Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Quick Verdict
Choose Aetna International If:
- ✓ You're American and want US-style coverage
- ✓ You need strong US coverage (CVS Health network)
- ✓ You want higher coverage limits ($10M)
- ✓ You value US-based customer service
Choose Now Health If:
- ✓ You're based in Asia long-term without US needs
- ✓ You want 10-15% lower premiums
- ✓ You value Traditional Chinese Medicine coverage
- ✓ You prefer Asia-focused expertise
Overview
Aetna International and Now Health serve different segments of the expat market. Aetna, part of CVS Health, brings American healthcare expertise and strong US connectivity. Now Health, founded by industry veterans in Hong Kong, focuses specifically on expats living in Asia and the Middle East.
For Americans moving to Asia, this comparison is particularly relevant. Aetna maintains your connection to the US healthcare system—useful for home visits or eventual repatriation. Now Health offers better value and deeper Asia expertise if you're committed to the region long-term.
Both are financially stable insurers with established track records. The choice depends on your nationality, US coverage needs, budget sensitivity, and how long you plan to stay in Asia.
Aetna International at a Glance
- Parent Company: CVS Health Corporation
- Founded: 1853; International division 1957
- Network: 1.2M+ healthcare providers
- Headquarters: Hartford, CT, USA
- Best For: Americans abroad, US coverage needs
- Pricing: Premium tier
Now Health at a Glance
- Parent Company: Now Health International
- Founded: 2012 (by Cigna/Aetna veterans)
- Network: 900K+ healthcare providers
- Headquarters: Hong Kong
- Best For: Asia/Middle East expats, value seekers
- Pricing: 10-15% below Aetna typically
Coverage Comparison
Both offer comprehensive international coverage. Aetna's strength is higher coverage limits and US integration. Now Health differentiates with TCM coverage and enhanced mental health benefits.
| Coverage Feature | Aetna International | Now Health |
|---|---|---|
| Inpatient Hospital | Up to $10M (Core) | Up to $2.6M |
| Outpatient Care | Full coverage | Full coverage |
| Mental Health | Included (30-day inpatient) | Included (enhanced) |
| Maternity | Optional add-on | Optional add-on |
| Dental | Optional add-on | Optional add-on |
| Vision | Optional add-on | Included in some plans |
| Wellness/Preventive | Included | Included |
| Medical Evacuation | Up to $1M | Up to $1M |
| Alternative Medicine | Limited | Traditional Chinese Medicine included |
| Prescription Drugs | Included | Included |
Plan Tiers Compared
| Plan Tier | Aetna International | Now Health |
|---|---|---|
| Entry Level | Pioneer | WorldCare Lite |
| Mid-Range | Core | WorldCare Classic |
| Comprehensive | Elite | WorldCare Prestige |
| Deductible Range | $0 - $10,000 | $0 - $5,000 |
| Annual Maximum | $10M (Core) | $2.6M (Prestige) |
| Lifetime Maximum | Unlimited | Unlimited |
Key difference: Aetna Core offers $10M annual maximum vs Now Health's $2.6M. For most expats, $2.6M is more than adequate—but if higher limits give you peace of mind, Aetna delivers.
Coverage Highlights
Aetna International Strengths
- ✓ Higher coverage limits ($10M vs $2.6M)
- ✓ CVS Health US network integration
- ✓ Strong prescription drug coverage
- ✓ Established US-based support
- ✓ Familiar for American expats
Now Health Strengths
- ✓ Traditional Chinese Medicine coverage
- ✓ Enhanced mental health benefits
- ✓ Vision included in some plans
- ✓ Deeper Asia hospital relationships
- ✓ More competitive pricing
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Pricing Breakdown
Now Health typically prices 10-15% below Aetna for comparable coverage in Asia excluding US coverage. The difference is smaller than vs Cigna, making Aetna more competitive when you factor in coverage limits.
| Profile | Aetna International | Now Health |
|---|---|---|
| Single, Age 30 (Asia excl. US) | $140-190/mo | $120-170/mo |
| Single, Age 40 (Asia excl. US) | $200-280/mo | $180-250/mo |
| Single, Age 50 (Asia excl. US) | $320-420/mo | $280-380/mo |
| Couple, Age 35 (Asia excl. US) | $280-380/mo | $250-350/mo |
| Family of 4 (Asia excl. US) | $480-650/mo | $420-600/mo |
Pricing note: These are indicative ranges for comprehensive plans excluding US coverage. Adding US coverage increases Aetna premiums significantly (40-60%). Now Health's US add-on is limited and expensive.
What Drives the Price Difference?
- US infrastructure: Aetna's CVS Health backing means higher US capability costs
- Coverage limits: Aetna's $10M maximum costs more to underwrite
- Regional focus: Now Health's Asia focus enables operational efficiency
- Brand positioning: Aetna positions as premium, priced accordingly
- Network size: Aetna's larger global network has higher costs
Deductible Impact
Both offer significant discounts for higher deductibles. Consider a $1,500-$2,500 deductible to balance premium savings with manageable out-of-pocket exposure.
Aetna Deductible Options
- $0 — Full premium
- $500 — ~12% discount
- $1,500 — ~22% discount
- $5,000 — ~35% discount
- $10,000 — ~45% discount
Now Health Deductible Options
- $0 — Full premium
- $500 — ~15% discount
- $1,500 — ~25% discount
- $3,000 — ~35% discount
- $5,000 — ~40% discount
Network & Direct Billing
Network access determines your everyday healthcare experience. Aetna has broader global coverage; Now Health has deeper relationships in Asia.
| Region | Aetna International | Now Health |
|---|---|---|
| Global Network Size | 1.2M+ providers | 900K+ providers |
| Hong Kong | Strong | Excellent (HQ) |
| Singapore | Excellent | Excellent |
| UAE/Dubai | Strong | Excellent |
| Thailand | Good | Strong |
| China (Mainland) | Good | Excellent |
| Europe | Strong | Good |
| USA | Excellent (CVS Health) | Limited (add-on) |
| Direct Billing | Extensive globally | Strong in Asia |
Direct Billing Experience
Aetna Direct Billing
Aetna's guarantee of payment system works smoothly at major international hospitals across Asia. Their US backing gives hospitals confidence—direct billing rarely requires extensive pre-approval for standard procedures.
The main advantage is US direct billing through CVS Health. If you visit the US, Aetna's network is extensive and familiar. This matters for Americans who return home regularly.
Now Health Direct Billing
Now Health excels in their core markets—Hong Kong, Singapore, UAE, and major cities throughout Asia. Their Hong Kong headquarters means strong relationships with the best Asian hospitals.
Members report smoother experiences at top Asian hospitals where Now Health has direct relationships. Outside Asia, direct billing is available but less extensive.
Regional Strengths
Your location should drive your choice. Here's where each insurer excels:
Hong Kong & Singapore
Winner: Now Health (slight edge) — Now Health is headquartered in Hong Kong with strong Singapore operations. Aetna is solid but Now Health's local relationships run deeper in these markets.
UAE & Middle East
Winner: Tie — Both have substantial Middle East operations. Aetna has long-established corporate relationships; Now Health has grown aggressively. Either works well.
Thailand & Southeast Asia
Winner: Now Health — Now Health's TCM coverage and Thai hospital relationships give them an edge. Their understanding of Southeast Asian healthcare systems is deeper.
China (Mainland)
Winner: Now Health — Now Health's Hong Kong base provides natural advantages in mainland China. Better hospital relationships in Shanghai, Beijing, Shenzhen, and Guangzhou.
Europe
Winner: Aetna International — Aetna's larger global network shows in Europe. Better direct billing availability and established relationships across the continent.
United States
Winner: Aetna International (clearly) — Aetna is part of CVS Health, America's largest healthcare company. Unmatched US network. If you need US coverage, Aetna is the obvious choice.
Claims Experience
Claims processing reveals an insurer's true quality. Both perform well, with different strengths.
Aetna International Claims
- Submission: App, portal, email, or fax
- Processing time: 5-10 business days
- Reimbursement: Direct deposit or check
- Languages: 10+ languages supported
- 24/7 support: Yes, global service centers
Aetna's claims process is straightforward if sometimes slower than newer entrants. Their US-based support is helpful for American expats familiar with US healthcare systems.
Now Health Claims
- Submission: App, portal, or email
- Processing time: 5-7 business days
- Reimbursement: Direct deposit preferred
- Languages: English, Chinese, Arabic
- Support hours: Extended hours, not 24/7
Now Health members often report faster claims processing in Asia. Their smaller size means more personalized attention. Hong Kong operations team is knowledgeable about regional healthcare.
Both perform well: Neither has significant claims complaints. Aetna's 24/7 support helps for urgent situations; Now Health's Asia focus means faster local processing.
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Pre-existing Conditions
Both insurers underwrite pre-existing conditions carefully. Full disclosure is essential with either.
Aetna International Approach
- • Full medical underwriting at application
- • Individual assessment of each condition
- • Options: exclusion, loading, or waiting period
- • Typically 24-month wait for pre-existing coverage
- • Some conditions permanently excluded
Now Health Approach
- • Medical underwriting required
- • Case-by-case condition evaluation
- • Exclusions or premium loading possible
- • Generally 24-month wait for pre-existing
- • Group schemes may offer more flexibility
Important: Always disclose pre-existing conditions completely. Non-disclosure can void your entire policy. Both insurers investigate claims related to pre-existing conditions—honesty at application protects you later.
Real-World Scenarios
Here's how each insurer performs in common expat situations:
American Tech Worker in Singapore
32-year-old, healthy, wants comprehensive coverage. Returns to US twice yearly to visit family.
→ Aetna International Core — US coverage is essential. CVS Health network makes US visits seamless. Familiar for an American. Higher limits provide peace of mind.
British Expat in Hong Kong
45-year-old, married, no US ties. Uses both Western and traditional Chinese medicine.
→ Now Health WorldCare Classic — TCM coverage is valuable. No US needs, so why pay for it? Hong Kong expertise and better local hospital relationships. Save $500+/year.
American Family in UAE
Family of 4, parents age 38. Company provides basic coverage; want to supplement. Occasional US visits.
→ Aetna International — Supplements existing coverage well. US coverage when visiting. Family pricing competitive. CVS MinuteClinic access during US trips is convenient.
Australian Entrepreneur in Bangkok
40-year-old, runs online business. Budget-conscious but wants quality coverage. No US needs.
→ Now Health WorldCare Lite — Best value for Thailand-based expats. Strong Bangkok hospital network. TCM coverage appeals. Save significantly vs Aetna for comparable Thailand coverage.
American Retiree in Malaysia
58-year-old, managed Type 2 diabetes, wants comprehensive coverage. Will return to US for specialist care if needed.
→ Aetna International Elite — US coverage critical for specialist access. Higher limits important at this age. Diabetes management programs strong. Familiar American approach to healthcare.
European Couple in Mainland China
Both 50, healthy, living in Shanghai long-term. Want quality care without premium prices.
→ Now Health WorldCare Classic — Better China expertise. Stronger Shanghai hospital relationships. 10-15% savings. No US coverage needed. TCM coverage valuable in China.
Who Should Choose Which
Choose Aetna International If You:
- ✓ Are American or have strong US ties
- ✓ Need US healthcare coverage
- ✓ Want higher coverage limits ($10M)
- ✓ Prefer US-style service and communication
- ✓ Value 24/7 US-based support
- ✓ May relocate to Europe or Americas
- ✓ Want CVS Health pharmacy network access
Choose Now Health If You:
- ✓ Are based in Asia/Middle East long-term
- ✓ Don't need US coverage
- ✓ Want 10-15% lower premiums
- ✓ Value Traditional Chinese Medicine
- ✓ Prefer regional expertise over global scale
- ✓ Are in Hong Kong, Singapore, or China
- ✓ Want enhanced mental health coverage
Final Verdict
Both Aetna International and Now Health are reputable insurers that will take care of you abroad. The choice comes down to your US connection and where you're based:
Aetna International is the better choice for Americans or anyone needing US coverage. The CVS Health integration is unmatched, higher limits provide security, and US-style service feels familiar. You pay more, but get strong US connectivity.
Now Health is the smarter choice for non-Americans settled in Asia without US needs. Their regional expertise translates to smoother experiences in Asia, 10-15% savings add up over years, and TCM coverage appeals to many in the region.
If you're American in Asia—the core overlap audience—get quotes from both. The actual pricing may help decide. If US coverage isn't critical for you, Now Health likely offers better value.
Bottom Line
Aetna International for Americans and those needing US coverage. Now Health for Asia-based expats without US needs. Both are excellent—your situation determines the right fit.
Frequently Asked Questions
Is Aetna International the same as Aetna in the US?
They're part of the same company (CVS Health) but operate separately. Aetna International serves expats and global citizens; domestic Aetna serves US residents. The benefit: Aetna International can leverage the US network when you visit home.
Why would I choose Now Health over a bigger name?
Now Health was founded by senior executives from Cigna and Aetna who saw an opportunity to serve Asia better. They offer competitive pricing and deep regional expertise. If you're Asia-based long-term without US needs, their specialization is an advantage, not a limitation.
Which has better customer service?
Aetna offers 24/7 support in more languages and is more familiar to Americans. Now Health's smaller team provides more personalized attention in their core markets. Americans often prefer Aetna's style; others may appreciate Now Health's regional focus.
Can I switch between them?
Yes, but you'll undergo new underwriting. Pre-existing conditions accumulated during your previous coverage may not transfer. Some insurers offer "continuous coverage" credits—ask specifically when getting quotes.
Which is better for families?
Both offer solid family coverage. Aetna is better for American families who visit the US regularly. Now Health offers better value for families settled in Asia without US needs. Children's coverage is comprehensive with both.
What if I'm not sure about US coverage needs?
If there's any chance you'll need US care—family visits, possible relocation, specialized treatment—lean toward Aetna. The premium difference isn't worth gambling if US access matters. If you're certain you won't need US coverage, Now Health saves money.
