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Aetna Health Insurance Online Reviews

Company Name: Aetna
Overall average rating of 1.2 out of 5, and the percentage of positive recommendations 1 %
Aetna service is beyond poor. 10 days after my son was admitted to ICU with a TBI and days after the trauma ER Dr. Stated we should be transferred to acute rehab. Aetna approved our facility. We checked out of our hotel, gas up and waited to follow transport of our son to PHX. At the last minute we are informed that they will not cover the Dr. Ordered transfer unless we cover 13k for transport and the hospital will not release him under Dr. Order to us to transport. Now we are sleeping in the hospital and our son is not receiving the directed care. We have been in touch and very active in this process without any quality of service. With Aetna buyer be careful. I pray this delayed treatment does not hinder my son's recovery.
As a practice manager I made many attempts to secure contracts for behavioral health providers and have been refused each time. Network management will not allow phone calls, direct emails to discuss the practitioners' qualifications. They provide only a basic form to complete and then send a denial stating the network is full. The network is not full, open choice is a right in this country (at least today it is) yet Aetna clamps the lid on new providers.
Aetna is the worst for everything. I went to urgent care for my wife and they billed me for $612.80 for emergency charges and $12 for doctor which I was able to see in my claim list. Then I got a bill of $482 which I paid assuming that it is the adjusted amount of $612.80 (I may wrong in my assumption). After sometime I got a call from the hospital that you have the amount due to paid. I said I already paid, then they said "no that is from different department."I said ok but whatever bill should come to me will come from Aetna and I should be able to see that in my claim list, which I was not able to see of the amount 482. Then I called Aetna and started having mail conversation then they said "no, you have to pay $612 + $12 + $ 482." I asked them why I am not able to see the claim of $482, the billed charged to me and they didn't answered me. They cheated me. So I will not recommend anyone for Aetna. Please be careful with them.
They send letters and demanding information. When I call, they say no information is needed. Any claims information they tell you is incorrect. Ask for a supervisor and none is available. They do not return messages. Hold times exceed 30 minutes. Never use this company.
Customer service is horrible. They don’t know why they didn’t cover my bill. They have to figure out and explain why they didn’t cover it, but they just said “I don’t know why”. I and my husband had the exact same insurance but they only covered my husband’s bill. They didn’t cover mine at all for the same dental office with the same insurance coverage.
I signed up for this particular plan after significant research. All my doctors accepted it. I pay nearly $850 per month for coverage. Every time I have a routine check-up, blood work, or an annual test like a mammogram, I am gauged with unexpected charges. Usually, they will say I never obtained a referral from my doctor even though I had. (My neighborhood lab would never agree to do a mammogram or breast sono without one.) After virtually every doctor's procedure or routine test this happens. There is no transparency with this company. I get a bill from Aetna that I have to immediately contest or appeal. They have set up their appeals process so this is standard protocol and no one is policing them. It is completely unethical. I see others are making similar complaints on this site. Someone needs to look into it immediately.
Aetna assured me multiple times that my grandchildren would be covered for 31 days following their births to my daughters who are dependents on my insurance. They paid the claims for my grandson but continually denied them for my granddaughter. They were born in May and June. A representative even wrote a letter to a pediatrician's office telling them gd was covered. Now in December they claim they paid grandson in error and have retroactively denied his claims! I have been placed on hold for up to 30 minutes, been talked to rudely, and denied the ability to speak to a supervisor! This insurance company is the worst!
Aetna is a horrible medical insurance and I would never recommend this medical one to anyone. Their representatives are very hard to understand and they cannot do anything right. I always had a problem like claiming. I missed a payment and I never did and they terminated me without giving me any kind of notice. And the people are just downright rude.
Finding a good doctor that accepted Aetna was relatively difficult. The receptionists all told me that they had so many issues with Aetna in the past that they will no longer accept it. After the birth of my son I absolutely understand why. It's been nearly 2 YEARS, and now I have another baby on the way. They are trying to stick me with thousands of dollars in bills. The most recent one I am fighting they are saying that I owe just under 30,000.00 that they are trying to say they will not cover. For reference, my deductible was 2,000 dollars so where they are saying I'm responsible for 30,000 dollars is beyond me. The customer service rep also couldn't tell me and tried to blame it on the hospital but unfortunately Aetna has been the common, miserable denominator in all of this. It's been a 2-year long battle with them between the hospital and Aetna and me. An absolute nightmare. I understand that insurance companies can be frustrating to deal with, but this one has no good reviews, and has been the most frustrating and deceitful company I have had to work with. I'm really, really looking forward to switching over to my husband's select med. Good riddance. How companies like this are still in business, I have no idea. This is one of those times the government needs to step in and shut these scam artists down once and for all.
Been with my family physician for 18 years and have had a myriad of health insurance companies. Nearly Every Prescription is denied stating it needs to be pre certified. I called to straighten it out, there is no getting to the bottom of anything. Excuses are that's the precert department not my department. Your Physician hasn't... (I know they have done what they are supposed to do)! Finally, I said "OK you can assume the responsibility then" when I can't take the prescription my Doctor says I need. I hope they save a bunch of money because it's going to go to legal fees! Aetna is the WORST Insurance Company I have ever seen!
In August of 2016 my fiance had back surgery that was very necessary because of a disc pressing on his spinal cord. He had to get the hospital put in network because the doctor (which was in network) needed to use the robotics at a certain hospital. After doing just that and having the surgery, Aetna refused to pay the $91000.00 bill saying it wasn't in network. After the first appeal, Aetna then claimed it was experimental. There was nothing experimental about it. After the second appeal, Aetna now resorts back to the hospital not being in network (which had to be approved before the surgery). Aetna will do anything to avoid paying even after you pay your premiums for years. We should all get together and start a class action lawsuit against those crooks.
This has been the worst experience with an insurance company that I have ever had! My husband has this as a retired member of a company. I have been told I was not a member... even though they were taking the money out. They kept saying my account had to be updated. Finally they found out I was a member. Now they don't want me to send in a check for my medication, and they have my medication on hold. They want to directly take it out of the bank. I have always been able to pay for my medication by check through other insurances. But now they have a "special" team to say if they will accept a check. Please do yourself a favor and skip this insurance. If I had it to do over, I would have skipped this insurance that was provided by my husband's company and went elsewhere! I'm counting the months till January. Oh and FYI, the survey you take after talking to a representative is only about the rep, not the company. I guess they would get tired of hearing all the complaints.
My mom is now on Aetna managed Medicare through Boeing and I can certainly say that Aetna is ruthless and worse than Medicare. At 80 years old my mom fell in her assisted living home and was hospitalized and got the flu all in a couple of days. After the hospital she was then transferred to a skilled nursing home and in less than two weeks Aetna managed Medicare is kicking her off the usual 100 days of covered skilled nursing and now my mom will need to pay over $600 per day out of pocket for skilled nursing care. They say she was refusing to get better. When you are recovering from the flu, dehydrated and in pain anyone would refuse to do physical therapy! For anyone who is on Boeing’s Aetna plan I would warn you and your parents not to get put on the Aetna managed Medicare. They are cold-hearted, profit-only oriented thieves who would rather cut off an old widow than help her recover. Great job Aetna and the morons at Boeing who shoved all the Rockwell retirees onto Aetna.
I was previously with Anthem Blue Cross and I had a great experience when I had to file out of network claims with this health insurance carrier. My husband's company switched to Aetna recently and it has not been a good experience. Almost every out of network claim that I have submitted has been denied and they do not ever provide explanations of why. And these are claims that were always covered by Anthem Blue Cross in the past. I have submitted some claims to Aetna for re-review over 4x after speaking to claims representatives over 6x to try and figure out why they are being denied. It honestly feels like Aetna is just in the business of denying claims instead of covering them.
I am insured by Aetna by a large prestigious company with a handful of employees overseas, who must go to doctors where we are based and file manual claims. We pay stiff premiums and have a medical spending account. Yet 80% of the claims are denied. Aetna reps have the lamest excuses: "We can't reimburse a claim involving a Mexican doctor." Or: "We can't reimburse an overseas claim unless it's a true emergency." Uh, wait, not even a mammogram? The countries we live in have much cheaper medical costs, and we are scrupulously honest. Once they sent me two checks for the same claim, and I tore up the extra check. But I'm still trying to get paid for a claim for a deep wound and a staph infection that cost all of $138. I have a chronic illness with no cure, and have required the same medication for years, yet every time I file, it's all new again.Thousands of dollars in claims mount up, and I have devised a bookkeeping system that's almost like a part-time job. Or the hobby from hell. I just keep filing the claim, calling the health advocates, or as a last resort, calling our benefits director. Finally, claims are honored. Though sometimes we just give up on claims that are under $100, because it's not worth the time -- and that, I suspect, is the whole point of their denials.
Aetna don't treat me like an adult, who goes to the doctor, paid her bills and make her own claims and like to receive her money back in her account. Because of my husband is the primary insured the information about my medical services are sent to my husband as the payments for my claims. After protesting they corrected but keep going back to send it to my husband. The information available in their website regarding my claims doesn't provide the current status of the claim: if the payment is in process or was paid and to where was sent. I have to call and spend time clarifying every claim. The phone service is correct but my time is valuable. After reading other claims about Aetna actions in your website I feel like this is not the most important issue but still is not the best way to treat the adult family members of the main insured person.
I have had Aetna for years, because it's really the only thing offered through my work that has providers in my area. They have gotten worse over the years. Here are some of the experiences I've had - I regularly see a provider who does not bill insurance. Lame, I know, but I have gone ahead and submitted the forms myself using the claim form provided by Aetna. They have lost the paperwork more than once, forcing me to resubmit. They have also reimbursed for some dates of a submittal and not other dates even though they were submitted at the same time.I was having surgery. We submitted the pre-authorization form. The approval came back for an office visit. We resubmitted the pre-approval, and it came back as an office visit. This time I had a copy of what the doctor sent in and could see all the correct coding and that it was for SURGERY not a consult. I called aetna. I was told that the doctor had submitted pre-approval for a consult. When I said "no", and I had the paperwork right in front of me that had all the coding and description of surgery, the story changed. She said they had entered it incorrectly and the doctor would have to resubmit. I said "no", there should be no more delays due to their error, we shouldn't have to resubmit. She still refused. I asked to speak to her manager and she refused.This happened two more times and then I told her she'd left me no choice but to go to the insurance commissioner. At that point, they changed it in their system so it correctly reflected that it was a pre-authorization for surgery. Approval came, I had surgery and the bill came and Aetna had reimbursed nothing for anesthesia. When I called, I was told that anesthesia was not part of the procedure?? Umm. I had surgery!Fast forward to now. I need surgery again (meh!). I have been told by 3 different doctors that the longer I go without surgery, the more likely it is I will have permanent nerve damage. My doctor submitted the pre-authorization form. Based on past experience I didn't trust aetna. I waited a couple days and then called to check on the status. The first person I spoke to at Aetna said "no pre-authorization has been submitted". I called back my doctor office and they assured me it had been submitted two days ago and gave me the confirmation number.I call Aetna back. This time they say they have the pre-authorization. They say the status is "pending". I ask them what that means and how long it will take. I'm transferred and told that it's being reviewed by a team of nurses. Hmm. She said "it can take up to 15 business days". I ask if there is anything that can be done to speed up the process and she says that if my doctor marks it urgent, it can be sped up. It really should have ended there, but then she gets snide and says she doesn't see what the hurry is, my procedure isn't until April 12 (about a month from now). I have no idea where she came up with that. My procedure hasn't been scheduled because they haven't flipping approved it. When I try to explain that to her, she cuts me off and says "that's what the schedule is". I am actually wondering if I should pay out of pocket for insurance just so I can get away from Aetna. That's how bad it is.
I initially called Aetna to make sure that my wellness exam doctor was in network and my appointment would be fully covered. The customer representative checked the Tax ID number that I got from my doctor and assured me that the appointment would be fully covered. After going to my appointment I was billed for the appointment because the doctor was not actually in network for me and the customer representative gave me incorrect information. I have appealed my claim to Aetna twice because I do not feel that I should have to pay for their representative's mistake. Both times the appeals were denied. Aetna has now told me that there is nothing further that they can do, and if I do not like their decision I can pursue an external appeals process. I should not be forced to pay for a mistake that the customer representative made. I understand that everyone makes mistakes, but as a company Aetna should back up its employees and pay for the mistakes that they make. It should not fall on the person who originally called to make sure that the doctor was in network to pay for being given wrong information. If I cannot count on my customer insurance representative to give me correct information then how am I ever supposed to know which doctors I can and cannot see?
Tried to have a script mail ordered to me. After 2 months calling I still do not have my script! They never got it right... not even the correct dosage!!! I have used mail order for a number of years, with no problems. Aetna is another story. They are completely incompetent. I will never sign up with them again.
I have this plan through my postal dental plan and it is very affordable and covers more than the other plans out there and you don't have a waiting period to get your benefits. This is a very nice benefit that most other plans also don't offer! And with the low price, you can't beat this plan in my opinion!
Writing for my son-in-law as he remains too sick to do this. He has seen two specialists (gastroentology) which have ignored him even after multiple calls to find out results of thousands of dollars of testing. He has been sick for almost 6 weeks and cannot eat anything without severe pain. One specialist, after a cat scan even told him that he should just go to emergency. Worse service I have ever heard of from an insurance and the doctors they represent.
Aetna denied my prescription twice for the doctor at 2 different pharmacies. The doctor's office got involved and Aetna agreed to fill the prescription using "their" pharmacy. This prescription is now 6 weeks old and has never been sent to me. When I spoke with Aetna's "special pharmacy" they have been sitting on the prescription for 11 days and haven't shipped it. They are doing this because of the extremely high cost of the drug. Denying someone these things should be criminal when they are just trying to curb their costs for 6 weeks. This is saving Aetna a lot of money by delaying the shipments. There is no way that I am the only person that is experiencing these issues with this insurance company.Has anyone contacted any lawyers for a class action lawsuit against Aetna? Aetna also had me under 2 different policies charging me the deductibles for both because they messed up the accounts. I took months of dealing and paying 2 deductibles before they changed the accounts and put me under the one that I actually signed up for.
I have been receiving ** infusions for 16 years. Been w/ Aetna since 2012. $35 copay all along. Plan/Dr/office/billing/Rx has not changed - $35 copay all along. Last year, Aetna decided to start billing me coinsurance of $3500. Said they made a mistake all those years only charging me $35. Threatened to go back and adjust all the prior years to charge me coinsurance if I didn't agree to pay from now on. I can't afford to pay, it's thousands of dollars, so I don't know what else I can do except pay now, but my plan doesn't require it.
Recently changed jobs, new job uses Aetna Insurance. First time I refilled my diabetes medication I received a letter saying the drug ** won't be covered. They recommend a medication that's been around for 50 years my doctor said. Very unhappy with this insurance co.
I have a severe medical condition and they have denied several of my claims. I pay my monthly premium on time, but they still are refusing to cover me. When I call them, they are extremely rude and won't give me time of day. Stay clear of Aetna. The insurance is for healthy people not those with serious conditions.
Aetna Whole Health VA Preferred - Absolutely horrible. If the doctor/lab/medical facility is less than 50 miles then they are in network. My lab is 47.2 miles one way and another is 47.7 miles one way. I am not getting the lab work or mammogram due to distance. REALLY MADE A MISTAKE WITH THIS COMPANY.
Needed MRI and was denied by their 3rd party. Stated had one 5 years ago. Dr tried peer to peer but no go. I got stuck with Aetna. No choice what retirement benefits changed to. As soon as I can I getting out. The company tells you one thing and it turns out to be wrong. Looks like their third party for precertification only wants to save them money.
It used to be that health insurance was simple. You met your deductible and then the company paid 80% of the rest. Now we have all this details about certain labs, certain procedures. It's ridiculous. I must go to a cardiologist once a year for congestive heart failure. My insurance has always paid for my echo, my blood tests, etc... This year, they will approve none of it because they want you to go to a central lab - which doesn't even offer the tests I must have. When I called about this, the customer service rep (whose name was Wendell) came out of the blue and said, "Well, we don't care about you. Not at all." I thought I was hearing things, but he repeated it. I guess I shouldn't be surprised, their CEO makes a quarter of a million dollars a day. Insurance companies are parasites on our population. We need to put them out of business with single payer medicare for all.
Prescription rates are more expensive than regular pharmacies. Customer service is NEVER helpful. They do NOT have a Pharmacist seven days a week. If there is an issue with your prescription, they do NOT contact you to notify you of any potential delay. They charge a fee for "quicker expedition" for a prescription!
I am an Aetna subscriber suffering from a severe case of cervical stenosis resulting in pain, discomfort, and numbness of my extremities (arms, hands mostly). There are two methods of treating this condition. One is Cervical Disc Arthroplasty (CDA) which has been a mainstream surgical procedure for the past 6 years. It is far superior to the alternate approach Anterior Cervical Discectomy and Fusion (ACDF) which has been around for approximately 50 years. CDA has a higher success rate (96% compared to 92%). CDA has a faster recovery time (6 weeks vs 6 MONTHS). CDA has no impact on neck mobility following the surgery, whereas ACDF limits neck mobility due to the fusion of one or more discs. CDA has lower risk of other complications whereas ACDF has a high tendency for bone spurs to form at the graph sites resulting in further complications and possible additional surgeries.Yet with all of this information, Aetna refuses to approve the CDA surgery for its subscribers because they consider it to be an experimental surgery. Interesting. Do the executives at Aetna still drive cars from the 60s and 70s because they consider current models to be experimental models? Come out of the dark ages Aetna and embrace the advancements being made in the medical field. The good news... Aetna still approves the use of leeches for various medical conditions.
Neurosurgeon try to get approval for ACDF but Aetna will not approve surgery in manner surgeon wants (anterior, artificial disc, cage vs posterior, bone graft, no cage). Aetna reps not knowledgeable about appeals process, telling me different time frames--take 20 days, 30 days, no right to external appeal, told me there is. And getting an address change? Next to friggin' impossible. Requested 5 times--still not changed. Can't wait to opt out. HATE AETNA SO MUCH!
I've had a series of dismal experiences dealing with Aetna, purely as a Plan Administrator. The website is balky and mostly useless. Changing even something as simple as the billing address is impossible. I needed to email my change - not possible online or even by phone. Our plan was once credited with someone else's $7000 payment. I had to spin my wheels trying to get Aetna billing to acknowledge and fix their mistake. I never got so much as a "thanks for noticing our SNAFU, oopsie, our bad" from anyone at AETNA. What is wrong with this company?
Once again, Aetna leaves me with a Sophie's choice: pay $417 in lab work myself or go without the blood test ordered by my doctor. When I called Aetna to make sure it would pay the 80% for the tests, the young person told me that this amount would be applied against my deductible. I have never met the $5,000 annual deductible in my life and doubt I ever will. I can't afford the premiums if I choose a plan with a lower deductible. In the meantime I have had to forego physical therapy that I desperately needed on my back and many a lab test because I hadn't met the deductible. This company gets thousands of dollars from me every year and what do I get?--bupkus.
Despite following every procedure as outlined in my plan and despite having written documentation from Aetna that expenses are approved and covered they, repeatedly deny my reimbursements. I always get paid but only after appealing 2 times every time. It's no wonder health insurance is so expensive with these bureaucrats. I am escalating to the insurance commissioner.
I have Aetna Better Health MD after losing my job. Nothing is covered. I don't drive and there's one available therapist who takes this insurance within a 20 mile radius. I just used the mobile app to find an obgyn. I got a list of providers, called the clinic for an appointment, and was told they don't take Aetna Better Health MD. Why are they listed on the app? So I called Aetna so I could talk to someone who could help me find an obgyn who takes this insurance. I was given one choice (a male - I would prefer a female) who has horrible reviews on Google, apparently has no website, and appears to be a urologist and not an obgyn. I'm not even going to bother with trying to use this unless some emergency pops up.
This company is the worst. When trying to find out about my disability claim my rep. is on vacation and they do not have any answer for my question about my claim. Keep giving me the runaround to different people. Strongly advise to avoid this company. Just want to take your money for nothing. What good is ins. if when in need no service!
I'll start by mentioning that it is 11 days past my group health insurance effective date. It was supposed to be active on December 1st, 2017. It is now December 11th and we still haven't been "entered" into their system. Therefore, my family and I "do not exist" in Aetna's world, nor does any medical professional recognize that we have health insurance. I have never heard of any insurer ever doing this to their customers.While waiting, I had to pay for two doctors' visits (full price since no insurance was "in effect" and we couldn't get the negotiated rate). Okay, I can deal with that and will file it when/if we are activated at Aetna. The straw that broke the camel's back was when I had to pay full price on my son's medication -- around $700. My patience was gone at that point. I called customer service (again) who wouldn't help me because "I wasn't in their system." After about 6 different phone calls and 4 hours of my time, they finally routed me to someone in the Rx insurer department.I had a simple question -- When my plan and member information FINALLY gets entered into their system, is it possible that the medications my son took were going to require a pre-authorization. I just wanted to be prepared since these pre-authorizations can take up to 10 - 15 business days from the time you have to send it to the doctor for initiation. I didn't want to fork out another $700 for the following month.The customer service (National Accounts) lady was very rude -- she wouldn't let me get a word in and interrupted constantly. I have never been treated like that by any customer service rep I have ever spoken with. She was very stern with her voice. I got her name and department, but somehow lost it over the following weekend. I wanted to file a complaint. I was angry at myself for losing it. The lady told me that no one would answer my question because the member information was not in the system. She refused to route me to anyone that might help.I understand that. I just wanted to know if it was typical for them to require pre-authorization for the medicines. I asked to be routed to someone in Rx to talk with anyway. She kept saying with a firm voice "No." Her reasoning... It could have been one of two Rx insurers -- Aetna or Optima Rx. I had a simple solution - Give me the number to both centers and will ask both of them. It would still give me some idea. She still said "No." After demanding that I have her full name and department, she finally gave it to me.Again, I know that when/if we get entered into their system, I can file the claim individually and perhaps get my money back. But, I was told by the pharmacist that since I didn't get a pre-authorization, Aetna/Optima is not required to pay the claim. A pre-authorization is required before obtaining the drugs -- and Aetna was known for doing this.I don't know how I will react if it happens. I will appeal, but who knows how long the appeal process will take and even if it would be overturned. I have some say-so whether or not my company will decide to change carriers for the next plan year. I assure you, I will do everything in my power to ensure this happens -- regardless of costs. NEVER, NEVER, NEVER will I use Aetna again and I would encourage the same for others if they have a choice. Also, if CVS acquires Aetna, then CVS will never receive a dime from me either. I hope this helps someone.
I have been selecting Aetna as insurance provider since 2009 and never used their services much until 2016 as I am young (31 years old now) professional. In 2016 we had a baby in October and my wife has been diagnosed with multiple diseases (not a good year from family health perspective). Since my wife has reached the plan coinsurance limit, Aetna started rejecting most of the claims for her. Recently she had to go in emergency for Pancreatitis attack and Aetna rejected the claim stating it wasn't necessary??? They are just increasing my pain. I will never suggest them to anyone. Next year onward I am planning to change to UHG - other insurance provider by my employer. Please suggest what should I do and who should I contact?
I have a severe intestinal disorder that requires infusions every 8 weeks. My first red flag with this company is when they denied my treatment at the infusion center that I typically get treated at. They said I would need to have it done at my doctor's office. My doctor's office tried to explain that they were not setup to do infusions in the office. Aetna still denied and now my doc office has to set me up in their office. I essentially have to sit in a chair for 4 hours in a windowless room which is uncomfortable and isolating. My infusion center provides a comfortable chair to lay, not sit in, WiFi, TV, pillow and blankets, snacks if need be because I need to eat small amounts of food throughout the day on top of my regular meals, and windows to look out of. My second red flag came when Aetna called to procure $5700 from me to cover my deductible upfront before they would send my medicine. Never have I dealt with an insurance company who owns their own pharmacy and then makes patients pay for the meds before giving them their treatments. Typically the insurance company would purchase the meds from the infusion center, I would get my treatment and then I could apply for financial assistance and a low interest loan to cover the deductible. This is ludicrous for a company to be able to operate this way. I am a week past due on my infusion and my health and pockets are now paying the price. This is an absolutely heartless company.
After a year and a half with Aetna prescription coverage, I am saying adios. I just read another complaint from a client who no longer can use her current pharmacy and going elsewhere is creating hardship. I have been denied on a third of the meds I was taking before joining Aetna, now three more have been eliminated from the formulary. They are "prior auth." - crazy and my doc is pretty disgusted. Just got a letter yesterday, they will no longer honor Rite Aid drug stores. I guess they have plenty of money, cause they sure aren't getting anymore from me. I spoke with another company today who assured me they cover all drugs I am taking. No prior auth's either. I immediately signed up. I will know next month if they are for real. If I have success, I will kick myself for not leaving sooner. Yes, it took about 45 minutes on the phone going over my list of meds, but that's nothing compared to the headache Aetna gave me. If I post the new prescription company name, it will look like I'm pushing them. Just believe that there is better out there.
In many cases, it is impossible to know what is covered: The customer service often contradict itself and anyway whatever they say isn't legally binding. And the 2 provided documents "benefit plan" and "schedule a benefit" are missing a lot of information. For example, I have exchange went over 10 messages/emails/chats with the customer service and I still cannot have a clear answer regarding a question as simple as whether going to a physiotherapist without a prescription is covered.
Aetna is horrible. For the 4th, 5th, 6th time they've messed up our billing so I can't get prescriptions. We have a primary and secondary account. They keep changing them blaming the doctor check with the doctor. It's correct and what happens is we wait months for prescriptions then you call them and you get a song-and-dance long-winded put on hold and no resolution. I'd rather be space dead than deal with him. Oh they're helping me by not getting me my medication so I probably will end up dead. Thank you. In return, taking my money and nothing in return. Run if you can the faster the better. They always take your payment but they don't return with any kind of customer service. These review sites need to put in the ability to have negative Stars. Extremely negative Stars.
I had to use my NEW insurance for the first time the other day. CVS bought Aetna, not good at all. I needed my prescription filled, I've been on this medicine for many yrs.. I find out that the insurance will only pay for 12 pills out of 30. Those 12 pills (generic) would cost $33. No change. If I wanted the remaining pills for my prescription it would be an additional $99.87... WHAT!!! I called Costco. For all the pills without my insurance watch this big change… $13.12!!! Guess where I'm getting my medication! No more CVS. Before Xmas I had a bad cold. Asked the pharmacist which out of the 3 would be better I showed her. She says, whichever 1 has the most √ on it. I said what!!? Very bad customer service. Our insurance is not helpful anymore, liked it the old way. We are being sucked dried of our money & taken advantage of.
I am currently off work with incurable illness and an accident while filing claim. This company has shown only attempts to deny and disqualify me from coverage. I feel that Aetna has no intentions of paying out any coverage and its only purpose is to collect policy money to further fill its own greedy pockets. I would not recommend using this company to anyone individual or corporate company for this reason.
Horrible experience with these people! They do not honor their claims even though it is written in their benefits plan. Every time you call to get more info about why they REFUSE to pay... you get a different person with a different EXCUSE as to why they won't pay. My office manager at my doctor's office who has 30 years experience with dealing with insurance companies said she has never seen any insurance company give so many ridiculous reasons and EXCUSES for non-payment on something that is in their own benefit package.They wanted more paperwork, then more documentation, then more this, than more that... So then we filed an appeal and guess what??? Then all of a sudden that was denied because they said it was more than 180 days and it's too late to do anything! So in other words they deliberately delayed the claim by giving us all these EXCUSES to tag us along so our 180 day time limit (and never told us this was time sensitive as well) would run out. What a poor excuse for an insurance company... I am cancelling and not recommending to anyone. Heard they were losing money anyway and very obvious they are trying to make it up by not honoring their claims! And just look at their reviews!!!
I had some tests done that my Primary Care Doctor has wanted done to determine the cause of my wheezing while exercising. Aetna paid the claim the first time, but then about 7 months later they charged it back to the provider, who then charged me for the services. For SIX MONTHS I went back and forth between the 2 companies trying to get the COVERED SERVICES PAID, after 6 months the provider threatened to send me to collections, so I had to pay it. What other choice did I have? I can't afford it, I can't have it on my credit, and this is I think how AETNA is making SO MUCH MONEY! THEY CHEAT PEOPLE by charging back covered services and then screw the people caught in the middle between the providers and the customer service reps who are all POWERLESS TO DO ANYTHING. DO NOT USE THIS COMPANY!
I am a retired space scientist. My former employer changed all employees/retirees in January 2015 from Blue Cross plan to Aetna plan. Mine is the top one available, Aetna Medicare PPO Premier Plan. It ostensibly puts control of health matters into the hands of the physician, but Aetna actually tries to influence and delay every action.On December 25, 2014 I went to Emergency Room at local hospital, with severe abdominal pains. ER physician ordered an abdominal CT scan which indicated a mesenteric mass in the abdomen, probably a carcinoid tumor. I have same primary and specialist physicians before and after the switch from Blue Cross to Aetna. Visits with specialists were scheduled for Jan 9 and a chest CT scan scheduled for Jan 13. Aetna denied the scan because the said Medicare required first a pulmonary function test (which actually had already been done in December 2014), but they never contacted me or the specialist who could easily have set Aetna straight. The CT scan was performed Jan 16. Cancer surgery had been planned for Jan 21, with octreotide tracer scans scheduled for Jan 19 and 20. Because of lack of planning time between scans and proposed surgery and since Aetna insisted on pre-approving surgery and viewing surgeon's detailed notes, the cancer surgery was delayed until Jan 22.I was in hospital for five days. When I was dismissed, the surgeon gave me prescriptions for pain, constipation and nausea if needed. Pharmacy would not fill prescription for nausea medication since Aetna insisted on having to pre-authorize it. Aetna's "fast" approval route takes at least 2-to-3 days (and by the way, Aetna does not work weekends). Pharmacist said they'd try to get Aetna's approval, but 2 days after discharge I had vomiting and, of course, no medication. The authority for medical decisions under my plan is supposedly with the physician. But Aetna's constantly meddling and delaying and denying service makes an already stressing cancer surgery an even more distressing experience.
I have been with Aetna Dental for 2 years. While Aetna tries hard not to pay any portion of my periodontal cleanings, they have been paying their little piddly $30 for my cleanings (every 4 months) while I pay the $95 balance. Keep in mind, periodontal scaling is fairly pricey and is needed at least 3X per year depending on the patient. The amount is not the issue though. After paying their piddly amount for almost 2 years, Aetna decides to decline payment on all future visits stating they have no history of periodontal problems. Not only do they have my dental records showing my history, including previous surgeries, they would never have paid anything for almost 2 years if they didn't have it, right? And I just now (January) got their declination for my August cleaning and December cleaning. They tried this before but when I called them, they said "sorry we must have made a mistake." Now they do this again? That's not a mistake. It's about as intentional as you get. My employer is one of the country's largest insurance companies, and Aetna makes a lot of money having such a large company as a policyholder. Although we don't deal with health insurance products, we would never treat claimants the way they do, and they should still be ashamed of themselves for even attempting their sleazy tactics with us. I can't wait until I can pull out of Aetna and join another carrier.
I ordered RX (3 month supply insulin must be on ice) on Dec 20, 2016. The delivery was held at UPS warehouse because someone at Aetna changed the delivery which was supposed to be sent to my doorstep. I called Aetna Dec 28th to have the insulin delivery changed and they told me that it would be delivered 7pm that evening. It never arrived. I called again Dec 29th and talked to a pharmacist Ruth that told me they would re-send new insulin because the medicine would have gone bad. I was told it would be shipped Jan 4th because of the holiday. I never received the medication and now the company will not retroactively send out the medication as my insurance has changed. This is so wrong!!!!
I had Aetna Med Advantage 2 years ago. I take 7 meds. Aetna made my meds Tier 4 and 5 which makes drugs cost 2600 for all HMO's and PPO's. I checked all 36 other plans. My meds were Tier 1-2 cost 1400-1600. Go with other companies - compare Aetna. Ripoff.
$2500 deductible although the prescription formulary provides my maintenance drugs at no cost. Med express is not covered and you must pay full price for a visit. It does count towards the deductible but it is an expense that should be covered like an office visit copay.
I had AETNA 3 years ago and they were awesome, no problems whatsoever. Now they are like dealing with a bunch of little children. Every time I call them, it is in regards to an error that has occurred on their end. So I have gotten loads of apologies but nothing changes. You know what that means, they really are not sorry. I miss BCBS... They drop AETNA like a bad habit in regards to health care and taking care of their members. I have been a Type 1 Diabetic since the age of 3, so thusly I have to have health insurance. They are the worst health insurance company I have ever had.
I changed my coverage to Aetna because it is the insurance provided by my husband's company. They refused to cover my migraine medication, resulting in a $500 copay. My Dr. and I demonstrated via paper trail that the generic medications do not work on me (I wish they did) and if I take them, my migraine is as bad as ever, almost to the point of going to the hospital for pain. In such scenario, a good insurance company should give a brand liability waiver, which would enable me to receive the only medication that works for me at the rate of a generic, since it is not a personal preference but rather a "the other medication does not work" preference. The Dr. and I demonstrated that it is not that the generic does not work as well, but rather does not work at all.The customer service at Aetna kept giving the Dr. and I the run around of how to fix the issue, saying that we could, but ultimately we got to the bottom of it and Aetna admitted they will not pay for it even though I pay for my insurance plan each month. I am extremely unsatisfied with their service. If you are able, choose a different insurance plan. I have an international trip coming up and because Aetna gave us the runaround, it will be too late to resolve this before leaving the country (despite me taking care of this four weeks ago). If I could give them zero stars, I would.
This is a horrible company. Canceled coverage in the entire state of NY without notifying customer. Only found out I wasn't covered anymore when I couldn't fill a prescription. They should not be in business, and US healthcare is a joke.
I process claims for a local eye clinic. Aetna has always been slow at paying claims, but they have came to a halt in the past 30 days. I call and call and all I am told is "still processing". Are they broke? Why don't they seem to be able to pay for legit claims? I read some of the stories on here and cannot believe how horrible they treat their members. Good luck to all of you.
My wife has Aetna through her employer. She pays a pretty penny to cover us. I recently went on dialysis, and Aetna is not paying anything related to dialysis. I've gotten calls/letters from my nephrologist, my clinic, and my medical supply company, informing me that Aetna has denied my claims. Why? Because Aetna claims Medicare should pay. Well, I don't have Medicare. I have called Aetna twice in the past 3 months to explain that I don't have, nor do I plan to get Medicare. There is no law stating I have to purchase it. Secondly, in my Medicare interview, they told me it would be secondary insurance for 31 months after I started dialysis. The first time I called Aetna, they said they would take care of everything. Couple months later, after finding out they're still not paying, I called again. After explaining everything again to them, the associate turns around and asks me, "so when are you getting on Medicare?" I lost it on the guy. My wife pays to get private ins and we expect them to cover us. He called me back after doing some research, and said that everything was taken care of. Apparently not. My wife has now got her HR dept involved and I contacted the BBB.
Aetna in Denver, Colorado is not adding new eye doctors in Colorado. In order to reduce costs, they feel that it is better to not add doctors, so waits to see doctors are longer so they pay out less money. Terrible patient care.
I have not had even one positive experience with Aetna administering my claims. Each and every claim has been an issue and has taken hours to resolve. The current issue has now been going for three months and I am back to square one due to Aetna inefficiencies.
I went for an annual physical with my new doctor. They ordered a basic blood panel to check cholesterol, blood sugar, etc. We went to LabCorp and had the tests done. Got my results, etc. I then receive email from AETNA that the blood work draw was not covered. Since when is basic blood panel NOT COVERED? One of the worst insurance carriers around, I would go back to Kaiser in a minute if it was an option!
Made the mistake of trying Aetna just to save a buck. The old saying you get what you paid for is true! One of the Parkinson's meds I take was 40.00 at Kaiser. Almost 400.00 with Aetna! Have a major medical condition that requires me to go to a specialty clinic. Rep I spoke to with customer service offered Spokane - a 8 hour drive! Parkinson's makes it difficult to drive more than a hour. Worst decision I ever made switching. Hopefully I survive financially.
I have Aetna insurance through my job at work and I had to go off of work at the beginning of December 2016 due to a medical condition. My first attempt to be put on short term disability was not successful. Not because I did anything wrong, but because the agent who I spoke to and whom I made sure to let her know this was for short term disability and not for FMLA *due to my knowledge of my business not approving FMLA until a year on the job* made sure to only put my claim through as FMLA. I got an online notice letting me know that my claim had been denied after 6 days. I diligently followed up and found out what happened, so my claim was already almost a week late in being started correctly. After this I have done nothing but jump through hoops, follow up and do literally everything I possibly can to make sure all information needed for Aetna for my claim was provided to them.I've had nothing but issues with my claim manager being available. Literally I've had him call me, leave me a voicemail and I call back within a few minutes only to be told he's gone for the day. I have had to call them every single time I know that the doctor's office has sent something over, otherwise, I found out the hard way. They will wait 10 days before they even review my claim (again, only because I had called at that point). Finally, I have a follow up with a specialist this coming Friday in regards to my health and I had spoken (for the VERY first time) to my claims manager on last Friday and he let me know that at this time that they would wait for that doctors’ information before they would be able to continue with my claim, only to wake up and find that in the middle of the night they sent me a letter denying my claim altogether.So, now not only am I facing horrible health issues that according to them does not hinder me from doing my job but they've now made it so now I have to appeal this. My doctor has taken me off work for a reason. I have done nothing but follow up with my doctor, be put on medications, go to specialty testing and now am seeing a specialist, yet none of this is clear enough for Aetna to substantiate my claim. They are a joke! And unfortunately for me, right now I'm the punch line. Thanks to their determination. Now lucky me gets to not only appeal this decision, but worry about how I'm going to pay the bills that I've been holding off on, while awaiting this decision from them. Can't eat from air or pay rent with no money, yet that isn't their concern. Glad, I'm fighting a health issue and now I get to fight the insurance company as well. Thanks Aetna... Thanks for helping deteriorate my mental health as I battle my physical health!
My wife and I have spent about $3000.00 getting ready for bariatric surgery. When we were forced to renew our coverage in January all of the plans excluded bariatric benefits. Aetna has been completely inflexible and callous through the whole ordeal. I have paid thousands of dollars to them over the years and have rarely had to use them for anything other than prescriptions. They have become very wealthy from people like myself paying them and them not doing what they exist to do which is to assist with medical needs. Aetna is owned by CVS and CVS will never get any of my business from now on.
Newly diagnosed adult type 1 diabetic. I didn't have years to prevent or a diet to change because it was developed as part of failing thyroid disease. I don't understand how Aetna could continue to deny and delay approving life threatening need for insulin. I don't have a thyroid and produce no insulin. While Aetna is waiting on paperwork pushing 90 days prescription, I could go into diabetic shock. I'm very upset with the politics of also telling us which drug to use when some generic brands have failed me for years. I want someone to understand that I'm just trying to live longer than 45 years old.
Between what my employer pays & what I pay, we're giving Aetna $2,200 a month for health insurance for myself & my wife. We have their "platinum" plan. It's almost impossible to find a doctor or facility in their network. Many providers say they take Aetna but Aetna always comes back with they're out of network. Also, Aetna's Navigator sucks!!! Absolutely the Worst! I have never hated a plan more in my life!!! Buyer beware!
My Arthroscopic knee surgery was approved and now after I have had the surgery I received a letter saying it has been denied. I wouldn't have had it done if it was not approved beforehand. This company is messed up.
I am leaving on a trip and will be gone when my next dose of osteoporosis preventative medication is due. Aetna refuses to authorize my monthly osteoporosis medication four days early. I will have to go without. Apparently they think fractures and crushed vertebrae serve you right if you have the temerity to travel. There have been nothing but complaints since Aetna took over the administration of the Alaska retiree health benefit plan. It is a truly awful company in the business of making money by denying health care to sick people.
I suffer from chronic pain. I don't look like I am in pain but I injured my cervical and lumbar area of my spine and I can't seem to get a true diagnosis but when I can't get my medication regularly, it creates a problem. My life is at a standstill. I can't fight fires and I am paralyzed at times. I have place on the beach and had to move back home, back to my parents at 40 and inconvenience my Mother who is 72 with ten grown children. They won't ship to Florida b/c of the "regulations". Why can't I be treated like an individual? They think with the meds I have been taken, which I have been taking since 2009 and in higher doses before and I need to have a local pharmacy b/c I live in South Florida and b/c they have kids and even adults abusing it? Is that my fault? I feel terrible that I have worked since I was 14, hit the the height of my success and trying to get back on my feet and be a contributing member of society and I can't b/c the local pharmacies have a limited amount of meds they get and there were times that I had to go to 40-60 pharmacies. Now, I have a pharmacy that would hold my scripts. Thank God!!! How am I going to get better. I haven't done three years of my taxes!!!
I was recently put on Donnatal and then when the new year changed I found out that I needed to get a preauthorization for my medication. The only problem is if I go off Donnatal for too long I can have a seizure, so I spent the next week waiting on Aetna to approve me. While that was happening I was spending 117 a day for four pills. My wife called after five days and Aetna said that my DR had never faxed in the preauthorization. We talked to the doctor and yes, in fact they did send it in. We called them back and then they said "Your case is still in clinical review." Then days later we get a letter in the mail from Aetna saying that my medicine is now no longer being paid for by Aetna. This means if I want to continue to live without pain then I will have to pay about $1500.00 a month. Donnatal was the ONLY thing that made my life better after decades of pain and anguish.
October 2012 I had my gallbladder removed. Had been sick for several months leading up to the surgery. It took me 3 weeks to bounce back to the point I wasn't sleeping all day everyday after the surgery. My job wouldn't allow me to return until the doctor released me 3 weeks after surgery. Aetna said 1 week was all they allow for this surgery and since the way it works is I have to be out 1 week for the short term disability to kick in. Technically they didn't have to pay unless there were complications like infection. If my doctor says I can't go back to work for whatever reason related to the surgery who is Aetna to say differently? Trust me if I could have gone back to work I would have.
Pt. gets Medicare Advantage Plan through Aetna. If Pt has dual MedCare and Medicaid plan and Pt filled his deductible this year with Medicare/MedAid it will not be valid for Aetna. With new insurance for Pt.- Dr. will be victim of cut payments and not be paid second time in the year normal fee for services he rendered - fee they signed to be paid for, with Medicare. Aetna got idea how to use all those murky, uncharted waters in their advantage - to count it as deductible again, in same year, even if Patient filed his deductible for this year and, Dr. already got paid at Medicaid rates that are MUCH LOWER THAN 80% of what is agreed amount that Dr. should be paid by Medicare. So Drs will eat up loss and Aetna will gain - it's not called for nothing ADVANTAGE - I doubt that Medicare had that in mind when they offered those insurances chance to serve as their contractors - not to take advantage of Drs and patients any way they can.
My daughter has type 1 diabetes and requires many supplies and life sustaining insulin. I order my supplies through mail order and order a 3 month supply so I have fewer copays. My daughter's primary insurance is Bluecross and her secondary insurance is Aetna Better Health which I chose because my daughter qualifies for Medicaid and Aetna Better Health is one of 5 insurance companies that I could choose from under Medicaid. I was told that my primary insurance covers most things and Aetna Better Health covers everything else. Well they have covered nearly nothing! They refuse to reimburse me for copays. My copays for my daughter equal a car payment every month! They reimbursed me once but I spent HOURS on the phone! I don't have time to spend hours on the phone each time I need to be reimbursed! I'm a mother of 4 and don't have the time or money to deal with this. Every time I call I have to explain that she has type 1 diabetes and she meets the loop hole clause that states everything is covered because she needs life sustaining meds. If anyone out there could help me or have been through this before please help!
Not sure where to begin. I first went to a hospital linked to Aetna for a routine physical and stated up front that my primary care physician (PCP) had retired so that I needed a new PCP. Filled out the paperwork, came back the following week for my physical, and all cool... until two months later when I am abroad and Aetna says that they will not cover because I did not go to my non-existent PCP.Later in a major vehicle accident, which hospital bills >100K, and Aetna sends me a letter that I need to find someone else to bill because it was not a medical issue. I somewhat agree here as should be covered by the other driver (at fault) insurance, but just the letter with the immediate exclusion ridiculous. I have paid Aetna well over 100K over 15 year. Stuck with them because my employer, and have pretty much got nothing in return when even the basics arise. All that plus just basic customer service really bad. Now stuck with trying to force my employer to jettison Aetna. Maybe will be not so hard, because seeing all the other complaints here, others might feel the same.
Aetna has been helpful with all my calls. They have a comprehensive list of providers in-network, the personnel is very friendly and follow through with any health issues is pretty thorough. They seem better than most other providers in this area. They are what works for me, but my husband has a different insurance provider that better addresses his needs. Also, sometimes the online member site is not so easy to navigate and sometimes they make you jump through hoops to get your medication. You have to reiterate that you have been through a step process, then have your Dr. notify them repeatedly in order to get the same meds you have gotten from them for years. This happens every time you need to renew a prescription.
I called today 8 times... They disconnected my conversation 6 times... Spoke to james ,gerald and roslyn etc. I think due to them getting out of obama care, they are doing disservice and poor service to force consumer away from obamacare... which is ridiculous... and outrageous. Poor business practices. I request department of consumer affairs to investigate these practices. Their doctors also doing poor services systematically. Doctors will make you wait for longtime in the offices... They will see other patience first purposely. So you can question them... and their office staff will tell you that I have different insurance. It happened to me more than two times. It's an organized crime they are committing and nobody to question these practices. When all these will stop. When government gives them the contract, they should sign to be penalized for these kinds and other frauds they commit to the consumers/Public. Poor people don't have time to complaints?????
I have had difficulty with Aetna covering claims multiple times in the past, so for this past visit related to birth control I called Aetna to ask about my coverage and preferred provider. I was told birth control is covered through contraceptive services 100%, so I went to the office that they instructed me to. Afterwards I received a sizable bill and when I called Aetna to ask why it was not covered, I was told that the contraceptive portion of the visit was covered but every contraceptive visit has an associated medical visit (although I did not seek ANY medical care or advice) and that this office was not my preferred provider for medical visits.
I chose this supplement when I turned 65 as a supplement to Medicare. Beware of their PRESCRIPTION stipulations! At 65, they are tinkering with what medications are okay for me to take. Seriously? If I have a written prescription from my physician of 8 years, the insurance company should not require ME or MY PHYSICIAN to jump through hoops to follow their guidelines. I have a prescription that they will only fill for people age 18 and younger. Oh my GOD! If my physician is intelligent enough to know of a use for this medication at my age of 65, why in the world am I paying them $40 for something that was free on my insurance. BEFORE I thought I was so lucky to be on Medicare? I am paying more out of pocket per month than I pay for the Medicare deduction out of my social security check. This is absolutely outrageous and UNHEALTHY for the patient! I'm leaving them ASAP!!!
Obamacare is the least American plan passed, then you get companies like Aetna that does exactly what is said in my subject matter (PRIOR) to the Obamacare Obama CRAP. I had good health insurance for 296 per month, $20 copay, $5000 deductible. Now with the help of Obama Crap (care) through this despicable company I have a $804 month premium, 0 copay, and a $7500 deductible. Anyone that thinks Obama Crap (care) is good is a Welfare **.
Signed up for Aetna's health care policy that was supposed to start Jan 1. They started billing me immediately instead of waiting for January. They would not issue me a refund or set up billing to start correctly. I had to cancel the policy entirely.
I'm currently rehabbing a (repaired) torn rotator cuff. I'd been to see my physical therapist 25 times and had no issues with authorizations, prescriptions, etc. However, after 25 visits Aetna requires a re-authorization of your claim. My re-authorization claim was submitted by my physical therapist mid-March 2016, at which point my therapy was put on hold. As of May 11, 2016 I still have not been able to see my physical therapist. My orthopedist and therapist agree that I still need aggressive physical therapy sessions, three times per week. My orthopedist is so displeased with my progress that he's begun giving me cortisone shots.I've heard many different stories from the many different people I've spoken to at Aetna's Member Services department (us plebes aren't allowed to speak with anyone at Aetna proper) about why I'm not able to see my therapist and none of them make sense: they haven't received a request for re-authorization (they had), they haven't received the necessary paperwork from my therapist (they had), they'd be sending a physical letter to my therapist containing their decision about re-authorization (they didn't), ad infinitum. Their member services phone support is abysmal and I've had to hang up on them multiple times after being put on hold for 30+ minutes. The most fruitful exchanges I've had with them has been on Twitter (yes, really).I was finally told today (5/11) that Aetna would be sending the official re-authorization confirmation to by therapist. However, this re-authorization expires on 5/31/16. I'm only allowed three visits per week, so the maximum number of sessions I could possibly have between now and then are ~10. However, between my schedule and the therapist's schedule, it's much more likely to be 4-5. I've asked repeatedly how I can avoid this rigmarole when the next re-authorization claim is made on 6/1/16 and no one will give me a straight answer; they've effectively told me to have my therapist re-submit the authorization and wait it out - again. I suppose I should just be thankful that my issue isn't life threatening or too debilitating.
Claims for 4300$ which insurance can’t explain is usual thingThey even doesn’t know who is provider and what’s going on. (I’ve finally received the bill from this provider for 90$ but claim for 4300$ is still there.) And one more claim for 900$ for annual examination (what supposed to be free). It’s super stressful to receive all these claims. The same thing happens for all my workers. Worst experience ever. I can’t understand why this company still exist.
Pulmonary recommended to take dymista as failed nasonex and Flonase for allergic rhinitis /nasal problems - The Pulm clinic tried preauthorization but denied by AETNA. Dymista was helping with the symptoms and I dont want any change of meds if dymista is helping! I called Preauthorization and was told to send appeal letter which I did, but no answer back if they have got it and reviewed or not. I am now feeling the heartache how my patients must be feeling. I have to change this insurance and have spoken to my husband. We have secondary insurance Blue Cross so I need to check if they would cover meds. Why are insurance companies giving us such a hard time - I now understand why my private colleagues are so frustrated!
I have asthma and use inhalers on a daily basis to control my breathing. I have a valid prescription on file with sufficient refills and not an expired prescription. I called in my refill on Friday morning and went on Saturday morning to pick it up. When I got to CVS, they told me that Caremark has rejected the prescription. I inquired on why and the pharmacist did not know and advised to call the insurance to find out. I called the insurance and they advised that because I filled the prescription twice already their contract requires them to fill a 90-day prescription to save me money. That's a laughing matter. They should be honest and instead say this is to save our corporation money.With asthma, my medication can change at any time usually every month to 2 months so making me get a 90 day supply and paying for a 90 day supply wastes my money and the medication which just piles up in my medicine cabinet. There are major prescription drug problems in this country but the insurance adds to it and promotes the issue. However, I explain to the representation that I need my medication and am willing to pick up the 90 day supply. They advised that they need a script for a 90 day supply in order to refill and has faxed my doctor's office the request for the 90 day supply. Please keep in mind I still have a valid 30 day refill on file. I advised them that it is Saturday so my doctor's office is current closed and will not be open again until Tuesday as it is a holiday weekend (July 4th). They apologized and said they can't do anything until they get a 90 day script. I spoke with a manager as well who refused to allow the refill on a valid prescription.Speaking with these people clearly shows that health insurance IS IN NO WAY SHAPE OR FORM about the health of the people who pay them every month for coverage, but instead about their profits. Clearly I am wasting my money by paying for health insurance. It's just amazing that they would refuse to refill a prescription that they have on file because of a contract they have to save them money. I asked them what would happen if something were to happen to me because I didn't have my medication and they simply said, "I can't refill your prescription." Please fix this health insurance issue not just for me but for everyone wasting their money on it. This is criminal of a company to hold medication hostage to save money. It is a matter of life and death for some people but they are willing to risk the lives of people.
Aetna's state employee health plan has zero out of network coverage. None. Unless inside a tiny network area - for us Oklahoma City only - you will pay full costs EVEN IF DR. HOSPITAL, or URGENT CARE says they take your insurance and processes your card. Aetna won't pay anything and you will get the full bill. When 90 miles out of town camping or on an out of state trip with an emergency they have denied all our claims and multiple appeals AFTER hours on the phone saying we were in fact covered. DocFind is not reliable at all. We've been denied several providers that listed as covered in network. Higher premiums than other options; terrible service.
Received a bill from Eastern Maine Medical Center for $215. According to Aetna, their contracted charges with the facility allows for a charge of $344.08. They sent me a note "Your responsibility on this claim is $344.08." This makes no sense. If the bill is $215, I'm not about to pay more than the bill because I have insurance with Aetna. I have the high deductible plan, so I'm paying all the bills until the deductible has been met.
WHAT A WASTE OF MONEY/PREMIUM COSTS! You proportionately have insurance, but it just does not pay the providers so more costs back to the consumer,Meritain Health cant explain their payment reasoning to the consumer. The adjudication takes months to settle a claim, and then it's really not settled to the benefit of the patient. Being a TPA allows these bandits to skirt all clean claim laws in the state I live in. Out of network consideration is below area averages and then the cost is thrust on the patient/consumer.Their website lists providers that are not par/in-network. I was told that the provider must tell Meritain they are not par to be removed. Yet another brilliant statement...chicken or the egg. So, they indiscriminately list doctors as in network and even if they were contracted at one time cant modify their website to reflect who is and is not par... Meritain Health denies claims but is a TPA owned by in the hen house. Yet another reason why nationalizing healthcare is a good idea since free market won't work based on the way these guys do business...
I have a claim for 162$ with Aetna HMO and have been calling them from the last 6 months. Every time, they have told me that a check has been sent. But I have not received the check yet! The reference number for customer service calls is **. The phone number of insurance company is 800-323-9930. Appreciate any help in making Aetna actually mail my claim check.
My family enrolled in a plan with Aetna in Dec 2014 after carefully looking at the doctors who accepted Aetna purchased through the ACA marketplace. To our dismay the list is not accurate. Most of the doctors listed would not take it. That's their choice...understood. When I called Aetna for assistance with finding a doctor who would take us they were no help. Besides not being able to understand them due to thick accents (calls routed to Philippines), they were just useless. I decided to cancel the policy before it even took effect. I will await my refund which according to 3 different people will take 3 different amounts of time to go back into the bank. One to three days, seven to ten days, or three to five days. Not sure who is right so I will watch my account closely. I switched back to Blue Cross.
I have the unfortunate pleasure of having polycystic ovarian syndrome, and the only marketed and proven BC for preventing cysts is Yaz. However, Aetna used a "clinical pharmacist" to decide to deny me from this BC. First of all, pharmacists do not prescribe or choose what medication you take, they fill it. I am sure it is illegal for a pharmacist to decide I cannot have that medication. Also, my father is a pharmacist, a good one, and he has never said I should take something else for my PCOS because it is "unnecessary". When I am on other BC's I get extremely ill, with multiple trips to the doctor, vomiting, and pain due to cysts. I spoke with them right now and they told me I should try something else and it is my choice for not wanting to follow the guidelines. First of all, this is a doctor prescribed medication, and it is NONE of their business or not their right to dictate what medication I am on for my PCOS. I am horribly disappointing. Horribly. If I get sick, like I always do if I'm not on it, they'll be hearing from an attorney.
My husband retired and I had to go on group plan at work. Aetna. The first time my doctor prescribed my blood pressure meds they denied it. She changed it to what they wanted, Diovan. I switched Sept 1, 2012. Our plan changes 1st of each year. I had it 9 months of 2013, last refill of the year they denied it. Tried, and tried, they even told me I needed to change doctors. No meds for 4 months. Went to doc today, denied again!!!!!! I am calling my state senator.
I have degenerative disc disease and had lumbar fusion l3/l4 in 2013. L4/l5 disc was herniating so I had injections. It finally went to protrusion so held off on surgery. Felt terrible pain in my lower back that made me cry; it hurt so bad. Dr. wanted to do MRI. Aetna denied. I also have fibromyalgia and rheumatoid arthritis. My rheumatologist prescribed me **. Aetna denied me this medication. Aetna is the worse healthcare that you will ever pay out the nose for. A company that doesn't care about your well-being, they are just in it for greed.
My daughter is required to use Aetna Specialty Pharmacy to get her Prograf needed to prevent rejection from a bilateral lung transplant. They do not bill her secondary and do not provide the generic she can use so she has to get name brand and pay $250 a month for that one med. If they would allow her to get it from our local pharmacy she would only have to pay $2 a month because they will bill her secondary and provide the generic she can use. I have spoken to someone at the pharmacy to get a long term override and they denied it. I cannot believe a company would prevent someone from getting a life saving medication at a cost they can afford. This is a drug that she needs to survive or she will go into rejection. I have now contacted our state's Attorney General and will also contact our state's Watchdog group. I cannot say enough bad things about this situation.
Joined Aetna about 3 weeks ago. It is now jan. 9. For 10 days I've been trying to get an ID card. Tried to activate account to get ID card. Answered questions and got a message that it couldn't activate account and I needed to call them. Called number and chose the call me back option because wait time was too long. Did this twice, been 4 days, no one has called yet. Two phone numbers and only useless virtual operators answer. They'll take your money but won't provide any service. Will start looking for a new insurance company tomorrow.
This company has some of the worst customer service I've ever dealt with. My son receives therapy once a week. I submit the same claim from the same provider every time. It goes smooth for a month or two then they start screwing up the claims. They aren't processed correctly or they're not processed at all and require me to call them. Now they won't cover the therapy and it's taken me over 2 months to find out why. Their only response is that there has been no measurable progress yet the report from the therapist says there is.They've promised documentation that I have yet to receive. I've had better experiences dealing with an Indian help desk. I can get different responses from different people on different days on the same question. The only reason I have this coverage is because this is the only option from my employer. Next year I'm going to find my own coverage on the open market. Even if I have to pay more it would be worth it for the stress I'll save. 1 star is too good for them.
This is absolutely the worst experience I have ever had with an insurance company and customer service in general. Representatives have hung up on me, been incredibly rude and shown little patience or understanding. I have never been employed in the insurance field and am fairly young (a year out of college) so I required some guidance when it initially came to learning about my new insurance provided by my current employer. I called requesting information and was treated with passive aggression and disdain. 2/3 customer service reps I spoke with over the course of several months acted as though I was a pesky telemarketer who had rudely called them during dinner. I went into this experience with a positive attitude, despite the fact the my co-workers all gave very negative reviews, but unfortunately I can't say that I disagree after being insured by AETNA for almost one full year. Thus far, the coverage has been less than satisfactory as well. Go ANYWHERE else for insurance.
Aetna constantly denies claims for prescribed medication. Then their appeal process is so absurd that you will quite possibly die before you get thru it. It is 100% made so the customer will give up because of time and lack of progress. I am sure because of Aetna low level of health care coverage people have died unnecessarily. There automated service is the worst, their callback reliability is ridicules and non-existent.Employee # ** is incompetent at (his/her) job. They simply don't know who the customer is. They try to talk over you. Their procedure is to argue the customer into submission, not help as the "Support Number" would imply. Elvin employee # ** is another on the incompetent call center personnel ("Manager"). I was guaranteed a phone call back in 30 min by the so called Next in Command in their ridiculous chain. Though I made it quite clear that the callback needed to be returned within 30 min (a time frame they choose), that time has came and went. There is a medication that I have been on for ten or so years. Aetna plays some pre-auth game every January, like they haven't been paying it for the last 12 (and ten years). THEY ARE THE WORST IN THEIR FIELD!! AETNA I AM NOT GLAD I MET YA. Corporate Greed is all this boils down to.
I have had a horrible time with Aetna and am grateful my company is changing insurance companies. They have inaccurately put holds on my account, stopping me from going to planned appointments when I first scheduled them. They have denied claims because it was not the main service. We were on a cruise and needed to go to the emergency doctor. They covered only part of the service because "the IV and medicine was not an essential part of the treatment." It has been a nightmare. They are not open any Saturdays and often are closed on lunch for team meetings (as stated on the automated caller).
I have a dental emergency. I called a dentist to get seen, and they need Aetna to fax them a pre-authorization before they can see me. No problem... Until I try to call Aetna and talk to a live person. Any time their horrible phone system tries to transfer me to an agent, it hangs up on me. It doesn't matter whether I say "agent", "representative", or press 0. Apparently those are set in the system to just hang up the call to avoid dealing with paying customers. HORRIBLE, horrible customer service.
Aetna is treating my going to see the Nurse at a CVS Minute Clinic as a visit to a medical specialist with the associated $40 co-pay. Actually even CVS did not know that their Nurses were Specialists, because they only charged me a $10 co-pay when I went in. Had they told me the co-pay was $40, I would have waited to see my family physician. Prior visits to CVS were treated as seeing a Nurse with a $10 co-pay, but now, beware of Nurse Specialists at CVS. Next year, Aetna will be out of my picture for good.
I have this insurance through my job. But they are so hard to deal with. When you call, they never know what you're talking about. Then they refer you to a case manager, Thats never available. They make mistakes on paperwork. Then dont take responsibility for them. & The customer suffers. Because of their mistakes.
I have chosen a primary provider with this insurance company multiple times. By the time I get the card, the providers do not want to take Aetna anymore. Apparently Aetna does not pay on time and sometimes not at all. If you do find a provider (about 50 miles from your house), they are usually rude people with the nastiest offices. Very low class providers accepting this plan (seems like the desperate ones that can't keep patients). Everyone I have talked to is rude, or not properly trained. Huge lack of customer service. This insurance is best used at the emergency room or urgent care offices and nowhere else.
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