Company Profile: Aetna

Aetna, Inc. is an American health insurance company. The company was providing numbers of traditional and consumer directed health care insurance products and related services. Their services also include medical, pharmaceutical, dental, behavioral health, group life, long-term care, and disability plans, and medical management capabilities. Aetna is one of the members of the Fortune 100 (Aetna Inc. 2011).

As indicated in the company website, Aetna, Inc. believes that they can help create a good health care system (Aetna Inc. 2011). With their drive towards this belief, Aetna, Inc. was considered as one of the leading health care benefits companies in America. The company was also aiming to provide excellent health insurance services to their members.  With the information and resources that the company provide, insurance consumers of Aetna was able to make informed decisions about their health.

With regards to the company mission, Aetna Inc. aims to help people accomplish health and financial security by giving straightforward access to cost-effective, high-quality health care. And with this effort, Aetna’s included in their mission to become a continuing leader in terms of building a stronger, effective health care system by working with doctors, hospitals, employers, patients, public officials and others (Aetna Inc. 2011).

Aetna was basically offering various health insurances and plans and the common among these plans and also available these days are HMOs (Health Management Organizations) and PPOs (Preferred Provider Organizations). These plans are actually both can be affordable offer access to high-quality care depending on the needs of a client.

In Aetna’s HMO plans, the client may choose doctors, hospitals, and other care providers that are members of Aetna’s HMO network.

An HMO obtains certain fees in monthly basis for everyone they cover. And these creates various restrictions in giving care like the requiring of pre-approval for service, and in most cases long waiting period to see specialists (Fundamentals of Health Insurance, 1997).  Aside from this, there were also some instances that the approval from client’s primary care physician was quite long and with this Aetna’s HMOs may let the client designate a specialist as their Primary Care Physician (Fundamentals of Health Insurance, 1997).  As verified in Aetna’s website, selecting the client’s Primary Care Physician was the most vital part in HMO decision considering that the client’s primary doctor will be the first point of contact with the healthcare system (Aetna Inc. 2011). In an HMO, clients have always the option of changing doctors, but setting up a good relationship early on is imperative in an HMO plan.

On the other hand, the Preferred Provider Organizations or the PPOs refer to the networks of doctors, hospitals, and other healthcare providers (Fundamentals of Health Insurance, 1997). Basically, the Aetna’s health plans associated with PPOs save money when the client uses a provider “within the network. (Aetna Inc. 2011)” But they will also provide clients with coverage in cases where the client gets services from “outside the network (Aetna Inc. 2011).”  As seen, PPO plans are an amalgamation of managed care and traditional indemnity plans. With the networks of providers, PPO plans is somewhat similar HMO plans but the difference in a PPO plan is that clients are not able choose a Primary Care Provider (Fundamentals of Health Insurance, 1997).

Actually, Aetna was providing excellent health insurance services in America but because of the increasing population and increasing healthcare needs, Aetna are having problems in accommodating clients aside from the issue of slavery reparations (Ethics Newsline, 2011).  In accordance to the healthcare insurance policy of America and capabilities of Aetna, there are still a lot of uninsured Americans.

As stressed by Aetna, health insurances can be beneficial and important to an individual (Aetna Inc. 2011). However, certain issues relating to health insurance still need to be identified and addressed. From the different policy reports and research gathered, the increasing number of uninsured Americans is among the most common and important issues related to health insurance. Considering that health insurance like what Aetna’s offering are made for compliance, parties involved in policymaking should then do their role in ensuring that the policy developed are being applied and that people are benefiting from it. The changing trends on healthcare, such as the increasing prices for healthcare as well as the rate of population growth, is another issue as this causes the decline on full employer-sponsored health insurance plans and increased deductibles on the employees. This occurrence implies that policies are in need of reforms in such a way that they are more applicable to current trends.

It is important to point however, that while there are a number of issues involved in American health insurance which the main market of Aetna, the government had done a number of initiative and efforts so as to make health insurance plans truly beneficial for the people. Reforms that led to cost containment as well as increased insurance coverage had been implemented by the government in response to these issues. In addition, businesses had also participated actively in helping the employees achieve the full benefits of their social security rights.

References:

Aetna Inc. (2011). About Us. Retrieved May 11, 2011, from http://www.aetna.com/about-aetna-insurance/index.html

Ethics Newsline (2011). Aetna Apologizes For Pre-Civil-War Policies Issued On Lives Of Slaves". Retrieved May 11, 2011, from http://www.globalethics.org/newsline/2000/03/13/aetna-apologizes-for-pre-civil-war-policies-issued-on-lives-of-slaves/

Fundamentals of Health Insurance (1997). Part A, Health Insurance Association of America, ISBN 1-879143-36-4.