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Out-of-Pocket Cost Estimator for Aetna Members

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As of September 1, 2010, patients covered by Aetna may obtain estimates of out-of-pocket costs from Aetna's secure member website.  Taking deductibles, coinsurance, copayments and plan limits into account, the estimator allows members to compare their anticipated costs for up to three physicians or facilities at a time for:

  • Physician office services
  • Surgical procedures
  • Diagnostic tests and procedures

Physician estimates are based on Aetna-contracted provider fee schedules.  Facility costs are based on historical claim data, factoring in a three-month time lag to help ensure accurate reporting for an entire episode of care.  If a facility's claim data is insufficient to support a credible estimate, none will be provided.