Aetna Health Insurance

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William of Mesquite, TX November 23, 2009

I went out on disability in June of 2009. My claim was denied by Aetna because they say I was able to do my job. I was on medication that made me sleep 12 to 14 hours a day. My doctor filled out and faxed them information repeatedly. After the first appeal, the representative lied to me, she said she could not find any information where my doctor took me off work.

My doctor has sent Aetna many faxes stating my condition. Aetna supervisors and representatives will not call you back. I am now into month number four. Still no short term disability benefits. The stress has only added to my inability to sleep. Here is the strangest thing. My job tell me I am not able to do my current job and will not let me come back to work.

Aetna says that I can do my job, and will not pay me. What am I to do. Broke in Texas. I have gone thru all savings. Still have to eat and pay bills, I am the only one who works in my household. Help.

Darci of 72 S Main Street, ME November 9, 2009

I had a Doctor appointment and she changed my Thyroid medication from Levoxyl to Synthroid to see if it would work better and be tolerated better. The pharmacy would not fill it. The insurance company said it was too soon and was too close to the same kind of medicine. I had a 90 refill of the old meds in October because I had run out. It was said that the Doctor would need to call the Parmacy Management department to state that she wanted me to have the medication. Isn't that what she has already done by writing the new prescription? Although they are 'like' or 'similar' drugs they do not work exactly the same. I find it very frustrating that the insurance company is overriding the DOCTOR in a patients health. I also find it a frustrating waste of my and the Doctor's time.

Economically - I will have to pay out of pocket for a 30 day prescription to get started on this med to see if it works better for me. If it doesn't work I will need to return to the original med. Physical Damage - Who knows - continuing to take a less effective med just leads to the condition not being controlled as completely as possible.

Rosemary of Cypress, TX November 7, 2009

In September / October 2009 my husband went to his PCP to obtain a new 90 day prescription refill for his diabetes medications. We received a 90 day script. On the following Tuesday, we learned my husband would be going to Dubai to work on the following Saturday. Because we were unable to work through the mail order process, we went to Wal-Mart and asked if they could assist us with his order. The pharmacist was kind enough to call Aetna on our behalf, after we explained our situation to her.

At that time, our intention was to relocate to the Middle East by December or January, depending on how things went with my husband’s work. We were honest and explained my husband would not be returning to the United States. Aetna partially complied with filling two of the three medications, but refused to fill one of the medications (I believe it was the long-acting diabetes medication).

We had no choice but to send him with what medications we had. Eventually he ran out of the medication Aetna refused to fill. When I asked why they would not refill the medicine, the Aetna representative stated people sell their medications overseas!

I want you to know that as a direct result of Aetna’s incompetence, my husband was unable to pass his physical because his sugar was elevated. He was shipped home without work after several weeks. I want you to know I called Aetna and really gave it to some poor lady who had to listen to why I was angry. I want you to know, Aetna does not need to worry about my husband and I selling his medications abroad. My husband leaves for work overseas without much more than a week’s notice, and we try to abide by the mail order policies.

My husband expecting to leave overseas once more. Today I have requested refills on your website. Please send the medications. We anticipate leaving Houston in Mid-December. A copy of this complaint was filed with the Ombudsman and Consumer protection Division of the Texas Insurance Division, as well as the Texas Better Business Bureau.

Fred of Houston, TX October 29, 2009

I was diagnosed with Hep c recently. When my Dr. prescribed me ribivirin and pegfinterferon Aetna declined my claim for the prescriptions. I appealed and was denied. I appealed again and was denied a second time. The second denial letter stated I needed additional blood work done, which my Dr. said was ridiculous and unheard of. So I got the blood work done and faxed it over to Aenta. It'll take another 3 weeks for them to have a hearing regarding the meds, and that's on top of the 3 months I've already waited.

This medication is needed, it's not like I can rid myself of the disease without out. And right now it is a mild case with 80-90% successful with these 2 meds. The Dr. said if i start meds now, I can wipe out the disease in 24 weeks, but the longer I wait, the longer it'll take as the disease grows stronger. Thanks Aetna. I gues when I get liver cancer or need a transplant I'll be denied coverage too.

Anthony of Stockton, CA October 16, 2009

Aetna is the worst at processing supplemental sickness claims. This is unfortunately the second time I've required there service in 4 years. This time I was without pay for 6 weeks before receiving any payment (yes the bills were stacking up) & they are still now one month behind on processing my claim! I attempted to contact my claims rep only to get a voice mail saying to "please allow 48 hrs for a response". Which after 48 hrs I received no response. I resorted to calling the vmx every hour & leaving a message.

On rare occasions the rep would answer the phone. How is it acceptable to run a business with a 48 hr response or not at all? I was told that their system had not received a statement from my physician. My physician confirmed that he had faxed the document & had a receipt of confirmation. Aetna miraculously confirmed receipt. I was eventually told by a supervisor the checks were to be over-nighted. 3 days later I made a call as to the status of these "over-nighted" checks. I was told they do not over-night, but that the checks had been sent out in the mail. I received the checks 9 days later. The mail can be slow, but not that slow. To be blunt & to the point, I was lied to....... If not for the fact this coverage is provided by my employer account were self insured, I would never recommend their service ever!

Leah of Gilbert, AZ October 15, 2009

My STD coverages were supposed to help with my recovery after my car accident but having to deal with Aetna has been a nightmare. I want to know how they get away with treating people the way they do. My life has been affected in such a negative way (currently unable to pay mortgage, auto payment, utilities, etc...) all because Aetna "supposedly" did not receive several faxes sent from several different fax machines over and over with confirmation letters of all faxes. Where do my faxes go??? And how can they justify denying my STD claim when I have proof that ALL requested documents have been faxed within alloted time all because they "say" no fax was received??? Can nothing be done about this??? I am currently in appeals process but as hard as this has been just for them to get info I have continuously been faxing I dont see this working out in my favor. Isnt insurance supposed to help???

Bob of Morton, PA October 15, 2009

Jennifer is a big fat liar. She told me she had contacted companies for my records for my LTD claim, but each company I called said she NEVER called. She is a liar and should be fired. Aetna Insurance looks for anything, any little detail to dent benefits to people. Complain people. Complain. Dont let people Like Jennifer do this to citizens of the United States.

Jeffrey of Urbana, IL October 15, 2009

I am a substance abuse counselor. I have a client who wanted substance abuse treatment for his cannabis dependency. He is a full time graduate student at the University of Illinois in Champaign/Urbana IL. He is from the Chicago area. Aetna is his health care provider and he is on his parents policy. Aetna would not provide coverage saying because our facility is not in their network or providers. The insanity of this is that here is a person who is wanting help for his addiction and because he is not "in the coverage area" they will not provide coverage. Just another reason our country's health care system is a mess. I have several horror stories like this in my profession. This is just the most recent. I support a public option and for insurance companies to be held accountable to provide services to those who are seeking it.

Susan of Miami, FL October 14, 2009

We are currently on assignment outside the US. We filed several out-of-network medical claims with Aetna. We sent them Fed Ex and they were signed for by Aetna more than 7 months ago. It has been an endless nightmare of "not received, sent for translation, can't find, must have not filed, need more info, oh, we have the info, need to translate, can't find, oh, maybe we have it, need more info."

A few small claims have now been processed, but they continue to delay on others, specifically on two of the larger claims which would result in a payment to us of about 4,000. For example, their most recent question is why I needed to stay overnight in the hospital after having a complete hysterectomy. What are they thinking?

They do not return calls, and each person I speak with tells me something different. No one seems to be researching anything. They simply parrot whatever the file says... Unbelieveably poor customer service, which seems to be geared toward not paying claims. Waiting more than 7 months for action. And my husband has since been laid off, so this money is desperately needed. Any help would be appreciated.

edward of bluff city, TN October 12, 2009

Aetan oh`d shoulder surgery in early 2009. Months later after many, many, delays and lies, hospital bill is still unpaid. Paying out my backside for this insurance and the joke is on me. Stay away from Aetna at all cost. I have records to prove what i`m posting here. IMHO, the actions of these insurance companies is criminal and they should be prosecuted. Someone, please show us the way.

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