Is Aetna in trouble?

Asked by: Ned McLaughlin Sr.  |  Last update: July 3, 2025
Score: 4.9/5 (13 votes)

Aetna's likelihood of distress is above 80% at this time. It has very high risk of going through financial crisis in the upcoming years. Probability of financial unrest prediction helps decision makers evaluate Aetna's chance of financial distress in relation to its going-concern outlook and evaluation.

Why is Aetna struggling?

Aetna majorly miscalculated utilization trends in pricing Medicare Advantage plans for this year, causing hundreds of thousands of seniors to flock to its generous coverage and saddling the insurer with an unexpectedly steep price tag for their care.

Is Aetna insurance having financial problems?

Aetna's revenues hit $33 billion in Q3, up from $26.3 billion in Q3 2023. But it posted an adjusted operating income loss of $924 million this year. Its Medical Benefits Ratio was 95.2% in the quarter, compared to 85.7% in the same period last year.

What is happening to Aetna?

CVS is removing Brian Kane, the head of Aetna, citing the division's poor performance and outlook. CEO Karen Lynch, who was the president of Aetna from 2015 to 2021, will now lead the business, while CFO Tom Cowhey will help oversee its day-to-day operations.

What is the class action lawsuit against Aetna?

The lawsuit seeks a declaratory judgment, injunctive relief to end Aetna's exclusionary policy, and compensatory damages for all policyholders who have had to pay out of pocket for gender-affirming facial surgery because of Aetna's discriminatory exclusion.

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26 related questions found

Why is Aetna not paying claims?

If you've had a health treatment or disability claim denied by Aetna, it could be because: The procedure is considered cosmetic (not medically necessary) Your doctor is out of network or doesn't participate in the plan. Your plan doesn't cover your medical condition.

Who took over Aetna insurance?

2018: On November 28, 2018, CVS Health completed the acquisition of Aetna. The company's ticker AET is delisted from the NYSE.

Is Aetna a reputable insurance company?

Although Aetna is one of the oldest insurance companies in the country, it's not accredited by the Better Business Bureau. It has an A+ rating with the BBB, but only a 1.05 out of 5 stars after 139 customer reviews.

Is Aetna having technical issues?

Aetna.com is UP and reachable by us. Please check and report on local outages below ... The above graph displays service status activity for Aetna.com over the last 10 automatic checks. The blue bar displays the response time, which is better when smaller.

Is Aetna changing its name?

We're changing our name and logo, but our relationship with you and our members will stay the same. We value our local relationships, so our plan offerings and contract agreements won't be impacted by our name and logo change. You'll continue to follow the same processes you do today.

Why is Aetna so expensive?

Factors influencing Aetna insurance monthly costs

Plans with broader coverage and extensive benefits, such as lower deductibles, co-pays, and comprehensive services like dental and vision care, often come with higher monthly costs.

Who is in charge of Aetna?

Steve Nelson. Steve Nelson is executive vice president and president of Aetna®. He previously served as chief executive officer of UnitedHealthcare, a division of UnitedHealth Group.

Is Aetna good insurance for seniors?

Aetna is an established health insurance company with a long history of providing coverage and support to millions of seniors across the country. Their Medigap plans offer a variety of benefits and options to make sure that older adults have the quality care they need and deserve.

Is Aetna losing money?

The insurance arm's operating income fell nearly 40% in Q2 2024. Aetna, CVS's health insurance arm and the third largest payer in the US, is struggling amid higher medical costs and lower Medicare Advantage star ratings.

Where does Aetna rank?

By membership and revenue, Aetna is ranked third in the country for health insurance. Aetna has over 22 million members and receives annual revenues of over $60 billion. With revenue over 50 billion and membership over 14 million, Humana ranks number five of all U.S. health insurers.

Is Aetna buying Humana?

Last month, Aetna announced its proposition to acquire Humana, which would make Aetna the second largest insurer in the country. Because of Humana's large share of Medicaid Advantage customers, this signifies a landmark health merger, which would bring Aetna's total Advantage members to approximately 4.4 million.

Does Aetna deny a lot of claims?

In the same year, Medicare denied 6.85% of its claims. One year later, AMA reported that all the surveyed insurers were denying fewer claims: Aetna's denial rate was down to 1.81%, Anthem BCBS reduced its rate to 4.34%, and private insurers overall were down to 2.79%, while Medicare denied only 4% of claims.

What company is Aetna under?

Aetna® group of companies. Aetna is proud to be a part of the CVS Health® family of companies.

Why did CVS take over Aetna?

Amidst all the buzz surrounding the merger, this article elucidates the motivations behind it, including operational cost-cutting, expanded services as a competitive advantage, and threats from both Amazon and UnitedHealth. This piece also explores potential market effects.

Who took over Aetna?

WOONSOCKET, R.I., Nov. 28, 2018 /PRNewswire/ -- CVS Health (NYSE: CVS), a company that is leading the transformation of health care, today announced that it has completed its acquisition of Aetna (NYSE: AET), establishing CVS Health as the nation's premier health innovation company.

What is the best health insurance company to go with?

Best Health Insurance Companies for 2025
  • Best Overall and Best for Self-Employed: Kaiser Permanente.
  • Best Widely Available Plans: UnitedHealthcare.
  • Best for Low Complaints and Best for Chronic Conditions: Aetna.
  • Most Affordable: Molina Healthcare.

Does Aetna have good customer service?

Aetna has an average rating of 1.2 from 90 reviews. The rating indicates that most customers are generally dissatisfied.

What are the new benefits of Aetna 2024?

Improved dental, vision and hearing benefits: Every 2024 Aetna MA plan will include dental,9 vision and hearing benefits, ensuring all members can maintain their dental health and access corrective eyewear and hearing aids. Dental: In 2024, all of our plans include a dental benefit.

Will CVS layoff Aetna employees?

Aetna headquarters, in Hartford, Conn. Oct. 11, 2024. CVS Health announced Friday it will lay off 164 employees who report to the Hartford headquarters of its insurance division Aetna, all of them remote workers.

Did the president of Aetna get fired?

Those higher medical costs led CVS chief executive Karen Lynch to remove Brian Kane, the president of Aetna, the subsidiary that operates all health insurance plans. Kane — who used to be the chief financial officer of Humana, another Medicare Advantage giant — was the head of Aetna for less than a year.