcount5,001–10,000
- GTM typeB2B and B2C
- OfferingServices
What Aetna does
Aetna is a diversified health insurance company and wholly-owned subsidiary of CVS Health Corporation (acquired in 2018 for approximately $69-78 billion), serving approximately 37 million people across all U.S. states. Founded in 1850 and headquartered in Hartford, Connecticut, Aetna provides health insurance products across Medicare (Advantage HMO/PPO/HMO-POS, Supplement, Part D, Special Needs Plans), Medicaid (Aetna Better Health), employer-sponsored group plans ranging from 2 to 5,001+ employees, individual/family coverage, dental, vision, and supplemental insurance. Distribution is multi-channel: enterprise field sales for large employers, broker/agent networks via the Producer World platform, direct Medicare enrollment through licensed agents and digital tools, ACA Marketplaces, and physical retail integration through CVS Health's 9,000+ pharmacy locations and 1,100+ MinuteClinics.
Aetna's revenue model is anchored in recurring monthly insurance premiums from employer groups, individuals, and government programs (Medicare/Medicaid), supplemented by administrative fees for utilization management, prior authorization processing, and third-party administrator services. In Q1 2026, the Aetna health benefits segment generated $35.97 billion in revenue (+3.3% YoY) with operating income of $2.81 billion (+67.6%), reflecting a medical benefit ratio improvement to 84.6% from 87.3%. The Aetna Health mobile app, member portal, and direct sales infrastructure support enrollment and ongoing service, while CVS Caremark integration enables unified pharmacy benefit management.
Aetna's technology platform increasingly centers on AI-powered automation across claims processing (Claims Assist Manager reducing complex claims processing time by over 20%), prior authorization (88% of volume standardized with 95%+ approvals within 24 hours), and customer service (conversational AI resolving approximately 75% of over 500 million annual calls). The company has launched AI-native products including Aetna Mental Health On Demand, partnered with Abridge and NVIDIA for real-time clinical documentation and claims adjudication, and is co-developing a persistent personal AI assistant through Google Cloud's Health100 platform. Simultaneously, the company is executing a defensive retrenchment under new CVS Health CEO David Joyner—exiting 17 ACA Marketplace states effective January 2026, closing 90 underperforming Medicare plans, and reducing more than 1,500 Aetna positions as part of a $2 billion cost-cutting program.
Aetna firmographics
Firmographics- Name
- Aetna
- Legal name
- Aetna Inc.
- Website
- https://aetna.com
- Company type
- Public
- Founded year
- 1850
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Short description
- Aetna is a diversified health insurance subsidiary of CVS Health serving 37 million members across Medicare, Medicaid, commercial, and individual markets in all U.S. states through employer sales, broker networks, and CVS pharmacy distribution.
- Ownership category
- akta.pro rank
Aetna industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)
- SIC
- Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Ancillary & Supplemental Health Products (Accident/Critical Illness/Hospital Indemnity) (HLAEABAJ)
- akta.pro secondary industries
- Group/Employer-Sponsored Critical Illness & Hospital Indemnity (FSAIAKAD), Flexible Benefits Administration (FSA/HSA/HRA) (HLAEALAK)
Keywords
Where Aetna is headquartered
LocationHeadquarters
- HQ city
- Hartford
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Aetna business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Infrastructure, Marketing or Sales
Revenue model
- Health Insurance Premiums: Aetna generates the majority of its revenue through health insurance premiums collected from employer-sponsored group plans, Medicare Advantage plans, Medicaid managed care, and individual/family health insurance plans. Premium revenue is recurring in nature, paid monthly by employers, individuals, or government programs.
- Medicare Part D and Pharmacy: Revenue from Medicare prescription drug plans (Part D) administered through CVS Caremark, as well as pharmacy benefit management services integrated within health plans. Net premium written growth driven by Medicare Part D changes under the Inflation Reduction Act.
- Administrative Fees: Fees for administrative services including utilization management, prior authorization processing, provider network access, and third-party administrator services for self-insured employer plans.
- Dental, Vision, and Supplemental Insurance: Separate premium streams from dental insurance plans (starting at $16/month for individual/family), vision coverage, and supplemental insurance products including hospital indemnity, accident, and critical illness policies.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Aetna Dental Direct DMO - Budget-conscious coverage for routine care |
| Subscription | Monthly | Aetna Dental Direct Core PPO - Similar to Preferred with lower premium |
| Subscription | Monthly | Aetna Dental Direct Preferred PPO - Broad provider choice with mid-tier coverage |
| Subscription | Monthly | Aetna Dental Direct Preferred 2000 PPO - Highest benefit maximum option |
| Subscription | Monthly | High-Deductible Health Plan (HDHP) - Lower premiums with higher deductibles |
Go-to-market motion3 records
Distribution channels7 records
Marketing channels8 records
Aetna product offering
Product offeringCore offering
Aetna is a diversified health care benefits company that provides health insurance and related benefit products to individuals, families, employers, and government programs across all U.S. states. Its core offerings include Medicare Advantage plans, Medicare Supplement insurance, Medicare Part D prescription drug plans, individual and family health plans, employer-sponsored group health plans, Medicaid managed care, dental and vision insurance, supplemental insurance products, and international and student health plans. The company layers digital and AI-powered tools (claims processing, prior authorization, mental health access, member engagement) on top of its insurance operations and integrates with CVS Health's pharmacy and MinuteClinic footprint.
Product overview
Aetna is a diversified health insurance company (wholly owned subsidiary of CVS Health) offering a broad portfolio of health coverage products and services across multiple segments. The core product portfolio spans Medicare Advantage plans (PPO, HMO, HMO-POS), Medicare Part D prescription drug plans, Medicare Supplement Insurance (Medigap), Individual and Family Plans, Employer-Sponsored Group Health Plans, Medicaid managed care (Aetna Better Health), dental insurance, vision insurance, and international health plans. Special Needs Plans (D-SNPs and C-SNPs) serve populations with specific needs. Digital add-on modules include Aetna Mental Health On Demand (real-time mental health access via chat/phone/video with AI-powered tools), Aetna Claims Assist Manager (AI-powered claims processing), Care Paths (AI-powered patient navigation), and the Aetna Health mobile app. Supplemental voluntary benefits include accident, critical illness, and hospital indemnity coverage. The company operates across all U.S. states with different legal entity structures by state.
Differentiator
Problem solved
Functional benefit
Brands
- Aetna Health: Brand name for health insurance products and services provided by Aetna group of companies
- Aetna Mental Health On Demand
- Aetna Claims Assist Manager (CAM)
- SilverScript
Products and services
- Aetna Medicare Advantage Plans
Quantifiable outcome
- AI resolves 75% of 500+ million annual customer service calls
- +7 more outcomes
Companies that use Aetna
Customer profileNamed customers6 records
Segments6 records
Ideal customer profiles5 records
Aetna technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration9 records
AI capability15 records
Feature8 records
Aetna partnerships and signals
Strategic signalPartnerships
13 partnerships are on record, tiered core, minor, moderate and unclear.
- AbridgecoreAbridge unveiled its AI-native clinician intelligence platform with enterprise-wide rollout at Northwestern Medicine, and announced partnerships with Aetna and Cigna to enable real-time claims adjudication. Aetna's AI-powered clinical documentation bridges payer-provider relationships.
- NVIDIAcoreNVIDIA partnered with Abridge to build the first AI foundation model designed specifically for clinical conversations. This technology supports Aetna's real-time claims adjudication partnership.
- Google CloudcoreCVS Health outlined plans for a future persistent personal AI assistant through its partnership with Google Cloud's Health100 platform, designed to proactively manage patient health by integrating insurance, pharmacy, and clinical data.
- NICE (Nasdaq: NICE)minorNICE announced NiCE World 2026 conference featuring participants from Aetna, Citi, Hyatt, British Telecom, Geico, Lowe's, Nationwide, and strategic partners such as Accenture, AWS, Deloitte, and ServiceNow.
- UK HealthCareminorUK HealthCare's Food as Health Program partners with Aetna and other payers to provide food benefits to patients with chronic conditions and food insecurity.
- Arizona Interscholastic AssociationminorBanner|Aetna, an Arizona-based health insurer, announced its sponsorship of the Arizona Interscholastic Association (AIA), becoming its exclusive health insurance partner. The sponsorship involves supporting high school athletic events and hosting community activities such as a food drive.
- Parsley HealthmoderateParsley Health, a functional medicine provider, announced it is now in-network with Aetna nationwide, covering 150 million lives. This nationwide expansion represents a tenfold increase in coverage over two years, building on phased expansion that began in New York and then California.
- Health CatalystminorHealth Catalyst, Inc. announced the appointment of Steve Nelson, Executive Vice President and President of Aetna (a CVS Health company), to its Board of Directors. Nelson brings extensive healthcare leadership experience.
- UnitedHealth GroupunclearUnitedHealth Group mentioned as key player in global group health insurance market alongside Aetna, Anthem, and Cigna in market research report.
- Parallel HealthminorParallel Health achieved in-network status with UnitedHealthcare in California, making it now in-network with three of the nation's largest commercial insurers: UnitedHealthcare, Cigna Healthcare, and Aetna.
- HeartflowminorAetna began coverage of Heartflow Plaque Analysis, bringing total U.S. covered lives for Plaque to approximately 75%. Heartflow's technology provides AI-powered fractional flow reserve (FFRct) analysis for coronary artery disease.
- UConn HealthmoderateUConn Health and Aetna reached a new multiyear agreement after their previous contract expired, restoring in-network access for Aetna members at UConn Health starting March 1, 2026.
- Chiro One Wellness CentersminorChiro One announced it will now accept employer-sponsored Aetna group health plans at all of its Illinois clinic locations, expanding access to chiropractic care for patients with employer-based insurance coverage.
Scale indicators13 records
Recent moves8 records
Expansion highlights6 records
Aetna competitors and assessment
Company assessmentEmerging players
- Oscar Health: Technology-led individual ACA Marketplace insurer that disproportionately stepped into counties Aetna exited in 2026, making it a direct emerging competitor in the individual segment Aetna is leaving behind.
Direct peers
- Kaiser Permanente: Integrated payer-provider system competing with Aetna in select commercial and Medicare markets. While structurally distinct (owned provider network), it is one of the largest U.S. health insurers by membership.
- Molina Healthcare: Pure-play government-sponsored health insurer competing with Aetna in Medicaid managed care and dual-eligible plans, with similar focus on low-margin government programs.
- Humana: The leading Medicare Advantage-focused insurer and a primary competitor to Aetna in the senior market. Both were jointly cited by OIG for elevated prior authorization denial rates, underlining their parallel operating models.
- Elevance Health (Anthem): Major diversified health insurer offering commercial, Medicare, and Medicaid plans through Blue Cross Blue Shield-licensed brands. Competes head-to-head with Aetna in national accounts, individual ACA markets, and Medicare Advantage.
- UnitedHealthcare: The largest U.S. health insurer and Aetna's most direct competitor across Medicare Advantage, employer-sponsored, Medicaid, and individual markets. Both share national footprints and integrated payer models, with UnitedHealthcare also serving as a benchmark on the same OIG prior authorization denial-rate report.
- Centene Corporation: Largest Medicaid managed-care insurer in the U.S. and a key Aetna competitor in government-sponsored programs through Aetna Better Health. Both compete intensely for state Medicaid contracts.
- Cigna Group: Closely comparable large national health insurer with Evernorth PBM and focus on employer-sponsored and Medicare businesses. Cigna similarly partners with Abridge on real-time claims adjudication alongside Aetna.
Others
- CVS Caremark: Pharmacy benefit manager and sister subsidiary of Aetna within CVS Health. While not a competing health insurer, its integrated role in Aetna's care model and Part D drug plans makes it an essential adjacent comparison.
Broad incumbents
- Blue Cross Blue Shield Association (BCBSA): Federation of 30+ independent BCBS plans collectively the largest health insurance network in the U.S. They compete with Aetna across all major segments but are not a single integrated peer.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat7 records
Key risks6 records
Key highlights7 records
Customer concentration
Aetna social profiles
Digital presenceAetna financial estimates
Financial estimateRevenue estimate
Valuation estimate
Aetna leadership team
Management profileNumber of profiles
Profiles2 records
Aetna subsidiaries and ownership
Company hierarchySubsidiaries8 records
Aetna funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Aetna M&A and investment
M&A and investmentM&A15 records
Investments5 records
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Aetna
What does Aetna do?
Aetna is a diversified health care benefits company that provides health insurance and related benefit products to individuals, families, employers, and government programs across all U.S. states. Its core offerings include Medicare Advantage plans, Medicare Supplement insurance, Medicare Part D prescription drug plans, individual and family health plans, employer-sponsored group health plans, Medicaid managed care, dental and vision insurance, supplemental insurance products, and international and student health plans. The company layers digital and AI-powered tools (claims processing, prior authorization, mental health access, member engagement) on top of its insurance operations and integrates with CVS Health's pharmacy and MinuteClinic footprint.
Is Aetna a public or private company?
Aetna is a public company. It is classified as corporate owned and is currently operating.
When was Aetna founded?
Aetna was founded in 1850. It employs 5,001 to 10,000 people.
Where is Aetna based?
Aetna is headquartered in Hartford, United States, in the North America region.
How does Aetna make money?
Four revenue lines are on record. Health Insurance Premiums are the primary driver. The others are medicare Part D and Pharmacy, administrative Fees and dental, Vision, and Supplemental Insurance.
Who are Aetna's main competitors?
Oscar Health is listed as an emerging player. Direct peers are Kaiser Permanente, Molina Healthcare, Humana, Elevance Health (Anthem), UnitedHealthcare, Centene Corporation and Cigna Group. CVS Caremark is listed as an others. Blue Cross Blue Shield Association (BCBSA) is listed as a broad incumbent.
Does Aetna have an API?
No public API is recorded for Aetna.
What industry is Aetna in?
Aetna's product category is Health Insurance. Its primary akta.pro industry code is HLAEABAJ, Ancillary & Supplemental Health Products (Accident/Critical Illness/Hospital Indemnity), with a secondary code of FSAIAKAD, Group/Employer-Sponsored Critical Illness & Hospital Indemnity. Its NAICS code is 524114 and its SIC code is 6321.