Aetna Health Insurance

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frank of Scottsdale, AZ March 5, 2010

I am on remicade. Aetnaspecialty pharmacy ( a wholly owned subsidary of Aetna) said that my co pay was to change from 40 to 30% of the 5500 the infusion (every six weeks) The long and short of it is from Remistart ( a subsidy program of Remicade) they found out that all I had to do was go to a Dr who did not get the Remicade from Aetna Specialty Pharmacy and my co-pay was 40. No one at Aetana every told me this.

As a result Aetna specialty pharmacy withheld the Remicade for 10 weeks I missed two infusions and had a complete relapse. In addition they are back charging me for previous infusions because they state they did not bill correctly...consequerntly I now have a debt collection company trying to collect thousands of dollars. I changed DRs and my total out of pocket was 40. In the meanwhils I had a total relapse. Pain and suffering frompsoriatic arthritis that was cin complete remission. I gained twenty five pounds and suffered for months.

Jane of Leesburg, GA March 2, 2010

I had active coverage until the end of July 2009 and made a routine doctors appointment. I then received notic from my school that I had to change insurance companys because Aetna did not cover what their required. I sent Aetna an email stating that I wanted my coverage terminated 8/3/09. They subsequently billed me for August for a different amount than my usual.. which I promptly called and got reversed. My doctors officed just sent me a notice (2/16/10) stating that my insurance did not cover the service. Apparently Aetna decided to move up my termination date to 6/30/09 to save them a few hundred dollars. I never received noticed of this change in policy nor did I receive a refund of my July monthly premium.

Sarah of North Bend, OR February 26, 2010

I enrolled with Aetna in November 2009. I don't have any major health problems. I just wanted to do the simple appointments Eye DR, get the Annual Pap, and see the Dentist. My first Appointment was with the Gyno for a Pap, I called Aetna to make sure I'd be covered and told them what the appointment was etc.. they just said they don't cover fertility issues (like if i wanted to know if I could have kids or not). They said I'd be covered and just have a 20 co-pay.

Later I receved a bill for 200.00 from the NBMC and another bill for 50.00 from the Hospital Lab. Aetna didn't pay it because it was a preventative appointment. They said they only cover it if I was sick or if the DR found cancer in my pap! Then I needed glasses co I checked to see if Aetna would cover my Eye Dr appointment, again they said yes and I'd have to pay a 40 co-pay. I got a bill today for 130.00 Aetna will not pay it because the Dr isn't in Aetna's Network!

I have paid Aetna 223.36 from my paycheck over the past 3 months! And they won't pay a penny on anything I make an appointment for. I am canceling my insurance and I'm sure they will not do this but requesting everything that they have taken out of my checks to be refunded back to me for lies and deception and unloialty to me as a customer. Aetna [is bad]!

Do not become a customer to them! In fact don't get insurance at all it's all a rip off! Well I'm Stressed out just when my credit is starting to get better I now have more debt building up and my credit will never get better cause I can't pay these bills on time!

Cindy of Bar Mills, ME February 25, 2010

I pay dearly for insurance coverage from Aetna. My insurance covers 3 visits to my doctor per year, no copay, and preventive visits are covered 100%. Physicals are covered 100%. I went to the doctor for a PHYSICAL. When asked by the doctor if I had any concerns, I specifically stated that my ONLY CONCERN was that this visit would be billed as something other than preventive or a physical, as this had happened to me before, and I had paid 153.00 for a five minute visit! She noted that and said it would be coded as a physical. I had the apptmt.

I just received a notice from Aetna that the visit was billed as an office visit for 104.00 and a physical for 274.00! Well last time I checked, doctors weren't making house calls, so I do not understand why I would be billed separately for an office visit when I had to visit the office to have a physical.

This is ridiculous, and just one more reason that people that HAVE insurance can NOT afford to go to the doctor. I am furious to say the least. I am now facing yet another 104.00 bill for something that should be paid by my insurance. I am seriously considering totally cancelling my health insurance. It is not worth the money I pay!

Wendy of Fishers, IN February 24, 2010

I have asked for approp way to get my COBRA coverage in place ASAP. AstraZeneca discontinued my insurance as of 1/1/10, khowever they never contacted me to tell me this. I found out when my dr. tried to get a surgery precertified. I called and that is what put the wheels in motion. I was told if I paid to rec a fax for COBRA application, I then paid to have it sent overnight and was told by Tony it would be process the day it was received w/in 30 minutes. It was deivered on 2/22 just after 12 pm. To date they say they do not know where it is. I had to reschedule a surgery because of this problem caused by AstraZeneca and Aetna! I do not know how to get this done, or get this done any faster!

paula of east providence, RI February 5, 2010

on 01/15/2010 i took a paid leave of abscence. on 011910 atena wanted paper work from my doctor to support this. my appointment could not be made until 01/26/10 .on that date my leave was extended thru03/01/10. i called brian at atena to state this. brian still talked about paper work not getting to him, and my claim would be denied. i repated to him that my appointment was not until 01/26/10, on 01/28/10 brian called me back. wanted to know where the paper work was. i told him again that i just went to the drs on 01/26/10,

i called the drs office and left a detailed message about how and where to submitt my paper work. 01/03/10 received a call from brian stating my claim was denied. called the drs office , they called aetna, aetna will deny. i have to write them a letter stating all the facts that they already know. this will take 45 days.

i said this wrong give me your supervisor, of course i was told she was not available, was reassured if i left a voice mail she would contact me that evening if not the nest day. of course the call never came. 02/05/10 i called twice to speak with ms t., and you gussed it she was in a meeting. i then asked for her supervisor, i was told she does have one. of course she does. no seeing that i am on a leave of abscence for work related stress, this adds to it. they think we will give up. i will not. my lawyer is fully aware nd will back me on this.

i have earned my aol. to be denied is wrong. not my fault paper work did not get there. i did keep aetna aware of all my issues. they knew and it is all noted. so today i will call all day until i get a suprvisor on this. they want us to give up, and many due just that. keep fighting as i am. how will i pay my mortgage next month if i have to wait 45 days for an appeal, that was not my fault? added stress, no money, i am a single mother with a mortgage that has nevr been late .

daniel of marietta, GA February 4, 2010

Aetna is extremely slow paying dental claims. Then they deny them with no reason. If the dentist is overcharging or slow sending records i need to know and use somebody else. But Atena tells you nothing but the amount is not allowable.. Even tho i have had their insurance thru my job for 10 years and probably only went 1 time in 2008 so they paid 1 claim! so it should be justified that i need more extensive work done in 2009/2010...

Alice of Jemez Pueblo, NM January 23, 2010

My primary care doctor sent my enrollment form and 7 prescriptions on 1/5/10 to Aetna. The following week I got a robo call from Aetna saying there was a problem and I called back and Aetna said they had only received 3 prescriptions. My doctor then faxed the 4 they said they had not received. I explained that I needed two of these fairly soon. On both calls I was transferred to various people during the long conversation. On Tues., Jan 19, I received a second "robo" call from Aetna that there was yet another problem. I called to find out about that and discovered that Nefazadone (a generic I have taken for many years with no problems in getting the prescription filled from other insurance plans) was what that rep called a "step up" drug and they would not fill it until my doctor let them know that I had tried other generic drugs. (NOTE that I had called Aetna BEFORE I signed up during the Medicare change time and specifically asked Aetna if Nefazadone was covered and they said "yes, there would be no problem."

Back to the call with Aetna -- I then asked about the status of the other 6 drugs and they said they had a total of 11 drugs for me. I told them they should only have 7. So we went through the list and it turns out that the 7 meds that were originally faxed by my doctor were received and the other four had been added to the order. They denied having duplicates; however, I walked the Aetna rep through the list and helped them remove the duplicates. I then asked if any of them had been filled and she/he said,"No." He/she said they could not fill any of those prescriptions UNTIL I got prior approval for the ONE PRESCRIPTION based on my doctor's letting them know I had taken other generics in the same class as Nefazadone. It seems Aetna's rules are these: If a customer sends in an order and one of the meds needs prior approval or there are any questions about ANY ONE OF THE PRESCRIPTIONS, then ALL of the prescriptions are held until the "problem" prescription has been approved. I did not know that "Nefazadone" had been classified by Aetna as a "problem drug" until I talked with 10 different people on 1/19.

I was scheduled to see the prescribing doctor for the "problem drug" on 1/20, so he managed to get the Nefazadone problem straightened out.(I hope -- I am waiting to receive it.) While talking with one of the 10 people from Aetna on 1/19, one of them graciously made sure that the other six meds that I ordered on 1/5/10 were sent by FedEx with no charge to me. Today an Aetna rep called and we reviewed what had happened. First he refused to believe that duplicate prescriptions had not been removed immediately by Aetna. Then he explained that Aetna has 14 days to fill an order and that they don't fill an order if there is a problem with any of the prescriptions. He said when there is a problem, they NEVER CALL THE PATIENT OR THE DOCTOR.

They send the patient a letter. And then the patient can contact the doctor and get the prior approval. GUESS WHAT -- I have never gotten the letter. It appears that Aetna does not care that sending a letter radically extends the time needed for an order to be filled. Or how long it would take for me to get a letter, then get the prior approval and then wait for them to fill the order (14 days) and allow 7 to 10 days to receive it. I just started with this plan and it is the worst Plan D I have ever had. Based on this experience, they are not consumer friendly and they obviously are not interested in doing all they can to serve their customers. And there is no way to find out about their "order system" before you sign up. Having spent 30 years in marketing research, including medical areas, I am appalled that Aetna is doing such a poor job.

Lacey of Post Falls, ID January 3, 2010

In April 2008 my husband and I found out we were expecting our first. In July 2008 I changed jobs for a better one. I went on Aetna's cobra. After three months with my new job I was going to get insurance (with aetna). Right at the end of my 90 probation period (oct 2008), I was let go from my job. My husband the same week started a new job and he would get health insurance in Feb 2009.

So I continued with the cobra. Delivered my son in Dec 2008. Found out later that my insurance had been canceled the end of Nov (my son was born the 9th of Dec). Call Aetna and was able to get it reinstated for 321. They covered my delivery.

And then in April 2009 I get a bill from the hospital for 10,000! Thats 8,000 more than I was to pay. Aetna had asked for the money they paid back. I have my statements saying that myself and my son were covered through the 31st of Dec 2008. Now I have a debt of over 10,000 thanks to Aetna.

Phillip of Dallas, TX December 29, 2009

My HIV medication has been on Aetna's open formulary for several years now with a 45 co-pay. The change letter for 2010 indicated no change of status for the drug, Atripla, and it continues to be in the 2010 version of the three-tier prescription coverage open formulary. When I placed my month order for my medication with Aetna Speciality Pharmacy they told me that Atripla had been removed from prescription coverage and was now covered under medical at 90%. This left me having to pay over 150 for a 30 day supply with no notice from Aetna nor any official document, that I could find, reflecting the change in status for this drug. I need this drug to stay alive and I feel that people who use this medication are being singled out and discriminated against by Aetna.

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