Have had both employer provided Kaiser and Aetna. Aetna was awful while Kaiser was great. Aetna made us jump through all kinds of hoops to get a simple prescription (not pain meds) while it was only a quick phone call with Kaiser. In fact, while in great pain we had to wait for over 8 hours with Aetna to even talk with someone before we gave up and went to GoodRx and got the help we needed nearly instantly. I don't really know where I'm going with this, but I have to say there's a wide discrepancy between employer provided health insurance. I had ACA and it was actually really good! No or low copay (less than $10) and was always able to get ahold of someone when I needed it.
Having had Kaiser, it really, really really depends on what care you seek.
Broken arm? great. Straightforward / well known ailment? Check check check. Psychiatric care? Hit or miss, but was not good in our experience (I can attest to some close friends and family who did receive quality care). Need an uncommon specialist or research doctor? Horrible.
My partner has a relatively rare thoracic spinal herniation issues, and Kaiser just wanted to put her on drugs and tell her "too bad, its all we can do". No physical therapist specializations, only 1 standard MRI and was looked at by a doctor who was not a specialist in thoracic spinal issues. When we balked at that, they then tried to turn around say it was "all in her head". We had to go out of pocket to see a physical therapist who specialized in this sort of thing to get any real help, and we have as of yet to meet a doctor who's willing to take on her case and advocate for specialized care, who then recommended us a chronic pain psychiatric specialist who's job is, to tl;dr, to help train the mind to lessen the daily chronic pain. That combined with a pretty strict diet & regiment of physical activities are the only thing giving her quality of life. Kaiser blew it. I can only imagine how much worse off we'd be had I not have a good job to cover the costs out of pocket.
Aetna is known to be low quality, especially after CVS bought them. CVS has a ton of debt and I do not see CVS management to have a culture of investing in employees. They are known for their retail business, where it is typical to ride employees to the limit until they burnout.
I like sticking to BCBS insurers, such as Elevance, Regence, Independence, Horizon, etc.
Except BCBS Premera here in Texas. They're having a bitch fight with Ascension/Seton healthcare, which includes Dell Children's Center and the majority of the good hospitals and ERs in the area, as well as many doctors practices. But Open Season ended in November, so now people can't switch insurance companies so that they can actually go to their healthcare provider of choice.
And BCBS desperately wants to force you to use only their approved pharmacies, but as of late last year there is a new law here in Texas that makes that illegal. So, what BCBS does is make their preferred pharmacy "optional", but what is not optional is that you can't get any drugs from any other pharmacy until you call up their preferred pharmacy on the phone and speak to a human being to get them to opt you out of the "optional" preferred pharmacy. And imagine how hard that process is these days.
Aetna used to be good here in Texas. That was a few years back. I had them when I worked at Whole Foods, and that was probably what you'd call a "Cadillac Plan".
Now, as bad as BCBS Premera is, it's still better than Aetna. Maybe it's because CVS bought Aetna, or some other reason, but they've definitely taken a major nosedive here in the last few years.
