Aetna International vs GeoBlue

Overview

Aetna International and GeoBlue are the two leading options for Americans living abroad who need comprehensive health insurance that works seamlessly in the US. Unlike other international insurers where US coverage is an expensive add-on, both of these providers build US network access into their core product.

Aetna International is the global arm of Aetna, now part of CVS Health. They've been providing international coverage for decades, with strong roots in employer-sponsored plans. Aetna offers both tiered plans (Pioneer series) and modular plans (Navigator) that let you customize coverage. Their US network includes 1.7 million+ providers, and they have particularly strong corporate and employer relationships.

GeoBlue is Blue Cross Blue Shield's international health insurance division. The BCBS network is the largest in the US—96% of hospitals and most doctors participate. GeoBlue leverages this massive US infrastructure while building out international coverage. Their plans are simpler (tiered only), but their mobile app is consistently rated as the best in the industry for finding providers and managing claims.

For Americans abroad, this comparison matters because these are arguably the only two providers where US coverage isn't a costly afterthought. This guide will help you understand exactly how they differ.

The US Expat Advantage

Americans living abroad face a unique challenge: they often need to access US healthcare for visits home, maintaining relationships with US specialists, or eventual repatriation. Standard international insurance handles this poorly—either excluding US coverage entirely or adding expensive riders.

Both Aetna and GeoBlue solve this by building US network integration into their core product:

• Direct billing at US hospitals and doctors—no paying upfront and waiting for reimbursement
• Full US network access—same providers you'd use with domestic insurance
• US prescription coverage—fill scripts at US pharmacies when visiting
• Seamless coordination—your plan works the same whether you're in Mexico City or Minneapolis

If you're American and will regularly access US healthcare, these two providers should be your starting point. Other international insurers are better suited for expats who don't need US coverage.

Coverage Comparison

Both providers offer comprehensive international health coverage with similar benefits. The differences are in the details—particularly around mental health, maternity, and evacuation limits.

Key Coverage Differences

Medical Evacuation:

• Aetna: Up to $1,000,000 for evacuation and repatriation
• GeoBlue: Up to $500,000 for evacuation

If you'll be in remote areas or developing countries where evacuation is more likely, Aetna's higher limit provides extra security. For most expats in developed countries, either limit is adequate.

Mental Health Coverage:

• Aetna: Included on all plans (with session limits on lower tiers)
• GeoBlue: Included on Choice and Excel tiers (not Essential)

If mental health coverage matters, check the specific plan tier. GeoBlue Essential excludes it entirely.

Maternity:

• Aetna: Optional add-on available on Navigator plans
• GeoBlue: Included on Excel tier; not available on lower tiers

Planning a family abroad requires careful plan selection. Both providers have 10-12 month waiting periods for maternity benefits.

Telehealth:

• Aetna: Available on select plans (typically higher tiers)
• GeoBlue: Included on all Voyager plans

GeoBlue's telehealth integration is consistently praised—you can video chat with a doctor through the app. Useful for non-emergency consultations anywhere in the world.

Pre-existing Conditions

Both providers handle pre-existing conditions similarly:

• Standard 2-year lookback period (conditions treated in prior 2 years)
• Exclusions or waiting periods for pre-existing conditions
• Some conditions may be covered after waiting periods
• Full disclosure required on applications

Neither provider is notably better for pre-existing conditions—both are standard in this regard.

Plan Options & Structure

This is where Aetna and GeoBlue differ most significantly. Aetna offers customizable modular plans; GeoBlue uses straightforward tiers.

Aetna International Plans

Pioneer Series (Tiered):

• Pioneer: Inpatient-focused, basic coverage
• Prime: Adds comprehensive outpatient, mental health
• Platinum: Everything including wellness and preventive care

Navigator Series (Modular):

Navigator lets you build a custom plan by selecting modules:

• Core (required): Inpatient hospitalization
• Outpatient: Doctor visits, diagnostics, prescriptions
• Wellness: Preventive care, screenings, vaccinations
• Dental: Routine and major dental
• Vision: Eye exams, glasses, contacts
• Maternity: Pregnancy and childbirth

This modular approach can save money if you don't need certain benefits. A 30-year-old who doesn't need maternity or dental can build a lean plan at lower cost.

GeoBlue Plans

Voyager Series (Long-term expats):

• Essential: Inpatient only, lowest premium, no outpatient or mental health
• Choice: Adds outpatient, mental health, most common tier
• Excel: Comprehensive including maternity and wellness

Trekker Series (Travel medical):

For shorter trips rather than long-term expat living. Travel medical insurance, not comprehensive health insurance.

Which Structure Is Better?

Choose Aetna Navigator if you know exactly what you need and want to optimize for cost. The modular approach rewards careful planning.

Choose GeoBlue tiers if you prefer simplicity. Pick Essential, Choice, or Excel based on how comprehensive you want coverage to be. No decisions about modules—just pick a tier.

Pricing Breakdown

Pricing between Aetna and GeoBlue is competitive. GeoBlue tends to be slightly cheaper at comparable tiers, but Aetna's modular plans can undercut if you skip benefits you don't need.

*Estimates based on 2024-2025 quotes for expats including US coverage. Actual prices vary based on health history, exact destination, and plan customization. Both providers include US coverage in base pricing.

What Affects Pricing

• Age: Primary factor—premiums roughly double between ages 30 and 60
• Deductible: $0 to $5,000 options; higher deductibles reduce premiums 15-25%
• Plan tier: Essential/Pioneer is 25-35% cheaper than Excel/Platinum
• Location: Some countries have regional surcharges
• Family: Children add relatively less; couple/family rates have small discounts vs individual

Ways to Reduce Premiums

US Network Access

For Americans, the US network is often the deciding factor. Here's how they compare.

GeoBlue: Blue Cross Blue Shield Network

GeoBlue provides access to the Blue Cross Blue Shield network—the largest and most widely accepted in the US:

• 96% of US hospitals are in-network
• 90%+ of doctors accept Blue Cross
• Familiar brand: Most Americans have used BCBS at some point
• PPO-style access: See any provider without referrals

If you have existing relationships with US doctors, they almost certainly accept Blue Cross. The network is so large that finding out-of-network providers is unusual.

Aetna International: Aetna Network

Aetna's US network is also extensive, though slightly smaller than BCBS:

• 1.7 million+ providers nationwide
• 90%+ of hospitals participate
• CVS integration: Pharmacy benefits at 9,900+ CVS locations
• MinuteClinic access: Walk-in clinics at CVS stores

The CVS integration is genuinely useful. Need a flu shot, quick prescription, or minor care? Walk into any CVS MinuteClinic. This convenience isn't available with GeoBlue.

Which US Network Is Better?

GeoBlue (BCBS) is marginally larger—96% vs 90% of hospitals. In practice, both cover essentially every provider you'd want to see in urban and suburban areas. The difference matters most in rural areas where provider choice is limited.

If you already have doctors you like: Check if they accept Aetna or BCBS. Most accept both, but some providers are in one network but not the other.

International Network

Provider Access Abroad

Both providers have approximately 1.7 million international providers. In practical terms:

• Major hospitals in capital cities have direct billing relationships with both
• Network density is similar across popular expat destinations
• Neither has significant coverage gaps in developed countries
• Developing countries may require more reimbursement-based claims

Provider Finder Apps

GeoBlue's app is consistently rated superior for finding international providers:

• GPS-based provider search
• Filters by specialty, language, direct billing
• Provider reviews and ratings
• One-tap directions and contact

Aetna's app is functional but less polished:

• Provider directory search
• Basic filtering options
• Claims submission
• ID card access

If finding providers via mobile app is important to you, GeoBlue has the edge.

Claims & Customer Service

Claims Processing

GeoBlue Claims:

• Mobile app with photo submission
• Real-time claim status tracking
• Typical processing: 7-14 days
• US Blue Cross claims process faster (existing infrastructure)
• Direct billing at network providers eliminates most claims

Aetna Claims:

• Online portal, mobile app, email submission
• Typical processing: 5-10 days
• CVS Health backend enables efficient processing
• Direct billing extensive in both US and international networks

Aetna's claims process is marginally faster on average. But with direct billing available from both, you'll rarely need to file claims for major expenses.

Customer Service

Both offer:

• 24/7 phone support
• Multilingual assistance
• Emergency evacuation coordination
• Digital ID cards
• Online member portals

Aetna adds:

• Dedicated case managers for complex medical situations
• Stronger corporate account support
• CVS Health Nurse Line access

GeoBlue adds:

• Superior mobile app experience
• Telehealth integration on all plans
• Award-winning provider finder

Who Should Choose Which

Real-World Scenarios

Let's see how these providers perform in situations US expats commonly face.

Scenario 1: The Corporate Relocator

Jennifer, 38, is being transferred to London by her Fortune 500 company for a 3-year assignment. Her employer offers international health insurance.

Best choice: Likely Aetna International

Large employers often have negotiated Aetna corporate plans with better rates and enhanced benefits. Jennifer should check what her company offers before looking at individual plans. Aetna's corporate relationships are stronger than GeoBlue's.

Scenario 2: The Retiree in Mexico

Robert and Susan, both 62, are retiring to Puerto Vallarta. They'll return to the US 2-3 times per year to see family and US doctors they've used for decades.

Best choice: GeoBlue Voyager Choice or Excel

Their existing US doctors almost certainly accept Blue Cross. The BCBS network gives them maximum flexibility when visiting home. GeoBlue's simpler tiers also suit retirees who don't want to navigate modular options.

Scenario 3: The Digital Nomad in Costa Rica

Marcus, 31, works remotely and is spending a year in Costa Rica. He's healthy and wants basic coverage with good US access for occasional trips home.

Best choice: Aetna Navigator (custom) or GeoBlue Essential

Both have low-cost options for healthy young expats. Aetna Navigator lets Marcus skip maternity, dental, and vision for a lean plan. GeoBlue Essential is the simplest budget option. Either works—Marcus should get quotes and compare.

Scenario 4: The Pregnant Expat in Germany

Amanda and Dave, both 34, are planning to start a family while living in Munich. Dave's job doesn't offer international insurance.

Best choice: GeoBlue Excel

GeoBlue Excel includes maternity in the base plan (after waiting period). Aetna requires adding maternity as a Navigator module, which adds complexity. Both have 10-12 month waiting periods, so they need to plan ahead regardless.

Scenario 5: The Remote Adventure Worker

Tyler, 40, does humanitarian work in remote areas of Southeast Asia and Africa. He needs robust evacuation coverage and strong international networks.

Best choice: Aetna International Platinum

Aetna's $1M evacuation limit (vs GeoBlue's $500K) provides critical protection for remote locations where evacuation costs can be extreme. Aetna also has dedicated case managers for complex international medical situations.

Frequently Asked Questions

Our Verdict

Aetna International and GeoBlue are both excellent choices for Americans living abroad. The right choice depends more on your preferences than objective superiority—they're genuinely comparable products.

Choose GeoBlue if you value simplicity and the largest US network. The BCBS connection gives you the most widely accepted US coverage, and their mobile app is genuinely the best in the industry. Pick a tier—Essential, Choice, or Excel—and you're done.

Choose Aetna International if you want more control over your coverage. The Navigator modular system lets you build exactly the plan you need without paying for benefits you won't use. The higher evacuation limit ($1M vs $500K) also matters if you're in remote locations. And if your employer offers Aetna corporate plans, the rates will likely beat individual GeoBlue plans.

Both include US coverage as a core feature—the main reason these two providers dominate the US expat market. You're not choosing between good and bad; you're choosing between two good options that emphasize different things.

Get quotes from both. Compare actual pricing for your age and needs. Then pick based on whether you prefer GeoBlue's simplicity and network size, or Aetna's customization and CVS integration.