specification: FinOps Framework
specificationVersion: '1.0'
alignedWith:
  framework: FinOps Foundation Framework
  frameworkUrl: https://www.finops.org/framework/
  dataSpec: FOCUS
  dataSpecVersion: '1.3'
  dataSpecUrl: https://focus.finops.org/focus-specification/v1-3/
provider: Aetna
providerId: aetna
publisherName: Aetna
serviceCategory: API
created: '2026-05-04'
generated: '2026-08-30'
method: searched
modified: '2026-08-30'
source: >-
  https://developerportal.aetna.com/ (no pricing, no plans, no billing surface),
  https://developerportal.aetna.com/assets/Data/quickstart.json,
  plans/aetna-plans-pricing.yml, rate-limits/aetna-rate-limits.yml
provenance_note: >-
  REPLACES a 2026-05-04 bulk-sweep scaffold that modelled Aetna as a usage-based, monthly-invoiced,
  USD-billed API vendor with api_requests, data_egress and compute_seconds meters and cost-per-1K-
  request unit economics. None of that exists. Aetna bills nothing for these APIs. The scaffold was
  also feeding derive-access-model.py, which was consequently labelling Aetna "Paid".
tags:
  - Health Insurance
  - Healthcare
  - FHIR
  - FinOps
  - CMS Mandate
description: >-
  Aetna does not monetise its API surface, so there is no FinOps posture to model on the supply side.
  The Interoperability APIs are published because CMS-9115-F and CMS-0057-F require a payer to make
  member, directory and prior-authorization data available; there is no price, no meter, no invoice
  and no chargeback. The only cost signals that exist are on the CONSUMER side - the cost of building
  and operating against a read-only FHIR surface with no numeric rate limit and no cache headers.
monetized: false
billingModel:
  pricingCategory: no cost
  billingFrequency: null
  billingCurrency: null
  chargeCategories: []
  note: >-
    Aetna issues no invoice for API consumption and publishes no rate card. "no cost" is the
    FOCUS-nearest label for a surface that is free by federal mandate; it does not mean a free tier
    of a paid product, because there is no paid product.
meters: []
focusColumns:
  ServiceName: Aetna Interoperability APIs
  ServiceCategory: API
  ProviderName: Aetna
  PublisherName: Aetna
  InvoiceIssuerName: null
  PricingCategory: no cost
  PricingUnit: null
  BillingCurrency: null
  ChargeCategory: null
consumer_cost_drivers:
  - name: Uncapped retry cost
    description: >-
      Aetna publishes no numeric rate limit and no Retry-After. A consumer must budget for its own
      backoff and for wasted calls absorbed by a 429 it cannot anticipate.
  - name: No conditional requests
    description: >-
      No ETag, Last-Modified or Cache-Control is documented, so a consumer re-fetches full payloads.
      This matters most on the provider directory, which is large, largely static reference data.
  - name: Bulk export as the cheap path
    description: >-
      $export on /v1/providerdirectorydata and Provider Access $davinci-data-export exist precisely to
      avoid "hundreds of requests" (Aetna's own wording, 2023-09-29). For any whole-network workload,
      bulk is the cost-correct choice.
  - name: Per-member authorization
    description: >-
      Patient Access data can only be retrieved with a token bound to one consenting member, so
      consumer cost scales with enrolled members, not with API price.
unitEconomics: []
maintainers: []