Aetna Member Payment Estimator



DAVID: Hi, I’m David with Aetna.  I wanted to show you this new feature we’ve been working on.  Here to help me out is my friend Alice.
ALICE: Hey David.
DAVID: Hey Alice.
ALICE Listen, David, you’re Mr. Medical Answer Guy, right?
DAVID: That is my official title, yes.
ALICE Okay.  You know how when you’re at the grocery store shopping for cereal, they’ve got all the prices right there on the shelf?
DAVID: Sure.
ALICE And you know how when you’re online shopping for like...a hedge trimmer, you can see all the different models and what they cost before you order?
ALICE Well, why is it that when you need to see a doctor or have surgery, you’ve got no clue what you’re paying until it’s over?  I mean, that…that…
DAVID: That’s not ideal.
ALICE: Exactly.
DAVID: Which is why Aetna’s developed a way for you to get an up-to-date, personalized estimate of what you’ll pay out of pocket for a lot of common medical services.  Before you make an appointment.
ALICE: This I would like to see.
DAVID: Then just log in at and head over to Aetna’s member payment estimator.
ALICE: What kind of stuff can it estimate?
DAVID: Got something in mind?
ALICE: Well, my doctor says I need this test to figure out what’s causing my acid reflux.  An endoscopy.
DAVID: The little camera dealy, right.  Okay, so you’d select Tests and Procedures…find endoscopy in the list…  If you know the name of the hospital or facility you want to use…
ALICE: Not really.
DAVID: Then just hit continue…and there you have it: all the places in your area and your network that can do your endoscopy.  Not all of them have price estimates available, but more are being added all the time.
ALICE: Gotcha, so I click here [she clicks one of the Get Estimate buttons]…  Hey, an actual dollar amount.  Just like the cereal aisle. 
DAVID: Yep.  This way, you know what you’re getting into financially before you go in for a procedure.  Which lets you plan ahead.
ALICE: Okay so what are “Cost Details?” [She clicks “View Cost Details”]
DAVID: That shows you a cost breakdown that’s specific to your medical plan.  You can see exactly what Aetna pays, what you’re responsible for, and how much you save with Aetna’s negotiated rates.  And it takes your specific copay and coinsurance amounts into account, as well as how much of your deductible you’ve already met. 
ALICE: Fancy.
DAVID: Mmhm.  And this is a real-time estimate, meaning that every time you run the tool, you’re seeing the most up-to-date numbers available, based on where you are in your plan.
ALICE: That’s pretty cool, but it’d be nice to see how THIS number stacks up against my other options.
DAVID: You wanna shop around?  There’s a comparison feature that lets you do just that.  That way you can see other prices side by side.
ALICE: Just like looking at hedge trimmers online!
DAVID: [a touch of sarcasm] Yes, we strive to bring that “hedge trimmer level of convenience” to your health care shopping experience.  [Sincere again] But, I like to think we take it a step further in the helpfulness department.  For example, you’ll also find info on how to prepare for an endoscopy.  That includes an overview of the procedure, why it’s done, how it feels, and what to look for in terms of results.
DAVID: Now you know what you’re paying, what you get, and what to expect.  So you can plan ahead and get the most for your money.
ALICE: Just like anything else you buy.
DAVID: And that’s just one of the way’s Aetna’s giving you the info you need to feel confident about your medical decisions.
ALICE: So now that shopping for health care’s caught up to shopping for everything else, what’s the next step?  Super-intelligent goldfish doctors that do free surgery at home?
DAVID: Nope.