Insurer profile · CVS Health · NAIC + CMS

Aetna Health Inc. (a TX corp.)

Aetna Health Inc. (a TX corp.)'s complaint record, claim-denial rate and reputation grade, drawn from published NAIC complaint data and CMS Transparency in Coverage.

F
Reputation grade
29.3%
Claims denied
1
States (CMS data)

The verdict

Aetna Health Inc. (a TX corp.) earns a F reputation grade - a significantly worse record than peers, according to CMS Transparency in Coverage filings, 29.3% of its marketplace claims were denied across 1 state.

F
reputation grade
29.3%
claims denied (CMS)

Reputation grade

F

Peer-relative, A–F

NAIC complaint index

N/A

1.0 = market average; lower is better

Claim denial rate

29.3%

CMS, 1 states

FFF
Reputation grade F (composite score 16.8) - A=Excellent, F=Failing. Based on NAIC complaint ratios and CMS denial data.

Graded on 1 of 3 measures: claim denials. The score is rescaled across the measures available, so it is not directly comparable with a carrier graded on more of them.

How we calculated this grade →

These claim figures are from plan year 2025, not 2026. Aetna Health Inc. (a TX corp.) does not appear in the CMS Transparency in Coverage file for plan year 2026, so the most recent figures CMS has published for this insurer are the ones shown here. Illinois carriers left that file when the state moved to its own health-insurance marketplace for 2026; other insurers stop appearing when they exit the individual marketplace. The numbers below are unchanged and still describe the period they cover. They are simply not current-year, and are excluded from every national and state average on this site. See our methodology.

CMS marketplace filing

Reported appeal outcomes for Aetna Health Inc. (a TX corp.)

1,811
appeals filed
386
overturned (reported outcomes)
21.3%
of appeals with a reported outcome

The reported appeals on this profile come from Texas (1,811 filed, 386 overturned).

CMS reports an overturn outcome for 1,811 of these 1,811 filed appeals; missing outcomes are excluded from the percentage. These filing totals are not a prediction for an individual appeal. View the CMS source ↗

What the data shows for Aetna Health Inc. (a TX corp.)

Aetna Health Inc. (a TX corp.), part of CVS Health, carries a F reputation grade in PlainInsurer's dataset, with a composite score of 16.8 (higher means more consumer friction relative to size). It does not yet carry enough NAIC complaint history for a normalized complaint index.

On the claims side, CMS Transparency-in-Coverage filings show Aetna Health Inc. (a TX corp.) denied 29.3% of marketplace claims across 1 reporting state - an elevated rate that warrants checking the plan's appeal-success record before enrolling.

See where Aetna Health Inc. (a TX corp.) sits against every reporting carrier in the claim-denial rate ranking.

Source: NAIC Consumer Information Source complaint data (2024). Source: CMS Transparency in Coverage PUF (PY2025), cms.gov.

Aggregates only, not advice. Full terms on the disclaimer.

Other F-graded carriers in PlainInsurer's dataset include Kemper Auto and Root Insurance, and the closest overall composite score to Aetna Health Inc. (a TX corp.)'s 16.8 belongs to Oscar Insurance Company (16.2), each rescaled across the measures that carrier reports.

Aetna Health Inc. (a TX corp.) is part of the CVS Health family, alongside Aetna (CVS Health), Aetna Health Inc. (a FL corp.), Banner Health and Aetna Health Plan Inc., Aetna Life Insurance Company, and 1 more in PlainInsurer's dataset -- a shared parent doesn't mean shared performance, so check each subsidiary's own record before assuming they behave alike.

Other F-graded insurers

Carriers with the same peer-relative reputation grade

Insurer Grade
Kemper Auto F
Root Insurance F
Dairyland Insurance (Sentry) F
Hippo Insurance F
Esurance (Allstate) F

Closest composite score to Aetna Health Inc. (a TX corp.)

Carriers with the nearest overall composite score (16.8)

Insurer Composite score
Oscar Insurance Company 16.2
UnitedHealthcare of South Carolina, Inc. 16.2
Summa Insurance Company, Inc. 17.8
Harvard Pilgrim Health Care of NE 18.4
Tower Hill Insurance 15.2

Questions about Aetna Health Inc. (a TX corp.)

What does Aetna Health Inc. (a TX corp.)'s grade mean?
Aetna Health Inc. (a TX corp.) received a grade of F, indicating a significantly worse record than peers.
How many complaints does Aetna Health Inc. (a TX corp.) have?
NAIC's public bulk data does not include a complaint-volume estimate for Aetna Health Inc. (a TX corp.) - the carrier may be new, small, or file under a parent company. Absence of an estimate is missing data, not evidence of zero complaints.
How do I file a complaint against Aetna Health Inc. (a TX corp.)?
File against Aetna Health Inc. (a TX corp.) through your state's Department of Insurance or the NAIC consumer portal at naic.org.
Is Aetna Health Inc. (a TX corp.) a good insurance company?
PlainInsurer's F grade for Aetna Health Inc. (a TX corp.) reflects a significantly worse record than peers relative to peers on published complaint and denial data.
What types of insurance does Aetna Health Inc. (a TX corp.) offer?
Detailed line-of-business data isn't currently available for Aetna Health Inc. (a TX corp.). The carrier is licensed in 0 states.

Source: NAIC published complaint index + CMS Transparency in Coverage PY2025 Complaint index, reputation grade and per-state claim denial rates for Aetna Health Inc. (a TX corp.) · 2024

Share, download, and related pages for Aetna Health Inc. (a TX corp.)

Download the data behind this page

The full PlainInsurer extract, covering every insurer including Aetna Health Inc. (a TX corp.), is available as CSV and JSON. Underlying federal data is public domain; see our methodology for the compilation and grading method.

Embed this widget

Paste to embed a live-linked card.

Data: NAIC published complaint index (2024) · CMS Transparency in Coverage PUF PY2025. Not affiliated with NAIC or CMS.

Every figure on PlainInsurer comes directly from NAIC MCAS and CMS Transparency in Coverage data; no editor types in numbers. See our editorial standards or methodology, or report an error. Data current as of 2026-08-11. Grades measure only the published complaint/denial data; we don't recommend any insurer or policy.