If you are looking into purchasing long term disability insurance to protect you in the event that you become ill or disabled and are unable to work for a long period of time, you may be overwhelmed or confused by all of the policies available. Two popular healthcare providers, Aetna and United Healthcare, both offer long term disability insurance policies.

Aetna vs. UnitedHealthcare Overview

Aetna and UnitedHealthcare are both large insurance and healthcare providers in the U.S. UnitedHealthcare serves approximately 45 million people, while an estimated 39 million people choose coverage through Aetna. Both insurance companies offer a variety of coverage, including health insurance, life insurance, dental, vision, and disability. Disability insurance is split into two categories: short term disability and long term disability insurance.

While short term disability will cover people who become injured or ill for several months, long term disability usually covers people who will be unable to work for years. Approximately 1 in 4 young people will become disabled before reaching retirement age.

How Does Long Term Disability Work?

Long term disability provides employees with a safety net in the event that they become disabled and are unable to work for a significant period of time. During the time they are unable to work, a long term disability policy will pay out a portion of their wages.

Many long term disability policies require people to be disabled for a period of time before they are eligible to receive benefits. This time period is called an elimination period. Some policies may also have time limits on the amount of time an employee is eligible to continue receiving benefits.

What is the Aetna Long Term Disability Schedule of Benefits?

Aetna long term disability insurance provides policyholders with several benefits. These benefits may differ depending on which disability insurance policy you choose. As many people who hold insurance policies hold them through their employer, your benefits may depend on how large your company is and which plan they have chosen.

Aetna long term disability plans may cover between 50% and 66% of your monthly earnings, or up to a maximum of between $2,000 and $10,000 per month.

In addition to paying out during the period of time you are unable to work, Aetna may also cover a portion of your benefits if you return to work on a part time basis. Aetna also offers additional benefits including a program that works with your employer to make the transition back to work smoother, and helps you to understand how to follow your doctor’s instructions while on the job.

In the event that you are unable to return to your previous occupation, Aetna may also offer training for other jobs.

Aetna disability insurance policies have an elimination period of at least 90 days. You must file your long term disability insurance claim with the company within 30 days of becoming disabled in order to qualify for coverage. Aetna coverage may not apply to people who have become disabled due to drug or alcohol abuse, or who are suffering from mental health or psychiatric conditions.

Additionally, the company does not cover long term disability caused by insurrection or rioting, intentionally self-inflicted injuries, acts of war, engagement in a criminal act, or as a result of operating a motor vehicle while under the influence of alcohol or drugs.

What About UnitedHealthcare Long Term Disability?

UnitedHealthcare long term disability policies may pay out up to 60% of your regular pay during the time you are disabled. Policyholders are eligible to receive these benefits after being disabled for 180 days.

Aetna vs. UnitedHealthcare: Which Provides Better Coverage?

When choosing between Aetna vs. UnitedHealthcare, you may want to consider several factors. Aetna and UnitedHealthcare are approximately the same size: Aetna has approximately 1.2 million health care professionals and 5,700 hospitals, while UnitedHealthcare consists of 1.3 million physicians and around 6,000 hospitals.

You may want to consider whether your current doctors or hospitals are covered through Aetna or UnitedHealthcare, if it is important for you to continue seeing the same physicians.

Depending on which policy you choose, you may be able to receive between 50 and 66 percent of your base pay, and will be covered until age 65 or even later, depending on your age when you become disabled. Looking at the details of each individual policy may aid you in making your decision.

Aetna and UnitedHealthcare also use different pharmacies as preferred providers, with Aetna using CVS, Safeway, Kroger, and Costco, and UnitedHealthcare choosing Walgreens.

According to Investopedia, neither Aetna or UnitedHealthcare made the top five long term disability insurers in 2020, however. Those spots went to Breeze, Guardian, Assurity, Principal Financial Group, and Mutual of Omaha, according to reviewers.

Aetna vs. UnitedHealthcare Claim Denials

According to The Post-Gazette, insurers try not to tell consumers about their claim denial rates when selling them a policy. However, the American Medical Association has been compiling data on denial rates since 2008.

According to the report, between 2008 and 2013, Aetna has moved from denying 6.8% of claims to 1.5%. United HealthCare moved from denying 2.7% of claims to 1.2%. However, a 2012 survey of health care administrators and executives revealed that United HealthCare ranks lowest in satisfaction, with Aetna ranking only slightly higher.

Aetna’s website details the actions policyholders must take if their claim is denied. Claimants have 180 days to appeal a denial unless otherwise specified in their policy. Aetna plans can provide for one or two appeals. For plans with one appeal, the insurer will decide between 30 and 60 days of receiving appeal paperwork depending on the claim. For plans with two appeals, the timelines are shorter, between 15 and 30 days. The second appeals process allows policyholders 60 days to submit their paperwork.

Policyholders with a UnitedHealthcare plan have 120 days to submit claim reconsiderations for improperly paid claims. Appeals can be submitted 12 months from the date of service, notes the insurer’s website.

Once you have made the choice between Aetna vs. UnitedHealthcare, you may be able to speak with an experienced attorney about how to file your claim. The process of applying for long term disability benefits may be complicated, and many first time applicants are denied. Having a qualified disability insurance attorney on your side may make it more likely for you to receive the benefits you deserve.

Get Help With Your Long Term Disability Insurance Appeal

If you filed a claim for long term disability insurance benefits and your claim was denied or terminated, the attorneys working with Top Class Actions can help you file for an appeal against the insurance company, which will help increase your chances of a successful appeal. 

You may also qualify for help if you are just beginning the application process or if you have already filed your appeal and haven’t received a denial letter.

Fill out the free form on this page for more information. 

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