Aetna, a CVS Health company, is launching a market-leading generative AI-powered conversational experience in its digital channels that will simplify health care, allowing members to quickly and easily navigate their benefits for a personalized experience.
This represents a paradigm shift, as Aetna continues to transition from the industry’s traditional transactional experience to a consumer health experience. Unlike other industry alternatives where conversational AI is relegated to a chat window, Aetna is embedding generative AI throughout its end-to-end digital experience.
The embedded approach ensures the Aetna assistant synthesizes all relevant information for the member. It will deliver immediate, easy-to-digest answers for the user, eliminating the need to weed through links or complex content. More specifically, members won’t need to use technical healthcare terminology, such as “prior authorization” or “claims” to get answers, but instead can use plain language and receive a response that is personalized, understandable and visually dynamic.
Nathan Frank, SVP and Aetna’s Chief Digital and Technology officer stated, “At Aetna, we are constantly innovating, leveraging tools like generative AI, to provide a personalized experience and help our members navigate healthcare in a new way. This capability will complement all the important human interactions our members already have with Aetna clinicians, care managers, advocates and support teams.”
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Key differentiators and capabilities include:
- Immersive assistance embedded throughout Aetna’s website and mobile app experiences with session awareness to help members navigate through any point of their health journey without having to engage a typical chat bot experience.
- Industry first, dynamically generated rich user interface (GenUI) components that complement the response such as maps, charts, financial breakdowns, and informational cards tailored to the question asked.
- Building off the existing “ask me anything” search capability, empowers members to opt for generated AI responses on their own terms with clear designations as to when generative responses will be provided. Members will be able to ask questions like:
- Does my x-ray require approval?
- Can you find me a female physician that is less than 10 miles from my house and is taking new patients?
- How much are my son’s bad teeth brushing habits costing me?
“We’re making it easy to meet members where they are – both in their journey and their knowledge of health care,” Frank said. “Our personalized approach offers a contextual understanding of a member’s unique journey and revolutionizes how Aetna members interact with their health care.”
This new capability initially launched to a beta population in October, and access will be expanded throughout 2025 and the first half of 2026.
These near-term enhancements will include:
- The assistant will be a cornerstone of Aetna’s member experience. Future proactive AI insights will be served to the member as they navigate throughout the experience. For example, if a member is viewing coverage for physical therapy, our assistant will proactively ask if the member would like assistance finding an in-network therapist. If a member is viewing benefits, our AI insights section will offer a highlight of benefits relevant to the member.
- Aetna’s AI-powered experience will support multimodal interaction – including voice, text and screen-reader capability – so all members can independently ask questions, receive answers, and complete tasks. By embedding accessibility into the AI framework, the assistant becomes not only smarter but more equitable – a digital assistant that listens, speaks, and guides every member, making it more accessible for all.
- In the first half of 2026, Aetna members can use their device to verbally interact with the assistant with full voice enablement to engage in a natural, two-way conversation out loud to speak and hear responses.
- The assistant will also be embedded within Aetna’s recently announced Care Paths feature. Care Paths is a US patent-pending digital experience that helps members navigate select conditions – giving clarity about procedures and benefits that might be encountered and offering personalized care recommendations. The assistant will be by the member’s side, every step of the way, as they explore the care path helping them better understand their care options and navigate their next steps.
Source: PRNewswire
