For years, the claims experience has been one of the most friction-heavy touchpoints in healthcare. Members struggle to understand their Explanation of Benefits, navigate claim submission processes and track reimbursement status—often ending up on the phone with member services when the digital channel fails them. Corporate Insight’s April 2026 Health Plan Monitor Update noted two major plans addressing this from different angles: Aetna through contextual cost explanation at the point of confusion, and UnitedHealthcare through a structured, self-service submission overhaul.
The two approaches are complementary. One tackles post-service, helping members understand a claim after it has been processed. The other addresses submission, reducing friction when members initiate a claim. Together, they reflect a maturing view of what claims look like in the digital experience.
Aetna: Explaining claims at the point of confusion
Aetna’s Explain My Claim slideout walks members through the calculation in plain prose: how the plan discount reduced the total amount billed, how the firm’s contribution was applied and what ultimately constitutes the member’s share. The explanation is specific to each individual claim, not generic guidance.
The slideout also includes a direct link to Aetna’s new AI-powered site search, enabling members who still have questions to escalate without leaving the task they’re in. This choice reflects a design philosophy increasingly visible across leading health plan member sites: self-service tools should be interconnected, not isolated.
Features like Aetna’s slideout are designed to absorb confusion at the digital layer before it escalates. Done well, they reduce call volume while also improving member trust and satisfaction. The key design question is not whether to explain claims, but how to do so in a way that is specific, timely and accessible to members with varying levels of health insurance literacy. By positioning the explanation on the claim detail page itself, rather than linking out to a general FAQ or glossary, Aetna reflects a user-experience principle that is straightforward but often underexecuted: deliver information in the context where the question arises.
UnitedHealthcare: Rebuilding the submission experience
While Aetna focused on post-processing, UnitedHealthcare directed its recent attention to the submission side. The firm revamped its member site Submit a Claim form with a restructured multi-step flow that begins by asking members to categorize their claim before entering any details.
The updated form opens with a triage step: members choose from three claim types: Service, Purchase or Foreign Services. Selecting a type surfaces a secondary step on the same page, presenting the specific medical service categories that fall within it. This prevents members from filling out the wrong form and discovering the mismatch only after completing multiple fields.
For prescription and vision claims, the form adds a third step: a coverage confirmation screen that establishes whether the member is covered under their medical plan, a separate plan or not at all. A banner within the form links directly to the Coverage and Benefits page for members unsure of their status. This inline clarification prevents downstream claim rejections caused by coverage misclassification, a common yet avoidable failure in self-service submission.
The redesigned landing page also introduces an Other Forms and Requests section at the bottom, consolidating access to the International Claim, Member Authorization, and Appeals and Grievances forms in a single location. The Submit a Claim page now functions as a comprehensive self-service hub rather than a single-task entry point—a meaningful structural shift for members with varying needs.
The broader trend: claims as a digital priority
Claims represent one of the highest-stakes digital touchpoints from a member-retention standpoint. A member who successfully submits a claim without calling and receives a clear explanation of what they owe has a fundamentally different experience than one who encounters friction at both steps. The Aetna and UnitedHealthcare updates observed last month are evidence of a broader trend: digital infrastructure decisions that affect members’ perception of plan performance.
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Bianca Falcone
Bianca Falcone is an analyst on CI's healthcare research team.