Aetna Health Insurance

I had a CT scan test at the Association of Alexandria Radiologists. They contacted Aetna to had it approved and contacted me to give me the appointment. The day of the scan, there were no insurance problems of any kind and I paid my regular $30 co-payment. Now Aetna is not paying them and I'm being billed for $579. The only information I can get out of Aetna is that the code the radiology services is providing is not the pre-certified code, whatever that means. They don't show any initiative or interest in looking into the problem. Their customer service is very restricted. You can only reach a real person on the phone during work hours, and that with some difficulty, a representative whose duties don't seem to include trying to help.

Their website claims to have a 24-hour e-mail service which seems to be a false statement since they don't answer. When you send an e-mail, there is not confirmation of being delivered, they can claim not having received anything. The information on your personal page doesn't help, with explanations and links not being available at the moment, which is really a standard, permanent answer because you always get this. It's clear that they are trying to get away with not paying. Aetna is a scam and somebody needs to take action.

I work here in MA through one of the consulting company and they offer only Aetna insurance. But recently I have figured that out that now I have to pay the penalty for full year of 2011 even though I had health insurance because this insurance does not meet the requirements of the state. Why they (Aetna) give this type of offer/plan to these companies? I'm really frustrated and don't know to whom I should report for this.

I'd like to share with you a personal struggle I'm having as I have recently had a "reality check" on my current choice of career versus a career that I have been pressured to pursue. I used to work in banking for year before learning fully about the achievement gap and how students from low-income communities are unfairly forced to go to low-performing schools. For this reason, I opted to go into teaching (necessarily accompanied by a severe pay cut and much longer and harder working hours) for the past two years. My long term goal is to stay in teaching for at least five years and stay within education for the rest of my life in order to push educational equity. I have always been an idealist and hope to continue working towards this bigger goal.

When I was six years old, I fell off my bike and consequently, my tooth was dead and have had to have numerous surgeries on that tooth. As someone who brushes at least two times a day and flosses every day, this has been the only tooth I've had such problems with. A couple years ago, I needed a crown (which was extremely expensive) and was told that it usually lasts ~10 years. Unfortunately, it came off within two years, along with my entire tooth. So for a couple of days over the weekend I had no front tooth (which you can imagine looks awkward and isn't a sustainable appearance) especially for someone who teaches 110+ kids on a daily basis. I find out that the procedure that is necessary for me to have is a complicated $6,000 surgery, none of which is covered insurance. When I have no front tooth, this is not merely a cosmetic surgery and is necessary for me to have.

For someone who works 70+ hours a week for my 8th grade kids, it is so heart-breaking that this "real-life" problem is making me question if I can afford to stay in teaching. Other adults have said that this is the "reality check" I needed to finally grow up and realize I can't remain an idealist and that I need to go back into finance. I've fallen in love with teaching and with my kids and truly believe that the achievement gap can be closed. Most of my students have my cell phone number so that they can call me when they have any issues come up, academic or emotional, since so many of them come from broken families. It is incredibly difficult, however, to take care of my personal needs and health on such a low budget and with insurance that requires me to pay 100% of a medically necessary procedure, one that I cannot afford although I am a productive member of society. This is almost three months (70+ hours a week) of my entire take-home pay. How is it that insurance covers 0% of this? I'm truly struggling to understand this. Thank you for your time and help.

I received services from a provider that was not on the healthcare network. I obtained pre-approval from them to add him as a network provider as there was no suitable provider within the area. I received an approval letter. I had to make multiple calls for my initial visits to be covered and paid for correctly. The representatives would not even provide their names for documentation and would not give me phone number or supervisor information to discuss my claim.

After much fighting, I got the bill paid. Six months later I went back for more work, and they denied the claim saying it was not in network. They said it was only good for six months. Upon review of the initial paperwork, buried within the body of the letter, was that description. Question, why would I only add a provider for six months when he is very necessary for me due to a disability, and there is no suitable replacement available? After two phone calls and emails, I have been basically told to go screw myself.

To sum up their response: It's my fault for not reading more clearly and taking responsibility for myself. If I want to appeal I can send and they'll look into it. No phone numbers, no contact people. I want this route earlier this year and even sent all the information certified mail for which I have the receipt, and they told me they never received it.

I am typing this blog so that anyone considering Aetna health care for themselves or their business please reconsider. Their customer service is the worst I've ever seen and they will do everything possible to get out of paying a bill.

My son takes an anti-seizure maintenance medication, Keppra, that I order via mail order due to the cost. The prescription has been filled via Aetna mail order for quite some time. I had my doctor contact mail order pharmacy 12 days ago to get the new script filled. We intentionally gave about two weeks notice since we typically have problems with mail order so this time we wanted to be certain we had the medication in time. Well, I received the order a few days later but was issued the generic product. I have been informed since my son was diagnosed two years ago that he should only be taking the name brand product.

So when I received the generic, my wife immediately called the Aetna pharmacy. There was much finger pointing through many phone calls between Aetna and the doctor's office about how the script was filled out and if it stated name brand only. We have spoken to numerous reps to try and get the right medication sent to us and made many requests for supervisory follow up. It has taken an act of God to get the override approved which just happened last night around 7pm with the help of a very empathetic rep who stayed on the phone with me for 56 minutes and was extremely helpful. Unfortunately, she informed me that a senior representative would not waive the overnight fee for the medication but I reluctantly accepted that because my son only has a day or two of medication remaining at this point.

My wife and I were informed by many reps that a supervisor would call us back and nobody has followed up with us even to this day. After being informed, the override was approved last night. I called this morning (1/24) to ensure the order was shipped. However, the expedite request has not even been opened yet. I was told by one rep they would "do me a favor" and get me a 30 day supply approved and it would cost me $32.23. All I had to do was contact CVS and pick it up. Well, I contacted CVS and they told me it was a script for 14 days (not 30) and would cost me over $300! So here I sit with no medication, no way of paying $300 and complete frustration regarding the incompetence of Aetna's employees. Nobody seems to give a *** and you get a different story from each person depending on where you call. It's not their son who's at risk so I guess that's why they don't care. Aetna pharmacy needs a serious overhaul and has hit rock bottom with the customer service they provided me.

I called the RX customer service number on the 18th of January for coverage of malara medication for an upcoming vacation for my wife and me. The representative confirmed that the medication was covered and had $10.00 co-pay. I got the RX from the Broomfield Health and Human Services. Last Friday I took the RX to King Soopers pharmacy and today I was required to have a doctor call for pre-approval. I contacted Aetna and they confirmed that their rep told me it was covered and too bad. I need to contact my primary doctor and have him call Aetna for pre-approval. They are not very professional.

I am so heartbroken that Aetna and the Kelsey-Seybold clinics in Houston cannot work out an agreement. I have been with Kelsey for over a decade and have relationships with all my doctors and my children's doctors. This is very traumatic because we will have to find a new general practitioner, pediatrician, pulmonary doctor, dermatologist, and cardiologist because of the fact that Aetna cannot work out a deal with Kelsey. Of course, interestingly, Aetna blames Kelsey and Kelsey blames Aetna. Honestly, I don't care who does what! We pay premiums to have insurance with Aetna and I am going to recommend to everyone I know that they start putting pressure on their HR departments to look elsewhere for insurance. I am surely not the only person who is mortified by this change!

The Kelsey clinic is convenient, organized, and excellent at customer service and patient care! In my opinion, they are one of the best operated medical clinics I have ever seen. If they want a little higher reimbursement rate than other places, they deserve it! This is just the beginning of my protest. Please join behind me if this is affecting you and your family. I believe I read that it is affecting 500,000 patients in the Houston area! Start placing pressure on your HR departments to get rid of Aetna!

I continue to have problems with Aetna. I got 2 new prescriptions, from my doctor last month, which were filled. Both are working better that what I was on before. Aetna authorized the prescriptions. I went back today and they were declined for other medicines that I have been on that did not work well.

They also insist that we use Quest Diagnostics in the Dallas area instead of Lab Corp. Quest is a rip off. For a normal physical, I have over $300 in charges from Quest even though they accepted insurance! Lab Corp did send a bill but it was much more reasonable. This is supposed to be preventive care that is supposed to be covered.

I personally think they owe everyone explanations on how they determine what is covered and what is not. Calling in for a refill certainly should not be declined!

I was on Cal Cobra with Aetna. My employer put me back on group health insurance roughly two weeks before my paid Cal Cobra premiums expired. I have spoken to both Aetna & the administrators of Cal Cobra. Both point fingers at each other & will not refund the $250 +/- premiums 'double paid'. When I directly bring up my circumstance, they give answers that have nothing to do with my questions.

Beware of using Aetna Insurance for any company or individual benefits. My company had Aetna, which we were given short-term disability, and I purchased a long term insurance policy with them. After being injured on the job, and my treating doctor stating that I am not to return to work, Aetna is denying my claim, stating they feel I am able to return to work, against my treating doctors orders.

Let me make this clear. My doctor says I cannot return to work. Aetna, who has never seen me, states I can. Let me make this even clearer. My injury is to my shoulder, elbow and back. Aetna denied my claim. Then when it was appealed, Aetna is the one who reviews and determines if the appeal should be overturned. How's that for irony?

Be careful if you are using Aetna Insurance. They will deny your claim for reasons they feel warranted. I am obtaining an attorney to sue Aetna, but why should a customer that paid for years into an insurance program be denied benefits when they are needed.

The State Corporation Commission in Virginia says it holds no responsibility. The commonwealth of Pennsylvania Insurance Bureau offers no advice or response. The Pennsylvania Insurance Board also offers no assistance or answer. The Bureau of Consumer Service, Insurance Department says to contact local officials. The NAIC Corporate office offers absolutely no response. Even a letter to the White House went unanswered.

So Aetna can do whatever they want to people, wherever they want to do it. Collect money for Insurance, knowing they do not have to pay out if needed and are allowed to practice this illegal activity in the general public without consequences of punishment. This is what our government is telling us.

I am not going to stand by and allow a company like Aetna to illegally and fraudulently strip me of what I am owed. I will write, call and do whoever or whatever is necessary until this lying business is punished.

I sent an order for needles for my insulin pen. You received it and acted on it on 12/27/11. You then cancelled it. You reestablished it and Aetna Navigator said you sent it on 1/3/12. I have not received them yet. However, I did receive last week medications that were shipped on 1/2/12. Last week! I became concerned and asked you to re-ship the needles order. My concern was based on the fact that Aetna mail delivery drugs and their subcontractors have not communicated well in the past. It took me 6 weeks to get my kidney medications and I didn't want that to happen again.

Recap: I asked you to resend the order. You said, "No can do. Procedures, you know." I escalated to second level management. They said, "No can do. Procedures, you know." I escalated to third level management. They said, "No can do. Procedures, you know." I escalated to fourth level management. They said, "No can do. Procedures, you know." I asked if there was any way I could get my needles before I ran out and had to skip my insulin and end up in the hospital emergency room. You said yes. Go to the doctor, get a new prescription and then go to a pharmacy and obtain them. What the heck good is Aetna if you can not fill a simple order? And what the heck are you paying four levels of management for if they can not rectify a customer complaint? I asked to be connected to Aetna customer service. A "Rich" answered and told me I should be ordering the needles via "Sterling" and not Aetna mail order drugs and they would be free. I have been paying $26 for a 90-day supply through Aetna mail order drugs for over a year. So between "Rich" from Aetna and "Sarina" from Sterling I will get my insulin needles free before I run out. No thanks to four useless levels of management in your mail order drug house. Please thank Rich for doing a superb job.

There are no consequences yet but there will be if I do not get an honest answer and a refund for my wasted money for diabetes supplies that Medicare should have been paying for. And don't tell me to fill out a stupid complaint form. I did that before and all I got were excuses. My next stop if I do not get satisfaction will be Medicare and IBM who has asked you to administer this plan. And no, I don't want some slick attorney calling me about this. I want a responsible manager acting responsibly.

Three months ago, my doctor prescribed medicine to me for acid reflux. Aetna refused to pay for it. Their excuse? Well, they said they would need to "evaluate whether or not it was medically necessary." My doctor had to appeal to them, explain to them why the drug was needed. So some two weeks later, they okayed the payment. By this time, I had already taken something else (OTC) which took forever to work and according to my doctor, was not as good in preventing acid erosion of the esophagus lining.

By the time Aetna okayed the drug, I was too aggravated and feeling better. I never filled the prescription. Net result is that Aetna delay/deny tactics saved them money at my expense. I was in pain longer than necessary. I may have a higher degree of damage to my esophagus lining and I paid 100% of the cost of the OTC drug. Today, Aetna denied an essential test my doctor ordered. Their denial could result in deadly results to me.

What Aetna is doing is exactly what they spent hundreds of millions of dollars to tell us how the government would ration and deny care when in fact it is Aetna and the health insurance industry who have been carrying out such practices for years. Their only concern is profit, profit, profit and to hell with you or I, or any other insured member.

My daughter and I started seeing a mental health specialist from 11/03/2011 to 12/12/2011. Before we started to see the specialist, I called to make sure that we indeed had coverage. The representative assured me that my plan covers mental health specialist and waives the deductible if they are in-network providers. During that time, the provider has submitted 5 claims (3 for myself, and 2 for my daughter). Out of those 5 claims, all of them have been processed incorrectly and they want me to pay the deductible.

So far, I have been able to reprocess the first claim successfully, however, I have made 6 phone calls to Aetna to have them reprocess the claims. Now, they are saying that I never called to reprocess the claim and they the will re-submit the claim again and that I will have to wait another month for that to happen. As for my daughter's claims, the first time they processed the claim, they said that I had to pay the deductible, and now that we submitted it for reprocessing they outright rejected it saying that she has been terminated from my plan. They are just giving me the run around. It couldn't be more obvious that they just want us to jump through hoops, so that we either pay or simply give up and stop seeing the doctor. This is getting extremely frustrating.

I needed to know what my out of pocket cost would be for a medical procedure in order to determine whether I would elect to go forward. I phoned Aetna prior to the procedure, giving the code and emphasizing my need to be absolutely certain of what I would be expected to pay. I even went as far as having a supervisor confirm the amount. After being told the procedure would be a simple co-pay, I went forward with the procedure. I received a bill for a vastly greater amount. I contacted Aetna and filed an appeal. I was told they cannot be held responsible for the information given from their customer service department. Even though, they refer you to this department for this specific purpose. How would any business be allowed to operate this way?

Denied a PET scan twice. Initially and via peer review between my GI physician and Aetna's. I have a very rare autoimmune condition that mimics Pancreatic cancer (complete with 4 cm tumor and subsequent blockage of the CBD with 3 weeks worth of jaundice and a hospitalization). My doctor wants to have the PET scan performed to ensure that there is no hidden malignancy and hence a "true" pancreatic cancer undiscovered by the biopsies he performed to be 100% sure for my peace of mind and to ensure that any undetected cancer will not spread and become life threatening as all pancreatic cancers are!

Aetna has twice referred to the request for the scan as "experimental" to my diagnosis. This leads me to conclude that their priority is not preventative care for my sake but denial solely on the basis of cost which is laughable seeing that chemo and radiation would be 10 times the amount of a PET scan and may never be an option should I be denied this treatment for too long a period. Aetna is the future of medicine in America under Obamacare. Deny, deny and ration (another word for denial).

Through my work, I had Aetna coverage for my son and I from mid Feb through end of Mar 2011. He had a doctor's visit on Mar 25, and I'm still waiting for reimbursement for this claim. Aetna has denied this claim over and over, even though the representatives with Aetna have told me that there's no reason for them to deny it. I've been getting the run around for months now, and currently it's Dec 2011 and Aetna rep is running this claim again through processing. I have asked for reimbursement of my insurance premiums during that time frame, and neither Aetna nor my employer will do that. But Aetna is denying a valid claim. Does anyone know of an attorney I can contact? Yes, I am debating taking this a step further. I am furious with Aetna.

They have the worst customer service ever! The reps can never hear you because every time you call, it sounds like there is some ghetto hootenanny party going on in the background! You have to repeat everything to them multiple times. They put you on hold for no reason. They sometimes never come back. Nothing ever gets resolved. I submitted a prescription refill to them 2 weeks ago. I still don't have it. They sat on it for almost a week until "I" called in to check on it. Then, they mailed it to the wrong address. They have no way to track it and no one knows where my prescription is. The managers never get back to you. Even the messages sent via their system are never returned! One rep lectured me as if it was my fault!

My husband's company changed our insurance from Anthem Blue Cross Blue Shield to Aetna Global when they moved our family to Mexico for a 3-year assignment. Upon moving us back to the United States, we went back to our regular pediatrician's office and paid higher out-of-pocket fees since the pediatrician's office was not in network.

Then Aetna declined to pay any services with the comment, "Coverage Not in Effect at Time of Service". Why does Aetna accept money from my husband's work, and also from our family (deducted from his check) to pay for coverage, only for them to search for reasons to deny claims? They also denied claims for me a year or two ago stating that I had to prove that I was previously covered before joining their plan. Absurd!

The employer selects the plans for their employees, only to allow the insurance companies to require we (the employee and family) actively prove our coverage upon receiving claims. Aetna will always try to deny claims first, and not because they have a valid reason to do so. It is borderline fraud and 100% greed. Maybe Aetna should stop paying so much money to lobby congress and buy politicians, and instead re-invest their hundreds of millions of dollars into providing service and finding valid ways to lower their operating costs.

I sent in claims via fax, and mailed at least 4 times during a 15-month period. Finally, my last attempt was in October of this year. I was informed that they had the fax from August of 2011, and that it would be reviewed. To date I have not had a response, and it has been over a month. Each time I contact them, it is a new story. I have each email I have had in response, and documents of phone calls. To this date, I have had no reimbursement, and I am tired of fighting with this company.

After a number of years of having Aetna Family Health through work, each year Aetna wants to charge more for paying less and requiring unreal amounts of paperwork, documentation and time just to get the basics you are buying. I'm sure the top management at Aetna is paying themselves larger bonuses each year at our expense. Every medical bill that is supposed to be covered becomes a battle of paperwork, technicalities and time.

My older son is in college and every year Aetna makes us jump through more hoops and fill out more paperwork to prove that he is a full time student while Aetna, through the college, tries to bill us again for more coverage for him. Now they are sending me more paperwork and documentation requests to prove that my dependents are actually my dependents stating that the dependent coverage will be canceled unless they receive all the paperwork and documentation in 3 weeks! I am fed up with Aetna trying to squeeze every buck out of us and take away what we are paying for with the endless forms, paperwork and documentation they require.

My doctor was not in Aetna's network. However, they accepted his billing in the past. My son was injured in a football game. We called our doctor on a Saturday who referred him for an MRI, with the surgeon who had operated on the same knee before. On Monday, he had the MRI. Aetna refused payment because they did not give permission to proceed. The hospital is not in the network either, even though they have used Aetna in the past. So now because of a loophole, I am struggling to pay a 4000-dollar bill. Fortunately, nothing was wrong with his knee and no further treatment was needed. Aetna will not talk to me. They refuse to put supervisors on the phone when I ask.

Aetna pharmacy is the worst. You go online to refill and it says you have 1 refill left but in fact you need a new prescription. They contact the doctor (yeah, sure they do) regarding but if the doctor does not respond they do nothing to contact you so you can get a new prescription from your doctor. You assume everything is going along and you should see your prescriptions arrive in the mail soon. By the time you realize they aren't coming and you call them, you're out of meds and not in a good place when you depend on them to breath or keep you from going into a coma of some sort. They suck and they wonder why people try to get their doctors to give them a prescription that is covered by Walmart or Target pharmacies. At least you can get your meds within 15-30 minutes and not 10-14 days. Duh! I***!

I elected to participate in Aetna Student Health Insurance on 7/21/11. The first payment of $868 was deducted from my bank account on 7/21/11 for 12 months of dental at $328/year and 2 months (August and September) of health at $270/month. On 9/1, I received health and dental insurance through my employer. I called Aetna and asked that the Aetna policy be cancelled. However, the representative refused, stating that I had to cancel the policy through the university and, further, that an automatic payment of $270 would be deducted from my account on 9/23.

I followed this up with two calls and a visit to Syracuse University. Syracuse University health representatives told me that they could not cancel the policy and that it was something that Aetna would have to do. I followed this up with another call, an email, and a letter to Aetna. As of today, 11/4/11, Aetna has charged me $1,138, of which they claim to have refunded me $270 (it is not showing up in my bank account).

In essence, Aetna covered me from 8/1/11 to 9/1/11 (my work insurance covered my medical expenses starting on 9/1/11) and is charging me $1,138 for it. The company is refusing to reimburse me the balance of the dental insurance (I paid in full for a full year) and the September payment of $270 and the October payment of $270 that they have supposedly reimbursed, but as of today, it's not in my bank account. In total, I should be refunded $840 (1 year dental at $328/12 months = $300.67 + $540 medical for September and October). This is one more example of a big corporation ** the consumer.

I have been with Aetna on their POS Plan. Meaning, I need no referral. I am paying over $760 a month, not including my employer's contribution.

I have had two separate instances where I have gone to search for a provider and found none of the doctors they list or give by phone accept this insurance. I need to see a psychiatrist for extreme depression and Aetna found one psychiatrist within 30 miles of my area who can only see me in January. Meaning, I must wait two months to receive treatment. The website is misleading and has false advertisements as many doctors do not participate with Aetna. Even the rep I spoke with agreed to that.

I must not continue paying for insurance while I am being delayed treatment for extreme depression, a serious condition that should not be ignored.

I have been seeing the same doctor for the last 4 years. He has been in network the whole time. Aetna was recently dropped by them and the hospital. Aetna tells me they sent letters to members but not to me because I had not been to the doctor in the last year and a half. My wife and I both saw our doctor recently. I am now charged $500 instead of the $60 I should have been because Aetna decided to not tell me I was "suddenly" out of network. They now tell me I have to verify my doctor is in network every time I see him even if I see the same doctor.

On 10/14/11, I went to an appointment with an Orthopedic Hand Specialist in regards to a long term wrist pain. Ironically, my plan does not require a referral for this. I estimate that the wrist pain developed in about 2008, and I received an x-ray from my primary care provider at this time. It was inconclusive and I was given anti-inflammatories to see if the problem would resolve. It did for the most part, but I have sharp pains or aches that are on and off for the last 3 years.

Fast forward to present day, I now have daily pain and suffer from limited range of motion with in an hour or two of waking in the morning. The specialist I saw last week ordered two x-rays which were still inconclusive. He then ordered an x-ray on the wrist with no pain for comparison. He was then able to notice some faint abnormalities but not enough to make any diagnosis. So, on 10/14/11, he ordered an MRI. Then, the Aetna ** shenanigans begins.

My initial MRI was scheduled for 10/19/11, but that has been scheduled because I cannot get approval from "Med Solutions" which is the 3rd party organization Aetna uses for MRI approvals. In fact, the initial claim has been denied because, and I quote, "Patient should receive 6 weeks of treatment and if pain is still present, a follow up x-ray should be given. Then if nothing conclusive is found on the x-ray, an MRI can be given." **? Does this make sense to anyone? How can a physician correctly treat an unknown issue?

At any rate, the doctor's office has gone ballistic and has appealed the decision. Now, I am waiting another 48 hours for Med Solutions to get off their proverbial ** and make a decision. If it is denied again, I do not know what course of action I should take or if there is even a course that I can take. Aetna is more than willing to deduct my paycheck bi-weekly for insurance, but then, I am forced to deal with this ** when I need to use what I am paying for. Aetna is a joke.

I receive IVIG treatments every 2-3 weeks for hypogammaglobulinemia and recurring pneumonia due to my immune deficiency. Aetna required a pre-certification for these pricey treatments, which my oncologist/hematologist provided. The treatments were approved till November of this year. I left my employment to take a new job in September and had to go on Cobra. Not only did I have to pay 800 dollars for the new premium, but Aetna dragged their feet to get it re-instated. Their customer service is awful and borderline offensive. They make you feel like their hands are tired and nothing can be done because this is "procedure". I paid this money so that I could get a treatment. I went into septic shock twice this year and have been hospitalized for numerous pneumonias.

I tried to schedule a treatment. And guess what? Aetna decided they wanted a new pre-certification. Why? Why do you think? My coverage elapses on October 31st. And they know that if they can demand a bogus new pre-certification, they won't have to pay anything! I paid 800 dollars to stay on the same plan with the same coverage. Now they claim that switching from my group policy to Cobra with the same buy up plan requires pre-certification. My hematologist's assistant said that this is ludicrous and he shouldn't have to resubmit since my pre- certification runs clear through November 2011. My benefits, coverage, and eligibility are all identical, as my coverage is simply continuation. They are merely delaying so they can pocket my 800 dollars and rip me off just a little bit more.

I called about a claims appeal. She was rude and hung up in my ear even though I felt that my case was just. The big business wins again. I guess we have to bend over and take it.

I am in enrolled through Aetna's HMO plan. I needed a test done by a specialist. I called Aetna to see if I needed a referral, since they are required under my HMO plan. I was told by the Aetna rep that I did not need a referral for the test. I then had the test done and received a bill from Aetna several weeks later. It stated that I was liable to pay because I did not have a referral. I called them and told them my story about how one of their reps told me a referral was not necessary. Aetna confirmed that they had record of the rep tell me that a referral was not needed. But even with that, they refused to pay the bill. They said that the rep made a mistake and that I was liable. The test cost $400.

Recently, I was diagnosed with Type II Hypertension and referred to my primary physician. My physician prescribed Cozar. The pharmacist informed me Aetna would not approve it. I called customer service to inquire about this matter. According to customer service, Aetna recommends generic first and if it does not work, the brand medicine is provided. I informed customer service I would prefer the brand one and pay extra cost. She provided a pre-authorization number for my doctor to approve. I do not understand because I have the original prescription. In any event, I left the number and message for my doctor. I arrived again and to no avail, there's no medication. I have been two days without meds. I believe this company is dishonest and do not care about patients. As soon as possible, I will change my insurance company. This company does not care about quality services. Rather than help patients, they participate in prematurely killing patients.

When I left the company, I had been employed with Aetna. They reported a change in my insurance coverage to Tricare. But through ineptness, they reported the wrong dates of coverage. Now, Tricare is recouping money from providers because of the idiots at Aetna giving the wrong dates of coverage. I have made numerous phone calls both to Tricare and to Aetna. And they, Aetna, put the blame on my previous employer. The cost of my insurance was ridiculous for very little coverage. Hey Mr. rich CEO, how about paying me back for what you ripped off from me? You can afford it. And your employees better start taking responsibility for their actions. My next stop will be the NCQA and the state insurance commissioner. Maybe then we can get your stupidity straightened out. Got it.

My doctor's office sent in a prescription refill to Aetna RX Home Delivery and my doctor selected the option to fill with a generic. The company filled the script with a generic that I am allergic to. I have put this information in my patient profile. Not having been in this situation before, I sent the medication back to the pharmacy with a confirmation delivery receipt. No one from Aetna called me and told me that I was not supposed to send the medication back. It took me several calls to them to find out what was happening. By the time I got the correct answer, it was time to take the prescription again. I finally went back to my local pharmacy to get the prescription filled.

I have medical insurance through Aetna. I recently had a routine physical exam that is supposedly covered 100% (including lab work and x-rays) according to the documents I have received from Aetna. Now, I have received a bill from the lab facility stating that I owe money on two procedures performed. After speaking with Aetna, they are stating that it is my responsibility to verify all procedures and lab work done, whether they consider it "routine" or not and if they will cover it. I expressed how I found this illogical and unreasonable that I would have to call about each lab test performed if I scheduled a "routine" physical with my doctor. I believe whatever procedures my doctor orders for a physical are routine and should be covered according to the plan documentation. It appears Aetna is now picking and choosing whatever procedures they want to cover in order to reduce their costs. This is the same thing that happened with my daughters during their "routine" physical exams. It is extremely upsetting to pay my dues on time each month, knowing that I have certain coverage by my insurance provider. And they have caused me extra expenses, because they want to limit the costs for procedures they state are covered.

I have abdominal and pelvic pain. I have some bleeding. My doctor ordered tests which Aetna denied without reason and have been unresponsive to my inquiries. Aside from that, they are not paying my bills for medical stuff, but spend a lot of time monitoring my health and contacting me when they think I have a health problem instead of, oh, you know, paying my claims.

Aetna won't cover my baby because I missed the 30 days (that no one told me about) so my 4-month old has to apply. My baby was born earlier this year via c-section so, even if I knew, I was not thinking about counting 30 days because I was healing from major surgery! I just found out the other day that my baby is not covered. I spoke to a nasty, stupid person on the phone who couldn't tell me a thing. She "elevated the call" (as she called it) to someone whose answering machine I had to leave a message on. That was three days ago. I have yet to hear from anyone! In addition, I called back and someone told me that I had to fill out a form from the website to have my 4-month old baby apply for coverage, but I have yet to find the ** form! I am very disappointed in Aetna!

I received a notice a few months ago that my son's insurance premium was being increased $25. The increase started July 2011. I just received a letter on August. 20, 2011 that his insurance premium is being increased again $27, beginning in November 2011.

Everything is going up except wages for the low and middle income wage earners. Economy is so bad and yet corporate America thinks that because they are suffering they need to raise their prices on everything. Our wages have not increased for at least the last 3 years. We are barely able to pinch pennies now. How can we stop the gouging?

If an attorney is willing to take this claim pro bono, sign me up!

Aetna refused to cover a PET scan recommended by two neurologists, even though their policy clearly states that for certain conditions of melanoma, a PET scan may be used for diagnosis. The policy states that a PET scan is rarely used for diagnosis, but in this case, it may be used. Aetna uses MED Solutions to determine this coverage. I called Aetna directly but they said that there was a 30-day appeal process. I am hurting so badly that I am certain that I will be unable to maintain independence for more than a week. I will have to go to emergency then, and who knows what Aetna will cover. I am very disappointed.

My company changed medical insurance to Aetna. I have severe asthma and I requested for a rescue inhaler. On our old plan, I was paying $10.00 for Ventolin HFA 90 mg 200 count inhaler. Today, I picked up my prescription and had to pay $38. The non-insurance cost would be $45.99. I called Aetna and spoke to an Indian, who told me that they only cover Xopenex nebulizer medicines. They look like a rescue inhaler but they are not. Xopenex nebulizer doesn't help quickly; it takes time to get the medicines inside you. Is there any company out there where a person with asthma can go to? I may start taking trips to Canada just to get my medicines.

I have filed a complaint with consumer affairs and got the suggestion from them to contact the NCQA. I did it and it was definitely a good move. They are helping me to investigate the rejections made by Aetna Health. I strongly suggest that any of you who also had a problem with Aetna, do the same. Just go to the NCQA website and email your situation to customer support. They may be able to help you out.

Every time that I go to file a claim with these people at Aetna, I seem to get the run-around from either the Internet response team or their claims department. I have been contacting these people regularly regarding the following claims:

Claim ID **, with services on May 20, 2011, for charges of $179.44 and Claim ID **, with services on May 20, 2011, for charges of $25.67, was allowed in full. Aetna was to pay the entire amount of $205.11 to my provider and here it is, mid August and that has yet to happen.

I received two late notices from my provider for payments as they have not yet received it from Aetna and I'm expecting a third notice here shortly with the possibility of having my wages garnished.

Each time that I have tried contacting Aetna through their website, I was told via a secure email message numerous times that they would fix the problem and expedite payment. But each time I was told this, payment was never made because they had stopped the original check ** for whatever reason after I had inquired the status of this claim. They have yet to answer my question as to why this check was stopped. Aetna then told me that they would reissue another check, the amount that was indicated in the email response was in fact the wrong amount and this has been going on back and forth with their Internet response team ever since I filed this claim.

A Ms. Donna ** from Aetna finally contacted my provider as I had asked them numerous times, so that they could explain to my provider that it was Aetna's fault and not mine that they have yet to receive their money. Well, Ms. ** gave the wrong amount over the phone, it was $147.68 check number ** issued August 12. Apparently, and as mentioned, this has been going on back and forth for some time now.

I don't know if these people even know what they are doing or I've been placed on their "blacklist" or what not, but as I mentioned earlier, I have problems with Aetna every time I file a claim and I dread or even avoid going to the doctor all together because I know what I'm going to face when I have to file a claim. This has caused me so much stress and mental anguish that I'm seriously considering dropping my insurance plan.

Your cooperation and assistance regarding this matter is highly appreciated. Thank you for your time and understanding regarding this matter.

Michael J. **

Over the past year, Aetna has raised my individual plan from 98.00 to 178.00! They keep saying it is because of the healthcare reform and their rising costs. But they just posted a record profit this year. I wonder why that is? They are gouging people who can barely afford individual insurance and who are unemployed. They will not give me an answer as to why they are raising rates. They just want me to cancel my grandfathered plan. I get calls weekly from them asking me to do so. So far, I have received a rate increase once every other month! I will be cancelling as soon as I can find a viable alternative. They are evil crooks.

This is a complaint about inaccurate coverage/benefits information provided by Aetna Representatives, over the phone between August 1 to 17, 2011. The original representative's name was Michelle.

I called in early August to find out how much coverage was left on my Dental plan. I have had some dental work done over the last few months (root canal which resulted in an extraction). On top of it all, one of my impacted wisdom teeth started to become infected and painful and I was told that I should have it removed. I called Aetna to see how much was left on my dental coverage. I was told my yearly benefits were already used up, but a wisdom tooth extraction plus general anesthesia was covered by my medical Aetna bc of the sedation. 90% coverage plus 10% out-of-pocket. With this being said, I went ahead and scheduled my oral surgery appointment. Everything revolved around this date-work-etc.

Two days before the surgery, I called Aetna (my gut told me to double-check) and they told me that the person I spoke with gave me wrong information. They said her name was Michelle and she read off the wrong benefits and there's nothing they can do. I still cannot believe or fathom the idea of them providing wrong information. It was unbelievable. So now, the surgery is cancelled as I can't afford to pay out-of-pocket on a whim. I wIll endure more suffering.

I spoke with them at 9:00am today and I was told that a director would call me back by 5pm, and I have yet to be contacted. I wish I was still a member of Empire Blue Cross/Shield.

We filed a claim on our patient for dental services received on February 15th 2011. We received two payments for this date of service from AETNA which resulted in a credit on the account. The patient called the next day requesting a refund for what they paid to us ($1,005.00) and demanded to pick up the refund the next day. We refunded $743.00 to the patient the next day.

Now AETNA is requesting a refund of an overpayment of $800.00. We sent them $57.00 and asked them to collect $753 from their insured. This does not meet their demands and now they want their money and the patient is not responding to our certified letter requesting the refund.

In June, my medicine was switched from being covered to needing certification. I complied and got a letter from my doctor. Meanwhile I paid out of my pocket for my medication. I was told I would get reimbursed for the medication as soon as the certification came through.

I got a confirm fax and called the next day but was told they didn't receive it and to fax again. This happened 5 times until they finally told me that they received it but needed it to come from the doctor but that he could call the medical member's direct line and expedite it, since I was going on 30 days of having to pay out of my pocket for my medication.

He called the number I was given and he was told he needed to fax the letter directly from him. He did this and when I called the next day, I was told they didn't receive it. I gave it 1 more business day, but had him call the following day to get the fax number again to confirm. He was told then that he did not need to refax, because he could do the certification over the phone. He did this but, just to be careful, re-faxed the letter.

I called that day and spoke to the certification department and was told that not only did they receive it, but within 24-48 hours, it would be cleared up and everything would be covered. This was on 8/10. I gave it until today, 8/15/2011, and was told today that they did not receive the fax or a call. This was after they told me directly on 8/10/2011.

This is absurd and is extortion. I have written to the Florida Commission for Insurance Regulation, the Better Business Bureau and I am looking into a more national level. But for now, I don't know where else to turn to and I'm desperate. I can't afford my premium and my medication. I would be willing to drop this if they would do what I know they should and can do. Clear my certification, considering how they told me they had it last week and suddenly they no longer have it! Exploitation cannot be accepted, especially in the insurance industry.

I have my husband included in my health insurance because his gets dropped occasionally as he was working on and off because of the recession and he has a Union health insurance that will pick him up when he works again. I thought my Aetna health insurance would cover what we had to pay above what his insurance may pay. This does not seem to be the case! They do NOT pay anything! They claim that what his insurance pays is the maximum that they would normally pay, and so they reject paying anything above that.

I just wanted to let the hundreds of people that complain about Aetna, they should all be sending complaints to NCQA. Their complaints are valid and many very illegal. NCQA is the governing agency that accredits Aetna. They deal with quality of care and all the issues everyone has alluded to about meds, denials, etc.

If each person filed a complaint, Aetna would then have to deal with it. They would be under more scrutiny for their improper denial of care, which by the way is a major reason the accreditation agency will go after them. Their denials have to be looked at more clearly because they do not list these as denials even though it is considered a denial of care.

When the accreditation agency comes in with a colonoscopy tube to look at Aetna's illegal denials they will be fined and can even lose their accreditation, which in turn would force them out of business because they need to be accredited.

So I am hoping anyone who sees this will google NCQA and file a complaint. Good luck.

On July 16, I called my pharmacy to have an Rx changed from my Aetna policy which ended on June 1 to transfer to Aetna policy that started on July 1. Aetna denied the medical prescription. When I called and asked where the denial letter was for both my physician and myself, they told me that they did not have to send out one because they rejected it and did not denied it. I don't know if any of you took English in class but .....wrong.

According to the federal and state law along with their accrediting agency (NCQA), they are required to send a denial letter to both the patient and physician. Needless to say, I was told that in their "scripting" they do not have any answers other than it is not denied but rejected and they can't do anything. After 5 hours on the phone with multiple people and enumerating on my very dangerous withdrawal symptoms, they issued 14 days of pills. I was told it is now in the system. Unfortunately, the pharmacy is still only getting denials.

We switched to a different Aetna policy because Aetna has also "rejected' all my bills for breast cancer (I guess they think this is something like a face lift that I wanted). So, I am sitting on top of tens of thousands of dollars for that. Of course I won't pay and they will. But it will take attorneys and a lot of aggravation (not good for someone with cancer) and a lot of bills that they ultimately will have to pay for. What is really problematic and so illegal is that Aetna has to provide statistics every month to NCQA, Medicaid and Medicare. They are lying to the federal and state governments on their stats. By refusing to deny (only reject), their statistics look better or even good. This is the only way the federal and state governments can take a look and see if they are properly authorizing care, which of course they are not. They likely have had patients who have died because of these dangerous tactics to save money and it will take a great deal of auditing to find those deaths associated with rejections of care.

The reason it is required to send out a denial letter to both the patient and physician is so that both know and can either order a different medication or explain to an uneducated clerk why this med is needed. It is really simple when a person pulls out a gun and shoots you. You know you have been shot. But when a company like Aetna plays these death games, those stats get hidden somewhere in a rejection.

I have filed an NCQA complaint. I will be filing a Medicaid and Medicare complaint as well. Although these blogs are lovely to vent, someone really has to go into these places and clean them out. They are way more dangerous to patients than anyone can really comprehend. How many people have to die before someone will do something?

So I was assaulted by a family member on 6/4/2011 due to a concussion/head trauma. Medically, I was ordered to remain out of work till 8-11-2011. I filed all of my paperwork and that's when the fun begins.

First, they didn't tell me before my claim was denied that I gave them the wrong paperwork. Next, I requested the proper forms to be faxed to my doctor's office in order to fix their mistake right away. Of course, they denied the claim for my STD (short term disability). The fax was never received at my doctor's office, so I had to find the right form online and fax it myself to my doctor's office. I have been calling every day to assure everything has been fixed and will stay that way.

Today, 8/2/2011, I called bright and early thinking everything would be approved and taken care of. Well, I only got approved for half of my leave and was told I never requested the 7/4/2011 - 8/11/2011 for STD, so the 15th through the 11th was covered but not for STD; they made it LOA. My boss at Boeing called me and said I'm on grounds for termination as well because of all of these.

Aetna did not notify my Boeing manager via email that I was requesting time off, which is what they are supposed to do. Nonetheless, I was screwed by this company and might lose my job and my apartment. Thanks, Aetna! Thanks a lot!

The dentist recommended that my son receive 4 sealants. Prior to the procedure I wanted to confirm dental coverage: (1) I called Aetna and confirmed coverage. (2) I checked the Aetna Website & confirmed coverage. (3) I requested a pre-determination of benefits & confirmed coverage. At no time did Aetna relay to me that this procedure is only covered till my son reaches age 15. (IN TWO WEEKS TIME!). Aetna either concealed or was negligent in providing that information.

I was charged a co-pay of $80 for a count of 45 Lipitor 20MG tablets with doctor's instructions to split the tablets in half and use for 90 days.

I was charged the same amount of co-pay ($80) for the previous refill of the same prescription drug for a count of 90 tablets with doctor's instructions to take a whole tablet daily for 90 days.

The Rite Aid pharmacist said that Aetna is billing me the same amount ($80.00) in the most recent refill, because the doctor's instructions to split the tablet caused the prescription to last 90 days.

Is this a fair or even a legal practice? And is Rite Aid have any culpability?

My son is covered under my health insurance (Aetna). He has been in over 7 different 12 step programs for substance abuse. He wants treatment, but the 12 step programs are not working for him. He has relapsed multiple times.

There is a program that he would like go to GHG in Florida, but it is out of network. I have tried to ask Aetna to allow him out of network benefits as a onetime exception; to try to get him clean before he overdoses and dies. He is only 21, and had to drop out of college because of his substance abuse.

I had multiple conversations with Aetna, his case worker Brenda ** and her manager, Wendy. Last week, they told me he had to be evaluated at a hospital before they can make a decision to make the exception. He checked into Florida Hospital on Friday of this week, and completed the evaluation.

When I called them today, Brenda is refusing to escalate. She will not grant out of network benefits for him. The 12 step program does not work for him; he needs to try something different.

I was denied the ability to pick up my prescription of hormones because it was too early. I had to live for four days without them. I am now being charged for my annual gynecological exam; though my policy says it should be considered as an office visit. The insurance agent, Thomas **, of Insphere Insurance Solutions has done nothing to help solve my issues. I was told by AETNA customer service to pay for it out of my own pocket.

I have Crohn's disease and I have to go through Aetna Specialty Pharmacy to receive my medicine, Humira. I was informed that my copay would be around $375.00. I can't afford that every month so they suggested that I get copay assistance.

I got my copay assistance through Opus and in turn, my copay would only be $5.00. They never sent the information in to Opus and now I owe Aetna Specialty Pharmacy over $1,000.00! They are telling me that I have to pay that first and then I can get reimbursed by Opus. I don't have $1,000.00 and I can't afford to pay up front the $375.00 every month. This was their mistake and now they are trying to say that Opus will not pay them. When I went through Medfusion Pharmacy in Dunbar, WV, they paid them. They are the ones that even got me the copay insurance.

Ryan, the supervisor, told me that they should have never told me that they would bill Aetna. I am at a lost here. If I don't get my medicine, I will become very sick and they will admit me into the hospital. I really need your help.

I purchased a medical/pharmacy policy through AARP and with Aetna. My doctor prescribes a "compound" medication for me that has to be made at a special pharmacy. I have paid all my deductibles for the year. The first 30-day supply of my legally-prescribed compound medication was denied. Two weeks later Aetna paid it as per the policy of plan, 60% non-member pharmacy minus copay, which came to $140.40 of $249.00 dollars I pay out of pocket for the medication.

Upon sending in another 30-day supply claim two months later, Aetna changed the claim amount from $249 to $25. This is fraud, by the way, as the claim amount is for $249. They paid only $6 dollars of the claim. After calling them and writing an appeal, they now say I was overpaid on the first claim and want $134.40 dollars back. What a joke this company is and a rip-off. First they don't pay; then they pay, then they state you were overpaid. Does anyone have control over this company?

My name is Jose Cabral, Jr, a current nursing student at University of Massachusetts Boston. Also, I work as a Medical Interpreter at Umass Medical Center in Worcester holding a perdiem position without any benefits. I have my health insurance through Umass Boston as a student. Last month I visited Dr. Ika Gayatridevi who is my primary care physician and I had a routine blood work done. Today, I received a bill from Umass Memorial Medical Center charging me U$ 1,277 for the blood work and U$ 320 for the doctor's visit. I called AETNA STUDENT INSURANCE and health services at school and after spoke with several people, I ended up with the same answer,"Aetna Student Health Insurance doesn't cover any routine visit and routine test". I have concluded that I'm responsible for the amount OF us$ 1,597.

I really don't understand because it comes from Umass Boston that knows exactly how important are the primary prevention strategies in order to avoid the developement of diseases which has been the topic of many discussions of the health care reform.

I am unemployed, needed to apply for individual health insurance by 8/1/2011. I thought Aetna would be all right. However, please do not make the mistake like I did and save yourself from unnecessary stress and time.

I also have pre-existing conditions which in the health insurance companies' world means I'm a loser for them so that gives them cache to treat people like me with total disrespect. Read on.

I started the application process end of May to get a quote for 8/1/2011. Firstly the sales agent was of no help; she never picks up her phone and lets it roll to her voicemail. She has an email address, but since messages pertain to insurance info. never can send any emails to one.

After the quote was received Aetna's underwriting dept. has their third party called RSA to bug the heck out of applicants to provide additional medical information. I explained to the first person (so-called nurse) at RSA that I was not able to obtain a PCP appointment until 6/21/11 so I would not be able to provide the missing medical info. until at least end of June/beginning of July. I thought that would be the end of that. No. Every two days until 6/21/11 RSA kept calling me requesting the missing info.; each time I had to explain I would not be able to provide it until the end of June/beginning of July! I found out their notes expire every two days so they kept bothering me.

Suddenly one day a RSA nurse told me that my application would expire on 6/22/11 though I was initially notified by them only on 6/7/11 and the notice said I had 30 days to provide the missing medical information. To me this meant I had until 7/6/11 to provide it, and I also confirmed with an Aetna underwriting rep. that I was correct.

Well, what happened is that on 6/21/11 I did see my PCP and was able to provide some of the necessary medical information: height, weight, and blood pressure reading they insist must come from a health professional! To my shock there was an email dated that very same afternoon saying that Aetna already approved my application BUT the rate was adjusted UP! In other words, the quote I received of $485/mo. became 50% higher at $970/mo. instead!!! And I only had 2 days to decide if I wanted to accept or reject it. If I did failed to reject it by 6/23/11 they would have the right to debit my bank account (because it's mandatory on the application to provide payment details)!

So Aetna not only gave me the run around and harassed me about needing more health information which obviously was not necessary since their inglorious, inept underwriters had made a decision for some time already) but worse they were hoping I'd accept their extortionate offer!! Or perhaps by offering such an extortionate high premium they were hoping I'd decline so I would not be such a drag on their profit line.

Well, tell me how in the world that anyone who is unemployed and has to face paying massive amounts of other expenses can afford to pay Aetna's extortionate premiums as well?! Certainly I could not, and since I surely didn't want to forget and not reject this 'offer' within the two day period for fear Aetna would be deducting $970 from my bank account, of course, I had to reject their so-called offer!

Bottom line: Aetna is a parasitic health insurance company that is akin to the mafia. Apparently people who work for them especially their underwriters must have thick skin and thick skulls because if they did not they'd have compassion for the millions of people whose lives they're playing around with all for the sake of higher profits. Worse is Aetna mirrors the general philosophy of the entire US health insurance field.

Aetna's website is one of the worst website designs I have encountered. It looks as though they really want to harass the members. I simply wanted to know what my copayment is for seeing a specialist. And I have spent better than 2 hours, trying to figure it out. I then called their phone bank, and after several gyrations, I was told to call back later, because they were too busy to handle the call.

Aetna should be ashamed of such a sloppy web design. I truly hope that it is not a deliberate attempt at making it difficult for the members. And I am still unable to determine my copay for a specialist visit.

Aetna is without a doubt the worst health insurance you could purchase. It's a ripoff and a total waste of money. I got this garbage insurance through my workplace last August. I work part time and they took $89 per paycheck out for their worthless insurance. I have made two emergency room trips since August and Aetna has paid a grand total of $400 towards the bills. I am now $8500 in debt. They pay for nothing. I dropped them this morning and was told I have to keep paying on the policy until July 1. What a joke! Avoid Aetna like the plague!

Please be careful when ordering your medication from Aetna's mail order pharmacy. Today we received the wrong medication in a wrong quantity and wrong dosage. Of course, they billed us for the more expensive prescription. They didn't send and refused to honor the original prescription because it has already been submitted. So, I guess we have to go to the doctor and pay for another appointment to get a new one. Anyway, please make sure to closely check any medication shipped from them. It's because if your life depends on it, well, there is a real possibility it is not what you should be taking. And if you call and get a ghetto sounding girl named Cheryl, ask for another rep. Trust me, not the brightest crayon in the box.

Aetna raises artificial barriers so they can avoid reimbursing me for Allegra. Each time I want my prescription filled, my doctor's office has to call Aetna, or Aetna will not cover my Allegra. When did insurance companies go to the "mail-in warranty" model? I guess, technically, they cover Allegra. But many consumers might not want to have to deal with an extra hour inconvenience each month to save $20/month.

Aetna uses extortion practice on its new members! I applied for insurance on December 15, 2010. Someone from underwriting called me over the Christmas season some 7 or 8 times asking "more questions". At one point the woman told me directly there was a good chance of not being approved. They said only when I received a letter of confirmation and a member's card will I know that I was approved. On January 12th, I finally received an approval letter and a member's card.

The problem is they expect me to pay them from when I applied on December 15, 2010 even though I was not approved yet. I called at least 7 different employees in a range of capacity and departments / supervisors, etc. All had the same story that I had to be billed from December 15 unless they were able to change my plan to a far more expensive one.

Whereas I would be covered 100% like promised, my rates would go up and only covered 90% and the other 10% by me. Then I was told 3 different plans I was supposedly on by 3 separate employees. Oddly, each one asked me, "Which plan are you signed up for sir?" I said, "Don't you know, is it not on your computer screen?". Each time I was then placed on hold and then the employee simply got back on and would again say, "You are on such and such a plan if you sign in after January and this other plan if we bill you from December. Which would you like to do?" Are they for real?

I just want the plan I signed up for. One woman kept asking for the exact name of my plan. It is not printed on the member's card yet they claim they know the name themselves and could not understand why I did not. I remember it to be something like the 3500 [some other numbers or letters] plan. Why is this important at this time? I do know the benefits and do have the original application which is all that matters. The reason I tell you all these seemingly erroneous details at this time is because this is their problem solving skills or rather resolution and disputes handling skills. These employees are painfully, obviously under the gun for putting people into the plan that will either force them out of Aetna, if that is the goal or they will have you pay for something of a higher premium than promised.

I truly believe this and know that there are Aetna employees that know this as well. Why does this feel like extortion? Their only feeble excuse is that "if" I had been approved even weeks after I signed up then all claims starting with the beginning of the application would have been paid, hence I was technically covered. But not knowing I had coverage prevented me from seeking any medical care, obviously as I was told I was not covered. Nobody bothered to make this clear nor did it ever get mentioned till now. I don't recall where or if it is in writing anywhere.

So in effect they have stolen just a little over $200 dollars which is not the end of the world, though I hate to support criminals, even the white-collared ones like Aetna. I thought Aetna was reputable and was a good insurance company but after talking from one rep to another, it became increasingly clear that this company is based on deceptive practices and the employees are all just following orders to support it. This is an indisputable irrefutable fact and someone needs to step up now to the plate and file a lawsuit and let a judge decide what is considered fair and what is considered extortion based business. Why is it that if injured, I have the sinking feeling Aetna is the one insurance company that you would rather sue at court than paying them up. Their bean-counter knows that the majority of people simply will eventually "go away! " This is Aetna, for all those involved and for anyone contemplating using their service.

I am requesting any and all legal advice, as well as filing a public lawsuit or class-action. I am also requesting all employees of Aetna to discreetly call me or write should you have even the slightest information that Aetna is not on the up and/or has done business in an unscrupulous manner. Even if unsure if it is illegal, all information will be used to stop this company before any more good people get hurt. We are dealing with people's lives. This is important - your name will always be kept confidential unless you yourself decided to let it become public. This you have a written commitment on, right here. Thanks in advance for all those that can help out.

On a class-action scale I am quite sure Aetna makes untold millions of dollars on deceptive practices. For myself, I have lost one month premium and possibly not have a good coverge if you don't pay up the money they want. They have already billed it so I put out the money unless they credit me for one month. Even two weeks is acceptable, "provided" they will not switch my plans. I want to be on the 2010 plan I requested that I was approved for on December 29, 2010. I should therefore not have to pay for December 15th till January 11th, when I actually was notified in writing. Other loss is I could not seek any medical attention as I had not been officially approved. These smaller consequences is herein the problem. They know no one will sue them and they make money out of it. I would sincerely like to change that.

I have a law background and as a trial preperation expert have never lost a case for a client. I can back this up with references to the appropriate party. If a lawyer takes the case I will put it together but need someone with the license. I am only a legal researcher/paralegal. I will prevail only because I know I am in the right.

I have been working with my company for almost 5 years. I have never had any medical problems in the past. In April of 2010, I started having some pains in my abdomen which were very intense and very painful, along with the pain came constant vomiting. I went to a doctor and he diagnosed me with gallstones. I have made an appointment to see a surgeon. The surgeon scheduled me for an ultrasound about a month out. Before my ultrasound, my condition worsened. I was in extreme pain and vomiting nonstop for 3 days straight (normally pains last for a couple of hours). I called my physician and went in for an appointment and he took me off work. I could not keep any food down for a week, my eyes and skin started turning yellow with jaundice. My liver was being affected. I filed a claim with Aetna but they initially denied me due to "not submitting enough information". So, sick little me went back and forth between the my physician's office faxing Aetna any and all info my doctor would give me. I spent hours on the phone with Aetna's representatives, who were extremely rude if I might add. Finally my doctor wanted to do an ERCP to see if there was any stone blocking anything in there.

The ERCP was not successful in stopping the pains along with the vomiting. About a week after the ERCP was performed, I received a letter from Aetna stating that their record showed I am not disabled and should return back to work, which to me was funny due to the fact that my doctor wouldn't release me back to work. So again I am disputing a claim with Aetna so that I can be paid short-term disability. Meanwhile, I am still sick, undergoing tests every week to check my blood, and MRIs. I am still doing my part as the patient and faxing every piece of my medical chart to Aetna just to find out they didn't receive half of the information I sent to them. I have every receipt from every fax I have sent. I would call their company about 3 times a week and they would refuse to give me what exactly they needed to support my claim. I received a letter in August stating that my claim could take up to 45 days to be decisioned . In August, my doctor finally agreed to laparoscopic surgery to remove the gallbladder. The soonest I was able to have the surgery was in Sept. My doctor gave me two weeks for recovery and I promptly returned back to work on October 17th. I then submitted all my medical info stating that I was able to return back to work and gave the doctor's release more than 45 days past the date of the original letter I got, saying it would only take 45 days. Again Aetna failed to receive the information I had faxed. But this time I faxed the information to two different numbers.

I continued to call Aetna and they stated that they have still not assigned me to a case manager. I then called and left voicemail after voicemail to managers in the Aetna office but I never got a call back. So I continued to leave voicemails for managers. Finally a manager called me back, left a message on my voicemail stating that my case was still under review. I then received a letter in the mail stating that Aetna would have a decision made on my claim by Nov 7, 2010. That date came and went. I'm still calling trying to get info about the money I am owed. Then made a complaint to my direct manager at work about the company we choose for our associates. I then received an email from Ann **, stating that the decision will be made by Dec 28, 2010. She stated that she had attempted to contact my medical provider and they were not responding to the messages she had left. She said she had to have one of their physicians contact my doctor. So I called my doctor and he completed a peer to peer with Aetna's physicians. I called a week after to see the status of the claim but Anne had no info to update me with.

When expressing my feelings about the way I was treated. Anne could only repeat herself like a robot saying she is trying to get me a fair claim and that if she had to make a decision today, she would deny the claim based on the info she has received. This completely infuriated me due to the fact that they didn't receive all the paperwork I faxed over to them on my own time. And when I finally found out that they didn't have all the information I faxed, I explained to Ann that I would be more than happy to fax it again. She advised me not to fax any further info because it would delay my claim longer. She stated all she needed was to talk to my doctor. Today is Jan 4, 2011 and I just got off the phone with Aetna requesting to speak to my case manager and she conveniently was not available. Aetna has ruined my life.

My husband's and my Aetna Part D premiums increased by 100% from 2010 to 2011. They say that there was a notification, but I'm not aware of such, and there has been no explanation of the extremely large increase. We didn't know about the increase until we received the January bill on January 2--too late to enroll in another plan. There will certainly be an economic impact, but my greater concern is that a provider of an insurance we are required to purchase has the ability and, apparently, permission to increase the cost so dramatically.

I am a disabled and I have health insurance coverage with Aetna. I also have Medicare A, but not Medicare B. Aetna continues to deny my claims saying I have B. I have called several times to explain what coverage I have. A representative stated they have this information and will process the "pending" claims. I have never gotten an explanation of payment or rejection letter. My providers are getting irritated with the process and difficulty of getting claims paid. I pay my premiums for coverage on time every month and should not have to go this process to get claims paid.

Being unhappy with Aetna Insurance, I have been trying to stop it as per their directions at years end, but they find ways for me not to do so! This is hard to do since from day one, they have been tapping into my Social Security for their payments. I am 81 years old, a widow, and I am at my wits end to know what to do. I appreciate your help. Thank you.

I submitted claim on 8/21/10. I heard nothing regarding the claim. I called and sent an email on 9/22. I spoke with Andrea and was told they would not pay shipping and handling charge (blood work sent to doctor) of $20. I old her I did not expect them to pay and to please process. She agreed. I called again on 10/19 and spoke with Rosa. The form was apparently sitting on desk or in file and had not been processed. She told me it was being submitted to the claim department that day.

I called again on 10/19 and spoke with Natalie. She last said it was returned to provider, then said it had all the correct codes and should be processed. She said she would mark it "urgent" under ICD9 code and it would be processed within 3 to 5 days. It is now November 23 and I have heard nothing. I have emailed them again. Most people would just give up. Apparently forms are not being processed. I pay $600 a month for insurance and this is what I get. Nothing! I have a health care account with IBM and I do not have a choice on my provider to use these funds. Otherwise, I would be changing my insurance company.

The consequence is that I have missed my last two follow-up appointments. I'm waiting for payment on this charge. I would appreciate an opportunity to pursue this as this is why our health care insurance is so high and I have no choice. I just wanted to be a better Aetna customer and they won't even communicate what the problem is. I have to continually call them. I think it is a scam, for most elder adults would just give up. I will pursue this until I get some type of response that is correct. Thus far nothing they have told me has been correct.

On top of being beaten and beaten to pay for services they insisted on covering, I dropped their coverage in August 2010. Now, here we are in November, and I receive a bill from 3 office visits in September that I never had. Insurance fraud! Their customer disservice group says it was a typo in their office, yet, I am now being contacted by this doctor to pay bills I never incurred. Then, when they said they would fix it, I requested written documentation that would state I did not use this doctor, that this was their error, and that I would not be billed again. They refused to accommodate my record keeping without reason. Besides, they say, "We can't do that."

I called on 10/23/2010 and spoke to Jivonne about reordering my prescription for 3 months for Arimidex. I was informed that the cost would be $384.93 for brand and $324.93 for generic. Formerly, I had paid $80 for brand and $60 for generic, but now I was informed I was getting close to the donut hole and had only $172.40 left. On 10/25/10, I called to ask how much I would have to pay for only 30 days (as in January 2011 my account would reset to $0 and regular co-pays would go into effect).

Christine informed me that it would be $40.00 and a new prescription for 1 month would be required. This was also verified by Sara in member services. Moreover, I could order 2 months for $80.00.Then began my struggle with my doctor's office to fax a new prescription exactly as they wanted. This took many days and many phone calls to the pharmacy (to see if they received fax and would be processing medicines) and to the doctor's office. During this time, I spoke to Nicole and Doris **.

Finally, I was informed by an automated phone call that cost of prescription was $600.00. This was verified by Kenyatta. I asked to speak to a supervisor and they put me through to Vicky, who stated that prices can change from day-to-day. She double checked the price and the co-pay for 30 pills would be $241.00 (since I had $172.40 in account before donut hole, I calculated that $241.00 plus $172.40 + $413.41 total for 30 pills). Why am I angry at Aetna? Because they do not train their employees properly. I was batted back and forth with misinformation from the pharmacy to member services. Moreover, something stinks badly when you go over how they decide to price pills when a person gets in the donut hole. Subsequently, I called a Canadian pharmacy that informed me that for 84 pills (generic), the cost was $274.00, and for 28 pills (brand) $165.00. Quite a difference from the price charged by Aetna RX.

Initially, I complained that I was assessed the "specialist" co-pay for a visit to my local Family Practice, where I had to see a physician's assistant or wait over a month for an appointment with my physician. A CSR supervisor told me on the phone that she would allow the lower non-specialist co-pay for this one time because she agreed that imposing a specialist co-pay on any provider not a general practitioner, pediatrician or family practitioner could be construed as confusing when considering a PA in a family practice office, although she stood by doing so as correct procedure. I then received a letter of determination on 8/25/10 (although the letter itself was dated 7/28/10; I had been away from 8/16 - 8/25 on vacation, so the letter may have arrived as early as 8/16, but certainly not before) informing me that my appeal request had been denied and the specialist co-pay was being upheld.

I had 60 days from receipt of this unexpected letter to request a 2nd level of appeal. I sent a certified request for this on 9/28/10, after researching the application of varying co-pays and drafting a response. I received a letter on 10/21/10 informing me that my request was "Too Late to Appeal". Interestingly, once again, this letter was dated 10/6/10, some 15 days before I actually received it and 12 days before the postmark on the envelope. I have written another letter to Aetna pointing out that they seem to delay mailing important time-sensitive letters to customers, hence cheating them out of the Aetna-stipulated timeframe for responding.

I reiterated that the initial letter was received by me on 8/25, could have arrived no earlier than 8/16 when I went away, and that, based on those dates, my request for the 2nd level of appeal was well within the timeframe they state of 60 days from my receipt of their "adverse benefit decision". The CSRs at Aetna don't appear to actually read the contents of correspondence, as this was noted in my 9/28 letter as well, so I don't expect a favorable response with regard to considering my 2nd appeal request. Moreover, even if they do agree to consider it, it would be a complete surprise if they did not uphold assessing a specialist co-pay for visits to a family practice Physician's Assistant.

It's a small amount of money, but a big point as it is one more way for the insurance company to increase profitability by paying less for the less costly service of a lesser qualified provider while reaping additional benefit by charging the insured more by considering a PA to be a specialist because it is not an MD or OD working in the limited fields of family medicine, general practice or pediatrics. It's galling.

I have suffered from back pain for several years in which I have seen my doctor for and have the X-rays and MRI showing protruding disc (2003). I did nothing about it because I had no insurance at the time. I just had to deal with the pain.

Over the years, it worsened (2009). With Aetna insurance, I had another MRI showing more damage to my back. So a month later, I start Spinal Rehab. I have had 3 facet injection procedures with no relief from the pain in my lumbar region. Still in Spinal Rehab (now at 1 year) and Aetna is paying for this, I have had my 3rd MRI showing even more damage to my back (5 annular tears in 5 discs, 6 bulging discs, osteoarthritis, stenosis in L2,3,4,5 and S1,etc..etc..) and I was referred to a neurosurgeon and had a consult for surgery (L-Fusion, etc) and was pre-authorized.

Surgery and Pre-Op was scheduled. The night before, my doctor's office called me at home stating Aetna sent them a letter denying payment for services for surgery. Mind you, I have been on medical leave awaiting this for two months, the company I work for that supplies this insurance does not have light duty jobs, you must be able to lift 50 lbs. continuously or you don't work there.

Aetna claims its reason for denial is in their guidelines, my back problems "show no instability". Seven years of severe back pain and living on pain killers in hopes of a less painful future taken away by guidelines and someone's opinion? Where does this leave me now with my employer? I am appealing it now, any suggestions?

I have suffered from back pain for several years in which I have saw my doctor for and have the X-rays and MRI showing protruding disc (2003) did nothing about it because I had no insurance at the time. I just had to deal with the pain. Over the years, it worsened, (2009) with Aetna insurance I had another MRI showing more damage to my back. So a month later I start Spinal Rehab. I have had 3 facet injection procedures with no relief from the paining my lumbar region. Still in Spinal Rehab (now at 1 year) and Aetna is paying for this, I have had my 3rd MRI showing even more damage to my back (5 annular tears in 5 discs, 6 bulging discs, osteoarthritis, stenosis in L2,3,4,5 and S1,etc. etc. and I was referred to a neurosurgeon and had a consult for surgery (L-Fusion, etc)and was pre-authorized.

Surgery and Pre-Op was scheduled, the night before my doctors office called me at home stating Aetna sent them a letter denying payment for services for surgery. Mind you, I have been on medical leave awaiting this for two months, the company I work for that supplies this insurance does not have light duty jobs, you must be able to lift 50lbs. continuously or you don't work there. Aetna claims its reason for denial is in their guidelines, my back problems "show no instability" 7 years of sever back pain and living on pain killers in hopes of a less painful future taken away by guidelines and someone's opinion? Where does this leave me now with my employer? I am appealing it now, any suggestions?

I have been off work from my company since July 29, 2010. Aetna is my short term disability provider and I am having a very hard time getting paid through them. My condition requires medications for anxiety, high blood pressure, and depression and after two weeks without my medications, I have had enough. I filed a disability claim with Aetna after a car wreck on the 29th and the claim (after 3 weeks) was approved through the 28th of August. My doctor filed for an extension of that claim, not allowing me to go back to work yet and as of today, September 24th, I have yet to receive a check of payment of disability insurance for September from Aetna.

In fact, after getting off the phone with a representative, they still have not approved the extension, and my case worker 'does not return messages after noon until the next business day.' This means I will hear nothing from Aetna until Monday, the 27th, at the earliest, and if approved will get a check the following Monday. How long does it take to read through doctor's notes and say, "Yes, this is the same condition and her doctor has ordered an extension on her leave?" How long am I expected to go without necessary medications while Aetna shuffles paperwork and orders more doctor's visits (which I have to pay a co-pay on that I don't have, because I haven't received a check from Atetna)? In my experience, this has been the worst company I've ever dealt with as to getting claims paid. No one should have to suffer through the uncertainty and financial hardship I have had to put up with while waiting on an insurance company to approve an already existing claim.

I had been paying STD (Short Term Disability) insurance with this company. They did all they could to avoid paying on my claim. I even ended up acquiring an attorney to work on such just to get my claim paid. Even then, my attorney told me I was entitled to a total of one year in benefits but they stopped my payments well short of that. As usual, insurance companies sure want their money but when it comes to paying it in. But when it comes to paying it out due to a claim, sorry. But then, they do everything they can to get out of paying on them.

I had met with a sales rep named James ** to obtain health insurance. After receiving my policy in the mail, I found he had changed my coverage and also requested easy pay from my checking account. I had requested monthly billing. I had also requested a reasonable health plan with dental included. Instead, I got a discounted plan where I will still be paying the bulk of any procedure I may incur.

I went out of work on February 18th due to Carpal Tunnel and De Quervain's disease. I have had two surgeries on my right hand and have had three cortisone shots in my left hand. I have nerve damage due to complications from the surgery on my right hand. I have no feeling in my thumb, first finger, back of my hand, and up my arm. I am still waiting to have surgery on my left hand but due to complications to the right, I was denied benefits on June 23rd saying that I do not have a medical condition that warrants disability.

I live in constant pain and have limited mobility and usage of my hands. I filed an appeal with Aetna and have yet to hear from Aetna in regards to my situation. I was told that they were to have a decision by September 2nd. I called to check on the status and I am told it is still under review. I am a single mother with a small child. How am I supposed to survive? I have no income. My employer has not supported me. I keep getting blown off by Aetna. I have an attorney hired for the short term and nothing has taken place. What do I do?

My wife and I received notices in the mail from Aetna Health Insurance and Blue Cross Blue Shield AZ, our premiums will be increasing from $592 monthly to $699 (for my wife who is holding Aetna) which is an 18% jump effective October 1. My insurance was increased from $553 to $622, again a 13% increase (BCBSAZ).

This is getting out of control. Please help us rein in these price gouging insurance companies. My wife and I have to buy our own health insurance and with this increase we will be paying over $15,800 a year to pay our premiums. We now pay more for our health insurance than we pay for our house mortgage. Could you investigate these exorbitant price increases?

It was recommended that I have a uterine ablation with an OB/GYN to help with the female problems I was having. The OB/GYN's office called Aetna and was told that the procedure was considered in office and would only cost $20.00 per visit. It would require 2 visits to perform. I received the paperwork from Aetna and they do not cover this as an office visit but as 90% after my $500.0 deductible. I would not have scheduled the procedure if I would have known the cost. I am among the underemployed and can barely pay the bills.

The doctor's office has been wonderful to work with and I would recommend them to anyone. The problem is with Aetna and the verification of coverage. I also called and verified that this would only be a $20.00 copay before proceeding with the scheduling process. It amazes me that the insurance companies can get away with this treatment of people who pay the premiums. I have called the Aetna service center and had a representative hang up on me. I do not know how I am going to pay this bill. This will cause a financial hardship on our family. I am hoping that the doctor's office will allow me to make payments. I do not know how I am going to pay this bill.

I am presently paying an attorney to find out why Aetna is saying Medicare is my wife's primary and Medicare is saying Aetna is my wife's primary. I am being sued for non payment by a hospital. Aetna has just flat out refused to pay. I guess they figure they are above the law. Medicare is just as bad. We've had health insurance for the last 35 years or so but I feel like I have no insurance and it's costing me money to find out why I pay premiums? We are disgusted with this whole healthcare nightmare and our health suffers too. We have two insurance companies and they flat out won't pay!

Thinking about selling our house as we are both sick over this. Just want to leave this all behind and live somewhere else. It's a choice we are considering. You would think that this should be an easy resolve ... not a chance. Aetna refuses to talk to my attorney so off to court we go! Just want to get the word out. It could happen to anyone and probably will. Make sure you have the resources to pay an attorney.

I had knee surgery on 7/20/10. The treatment after this surgery is intensive therapy for muscle strengthening two to three times a week, while non weight bearing and on crutches for a minimum of six weeks progressing to weight bearing. I am also on full disability at present. This therapy is prescribed by my surgeon and is the normal treatment for this surgery.

Aetna had denied to pay for the last nine sessions of therapy despite numerous appeals by the therapy office and different paper work submissions. I even have a medical advocate from my husband company working on this but they don't seem to be making progress. Aetna just seems to be coming up with reasons not to want to pay for these services. As of today, I cannot go to therapy due to an outstanding balance since I cannot afford to incur any further expense that I may have to pay. I cannot understand how Aetna can say this is not medically necessary after surgery. Without therapy, I will not heal properly and may have further injury occur. Please bear in mind as of today, I am still walking with the aide of crutches. Thank you.

I have been dis-enrolled from Aetna Medicare as of 09/01/2010 because "their records show my county of residence different than that of fact"; they stated they have Kern County when in actuality I live in San Bernadino County. I have made no medical or prescription claims in the last two years! I no longer have Aetna coverage. By wife of 46 years have the same coverage and the same coverage. However, she is listed in their records as living in San Bernardino County.

I had insurance with United since December 2009. They would not accept my husband, so I looked into other companies. In March, I found Aetna. They accepted my husband and I signed up. After the 30-day waiting period, our insurance kicked in on April 15. In May 2010, after chiropractic care, my doctor ordered an MRI. It found a tumor. After Aetna approved Brain MRI, which showed my brain MRI clear, they approved surgery for June 30 to remove the tumor. I spent 6 days at Rush in Chicago and 14 days in rehabilitation. I have been going to therapy, seeing a counselor to cope with having cancer.

I have received multiple documents stating they would pay the bills. Today, August 9, I received a letter stating my claim is now under investigation and I might be responsible for $75,000 in medical bills.

I am very involved in my own health care, and regularly research, and keep updated on my conditions, and my options in treatment, etc. Aetna continues to mis-process claims, and then attempt to blame my doctor, or me for the resulting mess. I see a specialist for diabetes. This doctor prefers to schedule a lab appointment, where they take blood only about a week before a regular visit. That way, the doctor and I can see the results and discuss them. My coverage clearly states that, there is no co-pay for a lab visit.

Over the last two years, every one of my lab visits has been mis-processed. Every time, they try to blame my doctor's office. I decided to do some research, and my doctor's billing, and insurance clerk showed me the computer program that generates the claim submissions. They were all identical, except for the dates of service, and for the exact tests they were doing, for those lab visits. The clerk also showed me the claim submissions for all my visit appointments, which were clearly marked as such.

When I brought this up to Aetna, they actually could not argue with me any more because I was right. They had to go back and reprocess all the claims, and pay their fair share without charging me the co-pay. Recently, I suffered a muscle tear in my shoulder, and was prescribed some physical therapy. I called Aetna to see if a co-pay was needed for the therapy sessions, as opposed to the doctor visits. They said yes, a co-pay was required. I complied, and presented the therapist's office with co-pays for two doctor visits, and five therapy sessions.

Now, here, the doctor's office made an error, and charged me another co-pay because the did not post one right. When I was able to prove my payments the next day, I was scheduled for a refund of the one co-pay. In the meantime, Aetna mis-processed three of the five therapy sessions, stating that no co-pay was due. The doctor's office dutifully refunded these three co-pays as well as the one in question. I cannot cash that check until I know it is right. I called Aetna to get an explanation. It has now been two months and they still have no clue. I called them again today, only to find out that the first agent did not even re-submit the claims at all.

I just want the truth. If the co-pays are due, then they are due, and all I want back is the one in error. If they are not due, then I want all five of them back, plus the one I was overcharged. The doctor's office is as frustrated with Aetna as I am. Neither of us can move forward until they get their act together.

Lastly, I know that the agents have lied to me. With all the problems I have with these people, I started getting smarter. I ask for supervisors, and get the standard "No Supervisor Available" line a lot. One agent told me that they don't have supervisors. I regularly am told that the supervisor will call me back in 24 to 48 hours. Rarely do I ever get a call back. The one thing that really irked me though, is when I insisted on speaking to a supervisor, I was transferred to someone who gave me the same non-responsive comments. But, I got her name. Two days later I called back, and guess who I got on the phone? None other than the "supervisor" for the previous call! I reported the two of them to someone, whom I am hoping was a real supervisor.

For the cases I am reporting here, my damages are minimal. They amount to $150 of co-pays that I may or may not be due. I also have the $30 I know I am owed, but the Doctor can't release until this mess gets cleared up. For both my doctors and myself, the way we are treated by Aetna agents, is horrible. We are not treated as valued customers, service providers, or anything. We are simply interruptions in the agents' day.

They can spend millions of dollars on sending out unwanted advertising, yet they refuse to send a customer a simple eMail notification that a referral is about to expire. Yet, they are the ones requiring the referrals, and they are the ones putting the expiration dates on them without letting us know when they are!

This wastes time, energy, and money, not to mention the sheer frustration of working with people who do not care about health. All they really care about is their bottom dollar!

This is an issue with several policies concerning mental health benefits. The policy is set up so that the client has a deductible large enough that they never reach it before the sessions' limit for the year is used up. I did get 1 representative to admit this online. Basically there are no benefits for mental health services, but the structure makes it appear that they exist.

Doesn't this violate the mental health parity law? Client has to pay out of their own pocket for all mental health services but company will not acknowledge that there is no coverage.

We have had Aetna Medical Insurance for almost a year. Every time we get a new prescription, my husband has to be on the phone sometimes for hours to get Aetna to approve or correct problems. I have acid reflux and am on Nexium. It got so bad it actually burned my vocal chords. My doctor told me to double up on my Nexium. Take one in the morning and one at night. Aetna denied the claim and I could not get a double dose. I took what I had and ran out. My husband spent hours on the phone until we finally got an approval for me to get 60 tablets a month.

This is not the first time we have had to literally argue with Aetna to get a prescription. Also my husband was taking testosterone shots every ten days. He is going through Andropause. It similar to menopause for a woman. His testosterone levels were down below 200 and they are supposed to be 800. All of a sudden, Aetna denied his prescription. He called and they told him that they would no longer cover it. We were told that we had to pay out of our pocket. He asked them if they denied women estrogen if they were going through menopause. He was told no. We had moved and my husband had to find another doctor to see if he could try and get a prescription for something else. His doctor has given him a testosterone gel and he is going to get his first prescription. We will see what happens.

Recently during our last anniversary enrollment date, my employer switched over to a less expensive group insurance plan. This plan was explained to the group and offered two different types of policies noted as the 801 original or the 911 cheaper type plans offered. I choose to keep the more expensive plan; (1) pre-existing conditions and (2) my age which were a major concern and also justified the cost difference. My problem is the unbelievable and tragic red tape and total run around nonsense one has to go through to get approval and authorization for any procedure to be preformed.

Two weeks prior to me having a procedure on m 6/7 cervical which was a revision of a pre-existing condition, and which had been approved, yet someone just decided to forget about the fact that I was waiting to be admitted to pre-operation almost five hours while some fat cat medical advisor forgot to send the authorization to the hospital. I pay a lot of money through my company and subsidized also by there contributions in maintaining my insurance.

Furthermore, I do not appreciate calling member, services and talking to someone in the Philippines half way around the world knowing that they have all this pertinent information on me. I think your company sucks! When it comes to the privacy and consideration of the money, you collect for you lousy service

My husband and I have dealt with Aetna Health Insurance for about two years, and even though we pay huge premiums, Aetna continually denies payment of claims for ludicrous and erroneous reasons, such as "employment terminated" (still employed), "need Certificate of Creditable Coverage" (sent several times and Aetna kept saying they didn't receive it), "need marriage certificate" (sent several times and Aetna kept saying they didn't receive it), and last but not least, my husband's claims were denied because they said I had no dependent CHILDREN on file. This year, Aetna is again denying claims because they're claiming that there is no Creditable Coverage, even though they have received documentation several times.

I would like to know what kind of action should be taken when Aetna does not provide coverage for a member who needs it? This person I am referring to is my father and they are denying him medicine that his LIFE depends on! Every day is making his health worse and worse without this medicine that he could already be taking. How can they deny someone medicine that doctors has said he needs?? Not only is it unethical and immoral, it's down right sick. Physical damage is his health, his liver is failing slowly.

I have been off work since the later part of Feb. 2010 for my back. My doctor has diagnosed me with Lumbar Radiculitis , which is sciatica. I was approved for short term disability up until April 15 of this year. This was to give me time for epidural steroid injection in a series of 3. These shots are only to numb the pain, I was also to have therapy which neither helped. My doctor's office is referring me to a surgeon. The appointment is on the 18th of May. Aetna was advised of this and of my situation and my back pain is not something that would prevent me from preforming my job in customer service, being that I sit all day. I called and spoke with Agostine and explained that the documents that the doctor's office sent over needs to be reviewed. I explained to her that nothing has changed, the pain has eased up some. I was advised that since the docotr put that pain level was a 5 out of 10 and due to me improving, I could go back to work; however, I was approved for medical leave, unpaid. I advised Agostine that I would be going to see a surgeon, she said that I would have to appeal the decision. A few days went by and I was really mad as I waited for the papers showing it was denied. When I received them, I called Aetna to see how I needed to file an appeal. The rep I spoke with at that time advised that there was missing paper work (did I mention Agostine failed to advise me of this before she closed the request). I explained that I was never told of this and wanted to know what I could do.

I was advised that I had 10 calender days to get the paper work to them for a reconsideration (something else Agostine failed to tell me). I was told that claim was denied on April 19, the same day I spoke to Agostine. So I called the doctor's office and advised his assistance that paper work will have to be sent back over to them, except this time explain in plain English what is preventing me from sitting all day. I also advised that she needs to include a rage of motion. She stated she would. I waited and called Aetna on April 30th in the morning and was told nothing was ever sent in to them. So I called back to my doctor's office and spoke with his assistant again. She told me that the day we talked on the 19th that she did fax over more documents and also called Agostine and left a message for her to call him back, but she never did get a call back. She faxed the documents back over again on the 30th, I waited until the afternoon and yet again I called Aetna. To my surprise this time they received the paper work. I asked to speak with my case worker, but could not. The rep called her on the other line and per the rep she was going to go back over the paperwork and it would take a few days and she would reconsider.

I called back on May 4 and was advised by a rep that no updates have been made and that they would put in a request for Agostine to call me back. I asked the rep at that time if she had put notes in regarding Agostine calling back the doctor's office. Nothing, they said once it's been closed then they don't reach out to the doctor's office. I asked her why they don't return calls, she could not answer that. Anyway today I got a call back from Agostine. She explained the nurses are still reviewing this and she will call me once a decision is made. So tell me why are nurses reviewing the information when a doctor advised how long I need to be off? I thought doctors know what's best, not nurses. So at this time the waiting game continues and I have to worry about having an income until my back heals.

I made inquiries early April about a new health insurance plan to see if I could pay less than with my current insurer. A broker, Andrew **, contacted me and suggested Aetna, saying that they have affordable plans and that I would be better covered than with my current insurer, Midwest. He helped me fill an application online and put in the date of April 15/10 as a tentative date, saying that the insurance premiums would not overlap, since I presently pay $340.65, which is deducted each month from my checking account.

1) the premium was higher than mentioned, and

2) they listed ear infections (sic)--I had one during the previous month--and sore throat as pre-existing conditions.

I phoned Aetna's customer service on 4/27 and said I did not want their plan. The person said I needed to write to them and to get the broker to call them. I left a message to Andrew and said the same thing, telling him to get in touch with Aetna. On April 28, I checked my bank account online, only to discover that $361 was deducted by Aetna on 4/27 (in addition to $340.65 by Midwest, my present insurer, on 4/20). I filed a complaint with the BBB; however, I feel that we have here fraud in disclosure, fraudulent and unauthorized debit, "forced selling" on an amount that I did not accept, deceptive practices, plus now, extortion.

The non-anticipated debit of $361 put me under financial stress after payment of residual taxes for 2009 and estimated tax for 2010, during a slow business month. And they now want to keep that amount for anywhere from 7 to 10 business days, obliging me to transfer money to cover my end-of-month bills! This is the message I received from Aetna to that effect on April 28 in the afternoon:

"...We received and forwarded your request to cancel your individual coverage to our billing and enrollment department for processing. Unfortunately, the initial payment in the amount of $361.00 was deducted from your checking account on 04/27/2010. Please allow 7-10 business days for your account to be canceled and to receive your refund. The refund will be issued directly back to your checking account."

I was sent home by my manager because I was in so much pain in my lower back and I was crying. She advised me to call Aetna and file a short term disability. I made an appointment with the doctor for the next day, but never got there as I was brought to the ER by ambulance the next morning. They had to put so much pain medication and muscle relaxants in me and had to admit me to the hospital. I was on intravenous morphine for the pain, had an MRI done, and it turned out I had a herniated disk. Actually, there were 3, but 1 was severe.

I was released from the hospital on the 3rd day, still in pain, still unable to walk properly, sit or lay comfortably. Aetna now denied the short term disability because they said the paperwork did not support my claim for not being able to work. When I spoke with them on the phone, I asked, "Do I have to be dead in order to qualify?" The lady said a nurse had looked at the papers and said I was okay to go back to work. A nurse, who looked at a paper, never saw me, never examined me but looked at a paper!

What makes her more qualified than a doctor? Now I have to file an appeal. I wish I could sue them, but I don't have the money for it. Aetna is the worst when it comes to short-term disability. Due to them declining my short-term disability, I will be behind on bills again. My husband can't work because he's a quadriplegic and they say America is the land of the dreams. Right now it looks more like land of my nightmares. I will have to go back to work even though the physical therapist might have to send me to a specialist because therapy is not working, and it's actually making it worse.

My complaints with Aetna Health Insurance range from August 2009 to present. The claims are regarding therapy services for my daughter who has cerebral palsy. I have two major ongoing problems: Aetna representatives lied to me over the phone, telling me that more therapy than the 60 days written in plan would be available once her doctor wrote in a letter, and then Aetna denied the coverage for these claims stating it was not in my policy and would not stand behind the misinformation given by their employees that led me to continue therapy and then had to pay for it on my own.

My second complaint is regarding the copay amounts for the therapy sessions that we did have. Aetna has retroactively changed the amounts of the copays, and credits have been issued to me; however, the amounts are not consistent and Aetna now is refusing to give me a detailing of what the copays were or show me where in my policy it states what the copays are. They are now saying that they made a "mistake" in covering the therapy in the first place, so they are not giving me the information or further credits to make the copays consistent. A complete detailing of all the problems I have had with Aetna can be found on my blog.

I have spent hundreds of hours trying to rectify the problems I have had resulting in many hours of lost work. The financial impact is in the thousands. I kept my daughter in therapy and did not pursue alternate insurance based on the information that Aetna employees gave me stating in no uncertain terms that my policy covered more therapy, so I continued her in therapy thinking that it would be covered and then was not covered. In addition, I believe I am owed credits for the copays that I did pay but Aetna is refusing to give me the details on what I should have paid.

I have Aetna part D prescription insurance. From the beginning, I had issues. When I looked to choose Aetna, I made sure all of my prescriptions were covered and I also qualified for the extra help plan. I have been using Lidoderm patches for my disease that makes my skin hypersensitive for about a year now. They have always been covered. However, once I tried to get the patches with Aetna, they let me have the first month then sent a letter stating that my doctor would have to submit a pre-authorization, not including what the pre-authorization would need to include. So my doctor sent the pre-authorization and they didn't tell the doctor they needed more info. I had to call and found out the pre-authorization had been denied but they didn't tell the doctor what they needed to know about my condition.

Then, I requested an appeal, which was immediately denied. After getting more info from my doctor, they said I had the wrong disease and I had to try another prescription first. But after the appeal came back, they said they wouldn't have considered it anyways because I didn't have the disease they said I would need. They refused to tell this to me or my doctor until after the last appeal had been mailed to me. I had to pay $218.40 two times for my patches the next month because I cannot wear clothes without my patches because of my skin sensitivity. I am on food stamps and did not have the money to buy my patches but I had to because I couldn't wear clothes or leave my house with acceptable clothes and I told Aetna that and they didn't care.

Then, about two weeks ago, I went to drop my prescriptions off and was told there was a block on my prescription card because they said I had another BCBS insurance plan and that medicare coordination of benefits told them that. I called coordination of benefits and they said that no, BCBS was deleted from their system when it expired a month ago. They stated that Aetna have not updated the info and they were making a complaint for me. I tried to get my prescription filled Friday and they had to write a ticket and didn't call me until Monday to say it had been a mistake. I waited three days without medication and had withdrawal effects.

I called Medicare and they allowed me to switch prescription d plans starting on May 1st. So yesterday, I went to get my prescriptions filled. I find out on another Friday that they put the same block on my prescription plan, stating that I still have BCBS, which is false, so they never took the block off after approving my meds two weeks ago. So, now again on a Friday, I have to wait three more days to get my medicines for a problem that is an inappropriate block that shouldn't be there. On top of that, the operators were extremely rude. One operator, Dino, started laughing at me when I started crying because of having to go through this again. He started arguing with me, yelled at me and told me he wouldn't transfer me to a manager after I asked 10 times. I called back and asked to speak to the highest manager, who still couldn't fix the problem, or see that they have already verified that I don't have BCBS insurance anymore.

I have just heard that CMS is upset with Aetna based on problems like these. I have made two complaints now and luckily my new insurance starts May 1st, however, I have to wait until then. Also, my new insurance, Community CCRX, will approve the lidodoerm patches wihtout pre-authorization or step therapy. I have to wait three more days without my meds and Dino, the operator alluded to the fact that I am having these problems because I have decided to leave Aetna and they are "punishing" me. I cannot believe they would treat me like this after clearing the block and fixing the problem, just a week ago. This insurance will lose its contract from Medicare, from what an operator there told me, and it's well deserved. Do not choose any Aetna plans for medicare part d or insurance. They will deny, deny, deny and make you jump through hoops.

I have had to pay out of pocket $218.40 two times for my lidocaine patches that they decided not to cover, plus I had to stay in my house one week because I couldn't handle the feeling of clothes on certain areas of my body because of my disease. I am on food stamps and I was foreclosed on because of this purchase and now I have had to move into an apartment. The physical damage was from feeling the pain on my sensitive areas without the numbing patches.

Towards the end of 2009, I chose Aetna Costco Plan for my Medicare Part D plan for 2010. In early January, my physician emailed my information/enrollment prescription form and seven prescriptions. After about two weeks, I called to find out when I could expect the prescriptions. When I mentioned that there were seven prescriptions, the person with whom I spoke said they had only received three. They told me which ones they had gotten and so I asked my doctor to please send the missing four.

I called the following week and discovered that: (1) my prescriptions were on hold, but got no reason for that and also that they had eleven prescriptions for me. I said that there should only be seven and explained that an additional four had been faxed, because Aetna said they only had three the previous week. This person assured me that if duplicates had been received, they would automatically be kicked out of the system. I then insisted they read me the list of prescriptions. They read the list and sure enough -- there were four duplicates. My prescriptions were still on hold and I did not know the reason.

I called several times and got no help. I finally tried the doctor's line and this person kindly told me that all my prescriptions were on hold, because they did not have a list of all the medications I had taken before I took Nefazadone. So I called Aetna again and they verified this, however, they had never told me this before. Please note that I have been taking Nefazadone since 1997 and none of the insurance companies or Plan D's had ever required me to provide this info. In addition, prior to signing up with Aetna, I called Aetna, told them which plan I was planning to use and asked whether Nefazadone was covered. They assured me that it was. However, after waiting to get my prescriptions, I discovered that I was required to have my doctor send a list. He did that and then ended up having to resend the same info over the weekend from his home.

In the meantime, my prescription for Asmanex Twisthaler was getting very low, and Aetna told me that it would be a minimum of two to four weeks before I got any of my prescriptions. So, after much hassle and worry, I was able to buy a one month supply from a local pharmacy. Please note that I asked if Aetna would please send me all my prescriptions except the Nefazadone. That person refused in a rather nasty manner. In fact, nearly everyone I spoke to at Aetna was extremely unhelpful, unprofessional and even threatening, saying that if I sent only one prescription at a time (to make sure it got filled and the whole order did not get put on hold), Aetna would discontinue my insurance. My doctors and I were not happy and I was quite worried about ever getting my prescriptions.

Finally, my prescriptions arrived. They were sent 2nd day air at my insistence because I was about to run out of several other prescriptions. This included three Asmanex Twisthalers, which turned out to be filled incorrectly. I got 3 boxes of 60 metered doses. I should have gotten 3 boxes of 120 metered doses. I did not know that until much later. A day or two after, I received my full prescription order, I got a letter from Aetna saying they would not refill my Asmanex Inhaler until March. Since this was one of the duplicates and it had been removed along with the other three duplicates. I assumed this letter was yet another Aetna mistake, since so many had already been made. They said something about calling them and I did not do that, because I had spent hours and hours on the phone with Aetna and had been treated horribly. I assumed there was no way they would send me a second set of Asmanex, since they had to know it was a duplicate.

Surprise! Aetna sent me two more Asmanexes earlier in late March. I called to complain and was told to call customer service. Well, they wrote down all I said, but said they do not take complaints, and I had to write to this address. (Oh, Aetna, you are so clever, you know that a lot of folks won't take the time to do that, so you make more money this way.) I have been in and out of town and so it has taken me a while to write this letter, however, here it is.

3) These two twisthalers are USELESS. They expire on July 11. They cost me $102 and I did not order them.

Also, given all the problems you have caused, you did not call me to see if you should send this order. Surely, you could have checked your notes and discovered that you had gotten a duplicate and had to remove it and that you sent my first order and then wrote me a day later and said you could not fill the new order, which was in fact a duplicate.

The person with whom I spoke about this problem was the first nice person I talked with at Aetna. First he told me that the order should have been split and I should have gotten everything sent except the Nefazadone. No one ever offered to do that. He was astonished that other Aetna staff people lied repeatedly to. Second, he said that the first Asmanex was filled wrong. And then he said he hoped I could get a refund on the two inhalers that were sent and which I will not be able to use.

Aetna, you have caused me a lot of trouble, cost me money, lied to me, and treated me horribly. I have had three previous Part D's and I have never had any problems with any of them at any time or any of my previous insurance companies since I have been taking Nefazadone. This is a formal complaint and I am asking that you send me a prepaid post office form that I can use to return the Asmanex that I did not order and also a check for $102 to reimburse me for the prescriptions that you sent and that I did not order and that I can not use. I have been charged $102 for a prescription that I did not order and which will expire before I will need it. In addition, my doctor is not sure I will need to continue taking this prescription, tests are in process.

On or about March 1, 2010, Aetna Medicare Insurance has reduced the number of Home Healthcare and nursing hours authorized for my care. The authorized amount was reduced from 7 1/2 hours per week to 36 hours per three months which is three hours per week. This action was taken without cause or prior notification. I have Secondary Progressive Multiple Sclerosis, am home bound and need daily assistance dressing, bathing, toileting and completing all activities of daily living. My condition, at present, leaves me prone to weakness, fatigue and the danger of falling. I have limited fine motor use of my left arm and leg and have recently developed pulmonary problems and heart disease. I am confined to my wheelchair or bed twenty-four hours a day, leading to serious breakdown of my skin.

For three years or more, I have had aides at least three days per week, increasing to five days weekly after a bad fall in the shower. The aides bathe and dress me, help me stretch and exercise and tend to my skin care. The nurses have overseen my overall care and health, changed my super ** catheter and provide much-needed expertise and advice to keep me as healthy and strong as possible. Removing and/or reducing these services makes no sense in view of my age (72) and the constant progression of my illness.

We have been getting a constant runaround from Aetna. We were first told to file an appeal, which was then thrown out because Aetna claimed there had been "no denial" for us to appeal. What about denial of services? Next we were told that my doctor needed to call Aetna and request the services that had already been authorized, and that I had already been receiving before Aetna took them away. (This after numerous futile phone calls and an appeal which was thrown out! ) Now, my doctor, too, is getting the Aetna runaround. His office has been trying for the last five days and cannot get through to make the necessary request for services! Meanwhile, my care has been compromised since the reduction in home care took place four weeks ago!

My care has been compromised in that I cannot shower, dress myself or take care of ADLs without assistance and have been relying on the kindness of neighbors in my adult community to help my wife assist me as best they can.

I had been diagnosed with cancer several years ago. I have had trouble with several things that I needed to get me through my everyday life. I was down for so long, that I would go to work, come home and get ready for bed. I had no life. I have a daughter and two grand kids. I have to be able to function.

I never received a policy manual from Aetna. I fought with them for a long time. Feb 2010, I received a copy of my policy manual, not the original. I began going to my family chiropractor. He was able to help me in ways, I never thought possible. I am able to function somewhat like a normal person. Now, I was told by my dentist and my doctors that treated me, while I had cancer, that my teeth were rotting out due to all the chemo and radiation that I have been through. Aetna will not pay for dental implants because they say they are cosmetic. I have letters of recommendation that state, in order for me to eat properly, I would need dental implants. I have been fighting with Aetna for a long time. They still refuse to cover my implants. I would not recommend them to anyone.

My fiance was on an Aetna plan through Cal Cobra (getting the coverage started was a three-month long nightmare in and of itself, but that's another story). For one reason or another (again, the subject of an entirely different complaint), it appears as though her coverage was cancelled as of 3/1/10 (not that we were notified of this, of course). The premium check for the month of March had already been sent in and cashed, however, now the office that cashed the check for close to $200 says that she's still "active", yet the office that should be paying the bill for a standard doctor's visit says she's been terminated. They won't return the funds from the premium check, nor will they cover standard medical expenses for the period the premium covered.

They are trying to get a free month's premium out of us for nothing! I'm not about to roll over and take this, yet fighting them is an insanely time consuming process. No one we can get on the phone can answer a question, and we've been waiting for a call back from a "supervisor" for the past two weeks (with repeated calls from us to them in the meantime). This is only the last and most blatant piece of extremely incompetent or purposefully fraudulent activity we have been exposed to through Aetna; she is leaving Cobra early just to get away from them. Bring on the single payer system - it can't be any worse than this! We have lost the premium amount (close to $200) and the medical coverage for the month of 3/10 (amounting to about the same).

I am on remicade. Aetnaspecialty pharmacy (a wholly owned subsidiary 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 doctor who did not get the Remicade from Aetna Specialty Pharmacy and my co-pay was $40. No one at Aetna ever 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. Consequently, I now have a debt collection company trying to collect thousands of dollars. I changed doctors and my total out of pocket was $40. In the meanwhile, I had a total relapse. Pain and suffering from psoriatic arthritis that was cin complete remission. I gained twenty five pounds and suffered for months.

I had active coverage until the end of July 2009 and made a routine doctors appointment. I then received notice from my school that I had to change insurance company because Aetna did not cover what their required. I sent Aetna an email stating that I wanted my coverage terminated on 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 office 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.

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 received 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 doctor found cancer in my pap! Then I needed glasses company, I checked to see if Aetna would cover my Eye Doctor 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 doctor 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 cancelling 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 disloyalty 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!

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 for a five minute visit! She noted that and said it would be coded as a physical. I had the appointment.

I just received a notice from Aetna that the visit was billed as an office visit for $104 and a physical for $274! 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 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!

I have asked for appropriate way to get my COBRA coverage in place ASAP. AstraZeneca discontinued my insurance as of 1/1/10, however, they never contacted me to tell me this. I found out when my doctor tried to get a surgery pre-certified. I called and that is what put the wheels in motion. I was told if I paid to receive 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 within 30 minutes. It was delivered 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!

On 01/15/2010, I took a paid leave of absence. On 01/19/2010, Aetna 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 to 03/01/10. I called Brian at Aetna to state this. Brian still talked about paper work not getting to him, and my claim would be denied. I repeated to him that my appointment was not until 01/26/10. On 01/28/10, Brian called me back and wanted to know where the paper work was. I told him again that I just went to the doctors on 01/26/10. I called the doctors' office and left a detailed message about how and where to submit my paper work. On 01/03/10, I received a call from Brian stating my claim was denied. I called the doctors' office and 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 is wrong; give me your supervisor." Of course, I was told she was not available, and was reassured if I left a voice mail, she would contact me that evening if not the next day. Of course the call never came. On 02/05/10, I called twice to speak with Ms **, and you guessed it, she was in a meeting. I then asked for her supervisor. I was told she does not have one. Of course she does. Now seeing that I am on a leave of absence for work related stress, this adds to it. They think we will give up. I will not. My lawyer is fully aware and will back me on this. I have earned my aol. To be denied is wrong. It's 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 supervisor on this. They want us to give up, and many do just that. Keep fighting as I am doing. How will I pay my mortgage next month if I have to wait 45 days for an appeal? That was not my fault.

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. Aetna tells you nothing but the amount is not allowable, even though I have had their insurance through my job for 10 years and probably only went 1 time in 2008. So, they paid 1 claim! It should be justified that I need more extensive work done in 2009/2010.

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 Oone 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.

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 cancelled 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! That's $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. Owing over $10,000 for the birth of my son when I have the paperwork proving I was covered.

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.

I called and asked what is the big risk and therefore the large dollar amount for such a minimal policy. They said it is all outlined in the April 15, 2008 letter I received. I RECEIVED NO SUCH LETTER. I requested a copy of that letter which I received on December 15t, 2009; 20 months later. The letter stated that I take Oxazem, a drug that does not exist, for insomnis, a condition I do not have.

I requested a review of my policy and a refund based on Aetna's three (3) mistakes that cost me $5,400 more than I should have paid the last 20 months. They said they can change the future policy but that the past is the past and I do not qualify for any refund due to their three (3) mistakes. Are they not responsible for errors made exclusively by themselves. I am in shock over this. This should not happen to good, upstanding citizens that pay their bills and try to follow the proper path.

Now I am out $5,400 and have been told that once they review my reapplication I must wait six (6) months for the new, correct monthly payment to go into affect. ARE YOU KIDDING ME! If I committed grand larceny I am sure I would go to jail. UNBELIEVABLE!

I am constantly in contact with the prescription/pharmacy at Aetna to get details on many of the prescriptions that I must have filled through their department on a monthly basis. I am constantly called and reminded that it is too early for them to fill my prescription but yet they require that I mail my prescription to them as soon as possible for processing. I recieved a new prescription from my doctor and called the pharmacy to see if they will fill it. The member services dept. stated that their would be no problem filling the prescription which is a controlled substance. She stated that they put through a sample claim through my account and there was no problem with it.

So they contacted the pharmacy to see if there would be a problem with me recieving the controlled substance in the state in which I live. I live in South Carolina. The pharmacy told the rep that there would be no problem with getting me the medication. So I sent the prescription into the pharmacy and a week later I got a call from the pharmacy stating that I cannot get the 90 day supply of the medication filled through them due to a state law stating that a controlled substance may only be issued at 30 day intervals. They offered to fill the prescription at a 30 day fill and the gentlemen in pharmacy stated that they would not charge me for a 90 day supply if they could only fill it for a 30 day supply. I didn't believe him and made him check with billing.

When he got billing on the phone, billing stated that YES the charge would still be for the 90 day supply even though it could only be filled for the 30 days required by law.....not my law.....the states laws....why do I get punished for this? Now, I either pay $187 for the prescription at the drug store or I can mail in a prescription once a month and pay a 2 month co-pay for ONE 30 day supply of the medication. The pharmacy rep was stunned when I told him that I am sure they will not allow me to get a 30 day supply for only one co-pay and he did not believe me until he verified it with the billing dept.

This is not the first or the second or the third or the 15th time that I have called and spoken with someone in member services and/or the pharmacy and have been given wrong answers to my coverage questions. I am basing my coverage on the information that they give me and it is usually wrong. I never know when I am getting an answer that I can depend on. I still have to submit my claims to a supervisor for processing due to the fact that the processing center does not know how to process a special handled claim reimbursement. The service that I have recieved for the past 5 years from Aetna has been horrible and slack at best. I have documentation that can be given with any questions regarding these events with any request. Please ask.

Aetna is the insurance provider recommended by Curry College as well as many other colleges and universities nationwide. I needed coverage as a full time student, so I went there. Not only is the plan expensive, but it covers NOTHING.

Knowing it covers next to nothing, I called the company in August 2009 to ensure that a "well-woman" exam was covered under my plan. I was informed it was, so I saw my doctor for the first time in 3 years.

After the visit, I received a year's prescriptions, which, come to find out, ARE not covered. So, as a full time student, living on my own, I am paying full price for prescriptions. Fine, no big deal.

About 4 weeks later, I got a bill from my doctor saying that Aetna was refusing to cover that bill because it JUST SO HAPPENED on that day that I went to see my doctor, my insurance plan was invalid. I was not covered. So, after some debate, they decided to pay it.

Last week, I received the SAME bill from my doctor, saying Aetna again refused to cover the bill. This time, their reasoning was that my exam is not covered under my plan. I find this comical because I CALLED TO RECEIVE ORAL CONSENT TO SEE MY DOCTOR. THE INSURANCE REP TOLD ME IT WAS COVERED. And now all of a sudden it is not. With numerous phone calls between Aetna and my doctor, it has been determined that Aetna just does not want to pay. The rep I spoke with first said the visit wasn't covered, but then 15 minutes later she said it was indeed covered, but she didn't know what to do. I demanded to quit my plan and get my refund check, but she said I had to cancel my plan within 31 days of signing up. That too is hilarious because another representative told me my plan was not activated for the first 30 days.. so essentially, after those 30 initiative days, I had ONE day to decide if I liked my health insurance coverage or not. I could not use my plan for the first 30 days, so how in the world was I suppose to know if I wanted to be under their "umbrella" of insurance if I wasn't allowed to use it?? To me, it's a complete scam running rampant through colleges and universities.

I asked Aetna what they covered and they said accidents and sicknesses. Well, I have car insurance-- they cover accidents. And sicknesses.. well, if I'm sick, I can't get prescriptions to be healed because they don't cover prescriptions, so really, WHAT THE HECK AM I PAYING FOR??

Someone help me. I don't know what to do. And I know I'm not the only one out there who feels this way.

My son came down with a fever of 102.5, we took him into our doctor and they were shocked that it had raised to 105.2, He was coughing and had all the signs of H1N1, so they advised us to take the nose swab test. The results came back positive a few day later. Our family of five came through this ok but knowing made all the diffence. Aetna had been sending us waring about swine flu and the value of early detection yada yada. When they refused to pay for the swab test the identified H1N1 I was floored. 320 dollars. Some partner they are in the fight against the flu.

Insurance company denied my surgery request that was scheduled for yesterday. Letter states that lumbar spinal fusion is experimental and investigational for degenerative disc disease. And something about the MRI not showing what the CT scan shows.

I do have a pretty back brace (in Ice age Blue) for post surgery that they paid for that is sitting on my dining room table as a center piece.

Supposedly there is a pier to pier appointment set however i cannot seem to get the specifics on when

i feel i am being pushed out tell next year as my co-pay and out of pocket have been met for this year.

Doc office states they have other claims for lumbar spinal fusions approved by Aetna for other patients

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.

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.

At that time, our intention was to relocate to the Middle East by December or January, depending on how things went with my husbands 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 Aetnas incompetence, my husband was unable to pass his physical because his sugar was elevated. He was shipped home without work after several weeks.

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.

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.

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!

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???

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.

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.

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.

Someone, please show us the way.

It has been a nightmare to deal with them, I had employer group insurance and tried to obtain a CT scan to diagnose symptoms of a stroke with numbness and tingling and severe headache and they denied the test and all subsequent MRI's that were ordered, I have no prior treatment and no pre-existing conditions and they kept stating that since a headache was present along with the other symptoms that the MRI's and CT scans were not necessary.....after a four month fight I got the CT scans approved but it took me using an outside advocate group and even then the turned back around and denied some of the MRI' that were completed after they authorized. I also had short term disability with them and they turned me down to receive short term disability pay even though I had paid for this coverage and and fully entitled to short term payment while out of work being treated for what turned out to be a herniated disc in my neck. These people are crooks and buyer beware......I have no prior medical conditions and no pre-existing conditions and they have denied basically every test and claim that has come their way. And this was group insurance that my company paid over $1000 per month toward my premium....as far as I am concerned they should be closed down and their executives prosecuted.....putting honest hardworking people through this kind of hell is unethical, illegal and BAD BAD business!!!!!!

Called collections department.
"We don't show where those charges came from. We'll have to investigate. I'll call over to the pharmacy and call you back in 15 minutes."
6 hours later, I was still waiting.
Called three times in 2 and a half hours. Every time I got, "he's on break."
Damn. Where can you work that you can take a two and a half hour break? Oh, my health insurance company that charges me an arm and a leg and then isn't available to take my calls.

Finally got a hold of guy I talked to in collections department.
Told me, "I sent an email over there. I never got a response." (What about the CALL you said you were making??)
Than had the nerve to say, "I'm doing all I can on my end maam." (ARE YOU KIDDING ME?)
Then had even more nerve to tell me, "It's five o'clock out here. I really doubt I'll be able to get a hold of anyone over there." (I'm competitive, bet me!)
Hung up.

Called over to mail order pharmacy company.
"Yeah, I called collections like you told me too, and they can't figure out where the $125 charges are coming from. He said he sent an email over six hours ago and doubted he could get a hold of you this time of day. But yet you're still here. Maybe you can help me?"
Associate laughs, mumbles something about collections than looks up my account and tells me there were three seperate prescriptions that were sent but never charged for.
"How can that be? You charge my account right when you send the order. You know, like that $90 you charged me for my husband's insulin and prescriptions but won't send out because there are past prescriptions from a year to almost two years ago that you claim I didn't pay for? Why wasn't I told this earlier?"

Check out the associate's answer, it's classic!

"So Ms. Associate, what you're telling me is, some of these unpaid prescription's are from over close to two years ago--way past the time I'll be able to track those on my personal account, and you charge me for my current prescription but fail to send it out because I owe you money from a year to two years ago that you tell me about NOW? How many prescriptions have I placed since October of 2008? Why didn't an associate EVER say, "Hey, you owe us $55. We didn't charge for it, but it's due. I would've HAPPILY have paid it. But no one EVER did. You've sent out 3 different prescriptions that you never charged me for but charge for all of the rest of them. And then you send me to collections so it's on my husband's credit on something we didn't know about!

This is yet another classic example of great customer service. Now you're withholding vital medication that my husband has to have and that we've paid for because you forgot to tell me about past charges I've had for over a YEAR?!? You've continued to send out orders to me for the PAST YEAR and never notified me I've had charges that weren't taken care of when I've called and placed orders? I'm sorry you're suffering, but I'm suffering too. I've just paid you almost $100 to NOT get my medications. Now you tell me I HAVE to pay you before I'll get my medications. You give me no time at all to pay you, but yet you take all the time you want sending me out medications my husband has to have in order to survive? We leave in a week. I don't have time. The least you could do is help me out a little so we can get these prescriptions to us before we leave."

Post Note: Today: Tried again to see if we could work out an arrangement to pay at a later date. Told associate that the charges for my order that was never sent were still on my account. Associate said it was a "temporary charge" until the order was completed than it would be processed. What the ??? does that mean? Managers I've talked to are unwilling to agree to allow me to pay the $125 next Friday and send the order because it was over a year old. Talked to manager about why I've been allowed to place so many orders without them ever telling me I owed money and the associate said, "because we updated our system." I asked the associate if it was done Monday night, and she said, "awhile ago." So shouldn't I be allowed to make an arrangment and still have the order I've paid for and is pending sent???

I would like to file a complaint against Aetna Insurance, (LTD), for failure to act in an appropriate manner regarding my current application for long-term benefits.

I have been out of work since February 12, 2009 with an injury, and paid for LTD insurance while I was at work.

I filed for LTD in the middle of July 2009, and as of the above date, Aetna has still yet to make one payment to me. I am entitled to this insurance since I paid for it, but Aetna has failed to make good on it. They continue to make excuses.

They have incessantly stated that they must investigate to make sure my injury was not a pre-existing one, which they should have found out by now that it wasn't, and when you call to find out, my caseworker Jennifer does not return calls.

After reading many stories on the Internet about Aetna, I am finding that many other people have had the same experience, whereas Aetna has come up with excuse after excuse for not paying the injured party.

This should not be allowed to go on like this. People are entitled to insurance they take out in just such an emergency. Aetna is collecting people's money but not giving the insurance that was paid for.

I have supplied everything they asked for, in a very timely manner, yet they have come up with excuse after excuse.

I am planning on writing letters to every committee person I can, every Internet portal, news agency, chat site, newspaper letting them know how Aetna treats its customers.

I am entitled to being paid and Aetna refuses to do such, but collected my money for the last few years.

I am a retiree of AT&T Communications on Medicare. After thorough investigation and research on my part, I was told by an Aetna Health Insurance representative that I would not get a much needed shingles vaccine because I was on Medicare. Aetna administers the AT&T health plan(s) services to AT&T employees/retirees. Aetna informed me that they would cover only employees/retirees NOT on Medicare. Medicare Part B does NOT cover shingles vaccinations. One must have Medicare Part D to get the vaccine.

I do not have Part D because I have private secondary insurance and prescription coverage from AT&T. I asked for a one time exception by Aetna/AT&T in order to get the vaccine, but they refused. I will pay out of pocket over $200. for the vaccine which requires special packaging for refrigeration.

In addition, I will have to pay my Primary Doctor fee (over $100. dollars,) to administer the vaccine. The risks involved in not getting this vaccine is too high. Furthermore, the cost for the vaccine would be far less than to treat the virus once it has been contacted. I am in my 60's and need this preventive measure in order to avoid this very painful virus.

very rude kept saying a refund check was in the mail for 3 months. called back said they never recieved fax of claim. had names and id # of people i spoke to. every time i spoke to a new person they would say all the other people you talked to were incorrect.

Because I will be 55 in September, Aetna sent me a notice that they are raising my monthly premium more than 25%. I have never been hospitalized, nor had a major illness, don't smoke, my weight is fine, etc. The cost is prohibitive and seems exploitive. Is there anything I can do?

Around June 21st I received a statement from Aetna stating that I was being refunded $508.00. SURPRISE! I called Aetna and was told it was for my June 2009 and May 2009 premiums - since I had canceled in early May 2009. I though this was odd, but was assured that it was because they had already withdrew funds for May 2009 and June 2009 from my checking account (prior to my cancellation). I accepted their explanation and my refund.

On July 23rd, I received another statement of account from Aetna. The statement lists a bill for $150 for services performed by my Dr. E on 2/28/09. Please note that the services were done while I was an Aetna member in February 2009. The bill was denied by Aetna because they claimed I was not a member with benefits at the time. THIS IS RIDICULOUS! After further review, I discovered that this same bill was initially denied by Aetna for the same reason in March 2009. Again, I was a member (premium already paid and on record) when this service/visit occurred in February 2009.

To add further insult, instead of CANCELING my policy as I requested by phone and email (see below) it appears that some incompetent employee VOIDED me and all record of my insurance out of their system. According to Aetna, this means that the bill they should have covered (for February 2009) to my Dr. for $150.00 is being rejected. This fraudulent and negligent act initiated the $508.00 refund (that I did not expect) and the refusal of the claims for services performed in February 2009. THIS IS FRAUD and it is illegal. You can not pretend that I was never a member and you can not deny coverage when I had paid the premiums for the month and the month that followed. Isn't that fraud. suppose I had had surgery during that time. the bills would be more than $30,000.00. I would loose everything.

After two days and no less that 6 phone calls, I finally spoke with someone that understood the problem. Cheryl handled my call very professionally. She took my information and worked very quickly to assess the situation - no small feat considering I was one step away from contacted someone at the Chicago Tribune. She then connected me to Kristine. Kristine also handled the situation very well. Let me be clear - I do not blame either of these ladies for the ridiculous and incompetent way this fiasco has been handled. Having said that, when Kristine suggested the Aetna way to fix this problem that Aetna had created I laughed out loud. She was told to suggest the following: In order to get this $150.00 claim paid I would need to #1 give the $508.00 back to Aetna (they believe it's a refund for February 2009 and March 2009 premiums), #2 pay $254.00 for April 2009 premium and $254.00 for May 2009 premiums. To recap - aetna wants me to pay $508.00 (that they refunded me in error) PLUS $508.00 for the two months that they were supposed to withdraw from my account in April 2009 and May 2009. All of this to cover $150.00 that was supposed to be paid nearly 5 months ago. SERIOUSLY?!?

I think Aetna owes my Dr. $150.00 for her claim in February 2009 + any interest that she is owed for carrying this delinquent bill on her records for nearly 5 months. Furthermore Aetna owes me for the stress, mental anguish and the 4 hours of time spent on the phone on 2/23/09 and 2/24/09.

Aetna refused to cover out of network costs specifically for the hospital. They only covered the doctor. Since Aetna was found negligent in not covering out of network costs in another matter, do I have any recourse in forcing them to cover the costs instead of my having to pay additional cost to the hospital?

I feel there should be checks and balances in place to catch obvious mistakes such as these. I was told it was up to ME to make sure the prescription is correct prior to mailing it. Considering I am mainly concerned with getting it in the mail so that my son doesn't miss a dose of medication, I don't feel it's fair to place 100% of the burden on me to make sure my doctor wrote the prescription correctly.

The sad thing is, there is an easy fix to this obvious mistake. I simply have my doctor fax a correction to the pharmacy and I get my missing 60 days of medication. However, the pharmacy refuses to give me any retribution whatsoever. They know a mistake was made, but are thumbing their nose at me. Their explanation is pathetic. After all, I AM the customer everywhere you look in this situation - to the doctor and to the pharmacy.

I contacted Aetna's Behavioral Helath Department in December 2008 for a referral to a counselor for stress related issues. I started seeing the counselor soon after but had to stop because paying a co-pay for going three times a week was too costly. I called Aetna to see if there were any other programs that I could attend. I specifically told the representative that I could not afford co-pays. She recommended a 6 week program at a nearby hospital. She told me that I would have to attend everyday from 8am-4pm and that everything would be covered 100%. I started the program that next week and was there for 32 days.

To my suprise, after the program ended I received a bill from the hospital for $640. I promptly called in to Aetna to ascertain the problem. The rep told that I was charged the staandard co-pay for everyday I attended the program. I informed her that I was told that I would not have a co-pay. She rudely told me that it wasn't her problem. I then asked to speak to a supervisor. The rep infored that there was no reason to speak to a supervisor because they would tell me the same thing that she just told me. I told her that I didn't care what she thought the supervisor would say amd that I would still like to speak to the supervisor. She asked me to hold and then hung up on me. I called a second time and asked to speak to a supervisor. I was told that she was busy and that if I left a voicemail my call would be returned. I left a voicemail and of course I never received a call. I tried again a couple weeks later and was told that the manager was in a meeting but that she would return my call shortly if I left a message. I left a message and still no return call yet.

This is very frustrating. No one has the time to constantly call and try to rectify someone else's mistakes. What is the point of them having a job if I have to do it for them? This is not the first issue I have had with Aetna. They are the worst insurnace ever.

Incompetence at all levels. Random cancellation and reinstatement of policy. Failure to pay claims in timely manner, resulting in dunning notices to patient. Employees answer phone but keep no record of the call. Repeated requests for prescription refills from Aetna Pharmacy are ignored, lost,... I hate these people. I wish they would all drop dead. The CEO does not deserve one dime, and the employees are so incompetent that they should all be fired. A bunch of outright liars.

I have an Aetna Select health insurance policy through Cobra. This Spring my primary care physician dropped out of the Aetna network. Aetna did not advise me, or any other insured members who used him as a primary care physician. When I learned, quite by accident that I no longer had a primary care physician, I called a physician in the network and asked that he be my primary care physician. I needed a physical exam at the time. He, of course, wanted to meet me before agreeing to be my physicial. I met with him. He agreed to be my physician and offered to do a routine a physical at that time.

Rather than making an appointment to come back, when I was already there, I got the physical and he submitted the paperwork, showing himself as my primary care physician. I have since received a new insurance card listing him as my "pcp". However, since he was not shown on Aetna's records as my "pcp" at the time of th physical, they won't pay for it. I will pay the doctor for the physical but will argue with Aetna until I run out of breath! This is typical behavior or a greedy for profit company.

Aetna is relying on a technicality to deny coverage for a normally covered routine physical condicted by an approved doctor in the Aetna system simply to save money. I can afford to pay the doctor. But, how many other small claims are denied by this company for no good reason other than to make more money? My claim is small, under $200.00, but when they deny a few thousand small claims because of technicalities, they make a lot of money and many who submit those claims suffer because they can not afford to pay for the services themselves.

I am sending this on behalf of my mother.

i had just gotten out of hospital for congestive heart failure, and had made a payment of $94.00 on a balance of $198.00.

after several months, it dawned on me that i had not been being billed for the last 4 months. upon calling atnea the said that i had been canceled for not paying full amount. i than faxed them a brief letter explaining what had happened, i haven't heard anything from them. i am 82 years old and am living on ssi.

Beware. Even though my policy stated that the colonoscopy screening was covered Aetna did not pay. If you have a diagnosis of diverticulitis the testing is billed as diagnostic and the insurance will not cover the screening. This information was not included in my explanation of benefits provided to me by Aetna

This common condition is being used against uninformed patients like me to rip us off. I had no signs of colon cancer and was advised to eat lots of fruits and veggies which I do already. A very expensive piece of advise!

apply...."

My out of pocket expenses up to now are $1021.98 that is just to the hospital. The added stress of making phone calls and trying to understand why insurance wouldn't pay. Distraught breaks and lunches spent on the phone. Getting no where.

hello i went to get a loan the other day and found out that i was not aproved for the loan when i asked why they told me that i have one outstanding bill for the some of $1371 from back in 2006 after some work on my part i found out what it was i went to the doctors for a cold one night on 11/02/05 everything was fine at that point in time and then i lost my job a few weeks later.

then i just found out that after i lost my job aenta went back and said i no longer had coverage at the time of the doctors vist but my pay stubs and the aenta documents that shows that i still was paying for aenta for almost a full month after i went to vist the doctor they covered it at first they covered the bill and then a few months later took it all back and stuck me with the bill i can get any answers for aenta on why they did this or what to do about it other then they told me to just pay the $1371 because that would be the easest thing for me to do they cant tell me why i was never told about the bill not being covered and why they never sent me a end of coverage summary preety much if you get aenta your paying for nothing i have no clue what to do about this they wont even talk to me they say they cant talk to me for some reason when asked why they cant even answer that one thing for me if anybody can help me please let me know thank you for your time

I had previously consulted other physicians about my condition. One surgeon advised I would undergo an eight hour surgery that would involve an anterior/posterior approach WITH a thoracotomy. I would be hospitalized for about one week and unable to return to work for about three months. Another physician suggested I live with the curve, even though it was progressing. I also had many, many appointments with a physical therapist.

Once my primary insurance gave the authorization for my surgery, it was scheduled for October 30, 2008. I had a surgery that lasted 4 hours, I was in the hospital for 4 nights. I was up on post op day one and off narcotics by the end of post op day two. I was dischared with no narcotics and returned to work, full time about 4 to 5 weeks later!!! My surgeon, Dr. Lloyd H was and is a million times more qualified than any of Aetna's peferred providers. I am now 6 months post up. My spine is straight and I grew one and a half inches taller! How is that for outstanding results!!!

I have filed two Grievance Letters with Aetna. The first appeal was denied because Aetna felt I should have seen a lesser qualified doctor within their system. The second appeal was denied again, for the same reason. I did provide supporting documentation to show Dr. H is the best surgeon around. I requested to know the name of the physicians who reviewed my case and which state he or she is licensed in. No matter who I spoke with at Aetna, no one could give me the name of any physicans who reviewed my case.

After both denials, I contacted the USDOL, EBSA. I did not and still do not feel Aetna really looked at any of my appeals throughly or the supporting documents. I requested the name of the physicans reviewing my case, for the third time.

I, once again, have sent another letter to Aetna's Customer Resolution Team and requested my case be reopend and to have a doctor who has knowledge of spinal deformities and correction review my case. I do expect my referral request to be honored and made retroactive. I only want Aetna to pay their small portion of my medical bills related to my surgery. My primary insurance paid a huge amount and I was left with about $5500.00. My primary insurance has already paid a huge amount and Aetna would have only picked up, in comparrison, a very small amount.

For me, it's the principle of Aetna not choosing to do the right thing for the patient, instead, Aetna decided to do the right thing for itself.

At this point, my surgery was scheduled and I was ready to move forward. I had a condition known as kyphosis with a nearly 90 degree thoraic curve and a nearly 70 degree lordosis. I had lost over an inch in height and suffered from daily low back pain which was interferfing with my quality of life. Basically, my spine looked just like a question mark.

My mother was placed in an Assisted Living facility for medical reasons in January 2007. We contacted Aetna prior to her placement and were assured she was 100% covered. We have submitted numerous claims and they have all been denied for various reasons. All proper documentation has been submitted. My mother passed away in February 2008. >p> After many attempts to receive reimbursement of her out-of-pocket expenses, Aetna still has not paid. We have now been informed that only the medical portion is covered, not the room and board (which was what we verified would be covered in the first place). My mother/her estate are out approximately $60,000.

aetna wouldn't give authorization for my husband to have a nuclear stress test in April eventhough he had a history of heart disease, triple by-pass, heart attack in previous years. They could find no reason for the test so instead he had regular testing.

My husband died Feb 23, 2009 at the age of 62 of a heart attack and they found two 100 % blockages plus another blockage.

Claim was submitted for emergency room visit on 11/22/07; It was initially submitted under wrong ID # and denied. We called Aetna in January of 2008, got the correct ID # and had the hosital, Wayne Memorial Hospital, resubmit. The claim has still not been paid, despite numerous calls to Aetna over the course of the past 17 months. Each time they tell us it has been re-submitted for payment, but will not confirm, and to date is still unpaid. We have even conferenced in the hospital billing department with Aetna to assist in resolving it.

We are still receiving a bill from Wayne Memorial Hospital in the amount of $3708.40.

January 21, 2009 I went off work for short term disability. My doctor put me on restriction and my job do on accommondate restriciton of any kind. Aetna should be going after my company not me. Aetna has made me re-certify my clam four times before April 7, 2009. Each time I re-cert , I have to pay for forms and my benefits stop. Aetna have not sent checks on a consistance basis. At one time Aetna was almost 3 weeks behind on my payments and they had to overnight me a check. Aetna did catch my payments up but I had to call them and ask about a check from one of the reinstatement period and they simply said they had forgot to process the payment.

I had to get money wired to me. I am behind on all of my bills because I never know when I am going to get a check. I only get 66% of my weekly wages and I have to keep paying for forms and faxes because Aetna have my doctor filing out paper work after paper work.

I retired in 1995 with 28 years of continous service. I chose retiree medical coverage for myself and my beneficiary(spouse). In 1995 the cost was $117.60 per month. Aetna Life Insurance Company is the medical insurance provider. From 1995 to 2003 my monthly medical insurance cost increased to $236,20 per month a monthly increase of $118.60 - $1,423.20 per year increase. From 2003 to 2007 my monthly medical insurance cost increased to 426.67 a monthly increase of $190.47 - $2,285.64 per year increase. From 2007 to 2009 my monthly medical insurance increaed to $589.67 a monthly increase of $163.00 per month -$1956.00 per year increase.

In 2008 I spoke with The Celanese Americas Human Resource Director a member of The Celanese Americas Retiremnt Board. I was told that their cost for medical insurance have gone up and they now pass it on to the retiree. I was also told that Celanese Americas may no longer provide retiree medical insurance in the future. I stated that I had a contract with Hoechst Celanese upon my retirement that provided a medical insurance benefit. It is my understanding that the Retirement Plan can be amended but retroactively for retired employees. Each year I receive a Celanese Americas Retirement Pension Plan Summary Annual Report. In 2007 the Pension Plan increased $41,129,283 in net assets. Over the years the plan has incresed net assets yearly. It doesn't appear the Retirment Pension Plan is in any danger of becoming illiguid or justifying the substantial annual increases for retireee medical benefits. I would appreciate your imput regarding my experience with this problem.

Because of the escallation of medical cost per month which now averages approximatley $80.00 per month my retirement will disapear in about 10 years. I am 71 years of age and have serious health problems and unable to work to off set the increases in my retiree medical insurance cost. This has caused a serious drop in my standard of living. Celanese Americas has an impatient attitude about questions regarding how cost increases are decided and the conection with Aetna Life Insurance Company in justiying cost increases. In a recent agreement, announced by New York Attorney General Andrew Cuomo, Aetna to pay $5 million plus interest and penalties for consumer reimbursement claims. I have relevant documents

I became disabilied and had to stop working as a Teacher in Dec. 2006. I applied for disability through my work insurance (Aetna) as well as Social Security Ins. I was approved through Aetna for my life insurance Policy to be paid for but denied for disability income from Aetna. I obtained a lawyer spending thousands of dollars which was a hardship and still was denied. I was then told I would have to civil sue Aetna insurance company. That is unrealistic to happen when one is disabilied with not enough income to live on.

I have since been approved for social security disability in March of 2009. How ever the amount allowed me is not enough to live on. I know this is a growing issue with insurance companys wrongly denying people there disablity money. I have paid into this insurance for many many years and this is what I get in return when I have a terminal debilitating disease. I dont understand how one sector of the same company approves me disabled and another can deny me. I ask what dose one do in this situation to gain a fair decision being I am legaly declaird disabled. I am single and need the Aetna Insurance disability to be able to afford to take care of my medical and living costs. Please help me with this serious issue. I rather have my health then to be going through this.

The consequences here are that I am unable to affored my medical and daily needs and my elderly parents are finding it very diffucult to help me financialy. I am also having higher symptom due to the stress of this unjust decision by Aetna Ins.

In June of 2006, my wife Pamela was diagnosed with frozen shoulder. Pamela received physical therapy treatment from Dr. Malcolm G in Daytona Beach, FL. Pamela was in Dr. G's office when the phone call to Aetna Healthcare was made to confirm insurance coverage. Aetna Healthcare confirmed coverage and her physical therapy started soon after. Aetna Healthcare paid their part and I paid my part, which was $464.11.

Dr. G is now billing me for $3,339.09. Dr. G said he is not in a NAP Contract with Aetna Healthcare. However, Aetna said he is in their network and is in a NAP Contract with them. I have a letter from Aetna Healthcare dated 6-17-08 stating that he is under NAP Contract. I hand delivered this letter to his office. My insurance card said NAP in large print on it and Dr. G's office copied it at the time of service. I have made over thirty phone calls, sent a certified letter, and still cannot get Dr. G and Aetna Healthcare to solve this problem. Dr. G's office said if I do not pay now, he is turning the bill of $3,339.09 over to a collection agency. I am disabled and have been on a fixed income for over ten years. I have done everything that I can do. This problem is between Dr. G and Aetna Healthcare!

BEWARE of a little known clause included ONLY in Aetna's health insurance policies known as protection stop.

As a very small business owner, I am under contract for a 12/mo. period and am billed monthly from the 15th of each month to the 14th of the subsequent month.

Since one of my employees will be leaving on the 31st. of this month, and will be covered by her new employers' ins. as of April 1, I contacted Aetna and asked to remove this person from our policy as of the 31st of March.

OUTCOME: I am still responsible for payment for the full 30 day period ending the 14th of April even though this person will (1) Be no longer working for me and (2) Will be covered by another health insurance company.

Needless to say, after numerous calls to various departments, supervisors and managers at Aetna, (although very curteous and understanding of my situation) there is really NOTHING they can do.

Therefore, Aetna will be receiving from me aprox $350.00 (1/2 mo. premium)for services which they will not render, and which I do not want nor need.

I have contacted the NJ Dept of Ins. and unfortunately it is all perfectly legal, however, they have informed that Aetna is the ONLY company with this provision in their policy.

I have been with Aetna for almost 25 years, but will not be with them much longer.

Once again, buyer beware!

I had to go to the hospital emergency room at 1:15AM because of extreme and excruciating pain in my lower back and right leg. The doctor assigned to me decided that I would need surgery to my lower spine. Fearful of such surgery, I decided to seek a second opinion from a chiropractor. The chiropractor verified that I had chiroproactor insurance coverage from my primary insurer, Cigna, and also from my secondary insurer, Aetna. She also assured me that she could cure me of the pain problems that I was having. Cigna covered 14 visits to the chiropractor without the slightest problem. Aetna, on the other hand, has been a nightmare to deal with.

My secondary insurance plan clearly states that I am covered for a total of 20 visits to a chiropractor within the plan year. That apparently wasn't enough for them. They covered the first four visits without incident. The next three, they refused to cover of the basis that I did not have a medical reason to see a chiropractor. But then, they covered the next seven without incident. I attempted to get them to cover the three visits left open but they refused.

Out of the blue, I received notice that they reversed themselves on the first four claims that they had previously approved and wanted their money back or else they would turn me over to a collection agency. My response to that was to file a class 1 appeal. The appeal was rejected, (surprise, surprise) and the basis of the rejection wasn't that I didn't have a medical reason to go to a chiropractor but rather that the chiropractor engaged in activities which Aetna claimed were inappropriate. Now, all fourteen claims were rejected and they will soon want all of their money back I'm sure. There is something wrong with this company. I don't know if they invested heavily in AIG type investments and are hurting financially but their conduct is anything but rational. I am in the process of submitting a level 2 appeal which I expect will also be rejected. I must do this by April 21st.

I have been forced to waste considerable time and effort in an attempt to ask this company to do what the medical plan states that they should be doing. They have a moral, ethical, and legal obligation to abide by the precepts of this medical plan sponsored by the BP Corporation and they have apparently chosen to do otherwise for some unknown reason.

The expense of counseling and psychiatric visits are very high and my husband was just forced to take a cut in pay. I can barely afford the meds that I take let alone pay out of pocket for med checks and lab tests! I don't know how these people sleep at night. And there just does not seem to be any way to get theses companies to foot the bill for this condition and if you want to fight them the work and cost involved is unreal. I feel trapped but oh well. Just wanted to vent.

This may cost me my mental health and if it does the blood is on their hands.

I applied for Short Term Disability help through my company's STD program with Aetna. I learned today that from R. Staple, my claim was denied because she claimed the clinical evidence did not support my claim although my doctors outlined the incident, the limitations that I suffer, and the treatments that I needed to under go before returning to work. I can no lponger afford medical treatments for this injury. At work I was returning to my desk when a fellow employee ran into me and twisted my lower back on the left side. I had previousley undrgone surgery to remove a portion of my disc at the L5-S1 level 8 years prior.

The MRI showed that a tear and bulge has manifested on the left side as a result of the employees very hard, intentional hit. I suffer from very high levels of pain becuse of the previous injury but this latest injury has mad e the pain double. Sometimes the painkillers don't even work. My Worker's Compensation claim was denied by our carrier, although the employee admitted to hitting me. I ended up filing with our Companies STD program to avoid a long litigation period and time off work and further physical deterioration and need for extensive treatment for this incident. I have lost the ability to sit for long periods as required.

I have decided that the only recourse is to hire an attorney and sue all involved, including the employee that injured me. It is also possible that I may ahve to file an assult charge against him jsut to recover some of my costs. I had previousley read the complaints about Aetna STD and hoped that they weren't true. However, the excuse for denying my claim was mirrored exactly as I read them. Aetna STD and LTD disability are the biggest rip-off scams of our time. I am begiining to wonder if they are even run by reputable people, if you get my drift. I can't help but think that my company may have been possibly involved in this decision as we are a self insured company and utilize Aetna to administer bout our STD program and our Health Insurance.

It is companies like Aetna (STD) and Gallagher Bassett(our Work Comp carrier) and their adjusters who drive the Personal Injury industry in the US. If it weren't for these denials of legitamite claims the hard working people of this nation would not need to hire attorneys. If Barack Obama cares so much about the working people of the US, lets see him attack this problem. It is causing hard working people to lose everything they ahve worked for and stripping them of their dignity.

The economic damage to me and my family is outrageous. I am in the process of losing my Health Insurance, which is the only way I have been able to get any type of treatment, my SUV will be repossessed soon, it is currently not running as I can't afford a fuel pump to get it running. I have been forced to eat and live with relatives, often only eating every other day, as I can no longer afford my own place or to feed myself. I can't sit for long periods and will be forced to ask my doctor to return me to work on a regimen of strong painkillers to just make it through the day and try to save what I ahve worked for and a little dignity. The only way to fix this injury is to have a spinal fusion which I am trying to avoid if at all possible.

I contacted the customer service dept. of Aetna, but to no avail. I used to have Blue Cross, but my company switched to Aetna. I went to pick up my prescriptions yesterday and Aetna is charging me a $40.00 co-pay for one (Vivelle) which is outrageous. My doctor wrote this up and didn't specify that a generic would be appropriate. The other medicine, Phentemine, which I was taking thru Blue Cross and of which Aetna was aware of up front, Aetna is refusing to cover at all.

This is my first dealing with Aetna since my company switched. I talked to a Joanna, Customer Service Rep, who spoke to Joe, another Customer Service Rep, and they again said all I could do was file an appeal, which I did over the phone with Joanna. Joanna said it would take 7-10 days to hear back and if Aetna denied my appeal, they said I could file another one. I told them this was ridiculous. I am not waiting to file another appeal. It is not fair that a patient should be forced to pay such a high co-pay and in addition, to have to pay full price for another medicine which was always covered.

Aetna is a nightmare to deal with. They want to play doctor and they are not physicians. They have no right to dictate to me what medication I should take and then refuse to cover a medication when I and my company are paying such high premiums. I have reported Aetna to my HR Dept. I plan to also report them to the Better Business Bureau. I want Aetna to resolve this to my satisfaction and that is not what they are doing. They don't have any problem with collecting the premiums, but they seem to have a big problem in paying out on prescriptions. I am very concerned and if these problems continue, I will make sure these concerns are addressed in Washington also.

I have dealt with Aetna in the past and they have been a nightmare. I had a folder two inches thick full of complaints the last time. Now, I have to deal with them again because my company switched insurance carriers. The first time I go to get a prescription, they want me to pay a high co-pay and on the other, they would not cover at all, even though Blue Cross covered it prior to this. The damage is I cannot get my medication because of these people. I am sure this is only the beginning of things they refuse to pay for even though they have no problem collecting over $569- per month. What is going on? There should be a class action suit against this company. If an attorney gets one initiated, I definitely would get involved. Enough is Enough!

I am a graduate student at Boston University. Last year, I paid over $20000 out of pocket for expenses not covered by Aetna Student Health. It was impossible to get accurate claims information. Reimbursement for out-of -network expenses was not received, except for two small reimbursements out of more than twenty visits claimed. I am a widow with a daughter in college and two children at home. Aetna regularly refused claims saying that we had other insurance when we didn't. Then, when I was eligible for MassHealth, they refused to cancel my policy, so the state computer indicated that we had other insurance and didn't need state benefits! It was the consummate Catch-22. I understand that New York filed a suit against Aetna, and I hope Massachusetts will take legal action as well.

I used most of my retirement fund for health needs which should have been covered, in addition to the $25 co-pay which is excessive for three people. Now, I am unemployed and could use the $27000 I spent on health expenses last year. I could live for six months on that money. As it is, I may have to sell my home.

I used the service for the first time in order to fill an Rx for Topamax-seizure medication. I called a few times as I was nervous that it would not be filled correctly/on time. I checked online last night, to check the status of my order & I noticed that I had been charged 70.00 for a 1 month supply of medication. It costs only 35.00 to fill it at the local pharmacy.

Whe I called to inquire about the charge, iwas told that the Rx was for 1 month with 5 refills, instead of 3 months. I mentioned that I had called numerous times throughout the week and it was never mentioned to me. I intended to pay 70.00 total. They advertise as follows:35.00 for the irst month and 35.00 for the second months supply and you get the third month free when filling it by mail. I knew it sounded too good o be true!

I am without medication and I have been charged twice!

I have Aetna Insurance through my medicare plan in June 2006 and in May 2007 due to a clerical error on Aetna's part I was removed from there data base. I went without insurance coverage for more then a year and now Aetna is trying to bill me for late fees. When receiving information from Aetna via mail I have tried to call Aetna and now I am faced with there requirement of giving out my full date of birth and social security number over the phone. Being a victim of identity theft I have learned the hard way not to give this information out over the phone to anyone. I am being told that this is the law and that if I do not provide this information they will not assist me with any questions or concerns regarding my account. Can you tell me where to find this law or tell me how to change insurance providers since I am currently locked into Aetna for the remainder of this year?

Dealing with Aetna has added undue stress in my life and hours of lost time spent on the phone only to be passed to supervisors and managers that state they can not assist me without my full date of birth and social securtiy number being provided. When I ask to see where this is written in the law no one provides this information. I now have to go either along with Aetna's outragious request of my PERSONAL INFORMATION or I go without having insurance coverage.

in aug 2008 I was approved for permanent disability! i have a letter from aenta stateing this. I also was approved for social security disability payments 12-05. My nuero surgean stated that I cannot work and my condition is permanent. aetna keeps wanting my dr. to prove to them over and over that I am permanently disabled. they keep threatening to cancel my insurance if their needs are not met. They keep switching my contact person as an excuse so they can continually put pressure on me.

they have put eronious statements in my file that were not true,I just had to correct this with my new contact person J. Robbins! they also want part of the legal settlement that I have pennding! why? social security doesn't ! I don't understand why they cannot accept my specialists diagnosis that my affliction as permanent, What don't they get?

aetna life and disability has cost me not fax fees but psychological distress and anxiety. I am so embarressed to keep asking my doctor to fill out yet another form that states my disability is permanent. this ongoing problem with aetna and the fear of losing my disability and the physical pain I must go through just is not in my best interest.

refusal to pay for health benefits and refusal to follow-up on an appeal even after I have repeatedly called. Did not mail me a statement of benefits or an insurance card until 8 months into insurance period. Have other co-workers having similar issues with Aetna and will gather together an file lawsuit if claims are not paid.

have payed over $1500 in the past year. Owe another $1700. Amount of money owed presents a hardship.

In August 2006 I moved from PA to RI. I called Aetna to inform them that my primary care physician had changed. They have denied my free wellness exam $150.00, because Dr. Potter had not authorized it. They claim that I never called to change my PCP. I have appealed and they still deny that they did anything wrong and will not pay for the yearly wellness exam. Unfortunately, my company doesn't offer any other insurance, so I am stuck with a company that doesn't pay for what they advertise.

My 4 yr old son had an incident on 01/11/09 where we found him unconscious in his room in the middle of the night. He wasn't breathing right, had a bloody nose and did not regain consciousness for 30-45 mins. The ER doc said he needs to see a pediatric neurologist asap and thinks he had a seizure. Well there isn't one within our area that is in network (designated by aetna as within 30 miles of our home), so they told us we could choose one, which his pediatrician did, and they would get them precert as in-network.

They just told us yesterday, right before the appointment, that they will not give us precert because there is another provider in our area. The provider they are listing is over 100 miles and 2 1/2 hours away! When we called member services, they confirmed that is not what they consider in our area. The people with precert can't seem to explain why it was denied and told us they would let us know on our appeal, and we still haven't heard back on that. So now here we wait, yet more, not knowing if something serious may be wrong with our son, or when/if they will approve for him to go to someone local. They don't have any excuse for us when we quote them the plan as stated and won't give us answers.

We have had to cancel his appointment that he has had for 3 weeks now, and wait hoping they will approve the local provider soon, and that it won't be another 3 weeks before they can see us. I don't want to go to the provider and use out-of-network benefits, but I'm getting desparate for my son to see someone. I even tried to see if aetna would approve an adult neurologist (that is in-network and area), only to find out that none of them will see children under 18 yrs of age. We are very upset right now, fearing he will have another incident like before. He was completely lifeless, it was the most terrifying night of our lives, and we still don't have any answers.

Since my wife was paid weekly, SRC originally would automatically deduct premium payments from her checks. Upon the birth of our first child, my wife stopped work temporarily, so we were required to continue making insurance payments weekly by phone. Since she's still technically on the payroll, but not salaried, we are not in a COBRA program. However, with the addition of our child, as well as the turn of the new year, the customer service employees could never figure out how much to charge our checking account.

Payments were automatically credited back to us for being either too large or too small. We then were listed as having not paid and therefor were not covered within their computer system. Suddenly our bills were coming due directly to us, and well as prescriptions being full price. Thus far I haven't been able to get a manager to call me back to ensure the bills are re-submitted. The company won't do it automatically, though it was their fault, so now I'm forced to take my time to keep calling, not to mention making back payments to get caught up.

In a related issue, they denied coverage for all charges for the birth of my son while my wife was in the delivery room at the hospital. The plan covers a certain amount for in-patient stays, but they didn't consider it in-patient until after my son was born and she was moved to the recovery room for the next two days. We now owe the hospital roughly an extra $3000.00 that should have been covered.

$3000.00 plus dollars for delivery room, ? as yet to be seen for crediting back payments in wrong amounts.

My husband found out he had a hiatal hernia in June 2007 our PCP decided in Oct. 2008 that he should see a surgeon to have it repaired. Our PCP got a referral for the PCP he saw the surgeon who wanted to do some test prior to surgery the tests were done 12/19/2008. It turns out the tests were done by a different specialist. I always look on Aetna's website at my claims since they fight paying anything that isn't a visit to our PCP it was 01/02/2009 I noticed they denied paying because we didn't have a referral we called the doctors office their insurance person told us they called and were told no preauthorization was necessary so I called Aetna on the same day I talked to Liz told her the specialist we had a referral to ordered these test she said oh since the specialist ordered the test I'll note that and resubmit.

On 01/23/09 I noticed on Aetna's website they were still denying payment for no referral so I called Aetna again at which time I talked to Nichole she told me no I had to have a referral and the 21 days has passed so I will have to appeal the claim. Nichole let me know it's up to me to know what my insurance covers and no one else.

If Aetna's on employees don't know the coverage how can I be expected to know it.

I have not be able to sleep and have had stomach cramps because of the stress.

I've had problems with my shoulder for the past year. Originally it was because of nerve damage. The only treatment was physical therapy and after 2 months, Aetna said I had run out of benefits. I had to pay the next 7 months of therapy out of my pocket. After that period it was determined I needed surgery. My doctor assured me that Atena would cover my physical therapy as it was part of the overall recovery process. Guess what? Aetna declined the therapy coverage.

Calls to Aetna were useless. All I heard is that I had reached my maximum benefit limit and that was it. How can they approve a surgery and then not cover any rehab?

They claimed that they did not file my request for a primary care physician that I then visited until after my visit, and so my visit was therefore a doctor visit without a referral. Therefore, it was counted as out-of-network and I was charged more than expected. Since I had no proof on the contrary, there was nothing I could do.

Unjustly charged $175

My 23 year old daughter, covered under my Aetna group POS choice plan, has a sever jaw deformity with an ever growing open bite. She suffers from Severe head and jaw pain, inability to eat..now losing weight and other serious conditions resulting from this condition. The reconstructive surgery for her jaw was approved by Aetna (an in-network oral-maxillary surgeon). The surgeon will NOT perform the surgery without the services of an orthodontist to get the teeth lined up correctly and expand her very narrow palate. The orthodontic intervention before, during and after surgery meets the standard of care for orthognathic reconstructive surgery and is mandatory.

Round and round claim submissions, denials, and the denial from an appeal (the person who performs the appeal is an employee of Aetna) have left me with a staggering $4500.00 bill. Verbal approvals for service were given to our broker, which Aetna denies making. We are allowed one more appeal, but the appeal will be handled by an Aetna employee. The Aetna policy manual on orthognathic surgery and braces is vague and contridicts itself, but clearly addresses the pre-surgical orthodontics for Managed choice plans with approved surgeries.

In responding to an inquiry, made by the state Insurance Commissioners office on my behalf, Aetna's response contained several errors. e.g. The letter states that I am covered by an HMO. I am covered by a high deductible Point of Service Choice Contract. The orthodontics need to be covered under Medical benefits, as the surgery approval was for medical benefits. I would like Aetna to provide in-network coverage for the orthodontics and get the bills, which I am already paying, PAID.

1. My daughter, a full time college student, is suffering emotionally from the worry that we will have to pay for the braces. My husband has a cardiac condition (pacemaker placement is scheduled for 01-15-2009) and his only employment is a part-time position at our church. Mary's bite is worsening and she is having trouble eating. 2. We are being pressured by the orthodontist to pay his bill, and after having the initial appeal denied, are paying his bill in installments. Our budget is stretched already and the added pressure from one large unexpected bill is extreme. 3. We went ahead and had the braces put on because we were led to believe that they would be covered. We went to an in-network dentist to preclude any out-of-network denials. But Aetna has found other bases for their denials, all of which seem in error.

I filled out one of Aetna's application for health insurance and in the end, they wanted my credit card #. This is similar to the application I filled out with Independence Blue Cross (IBX) Health Insurance. However IBX made a note that nothing will be charged until I have approved the final rate of the premium.

Unfortunately Aetna Health Insurance, 2 days after submitting the application, I was charged $122.00 on my credit card without notifying me by phone, mail, or e-mail until I found out myself from my online credit card account.

Attempting to contact Aetna was unsuccessful and thus very irresponsible for their actions. All of the customer support numbers resulted in being hung up. The fact that Aetna claims to not work on weekends make want to call my credit card company to dispute the authorized charges.

My mother was having severe back pain. Dr's diagnosis was osteoarthritis and gave her painkillers. They did not work she kept feeling worse. She got x rays and a cat scan revealed a herniated disc. More pain killers. They stil did not work right, then she bagan to not be able to walk at all, had constipation and numbing in her flanks. Doctors wanted an MRI done, Aetna denied it the pre auth. They stated their board of doctors did not deem it nessasary.

Her doctors appealed, Aetna denied authorization again. This went on for a bout two months. Finally one day my mother could not move at all. We rushed her to the hospital finally after 6 times Aetna approved the MRI. My mother had a herniated disc so swollen it cut her spinal cord. She is now in a nurisng home because she is paralysed from the waist down due to the delay in finding problem.

ALL DOCTORS ASKED SAID IF SHE HAD GOTTEN MRI SOONER SHE COULD OF HAD A PROCEDURE AND SHE WOULS HAVE BEEN OK. Aetna destroyed her life.

My mother went from an active happy person to a depressed woman living in a home she is not that old 74. she was 71 when all this occurred. I would cry on the phone with these heartless people from Aetna and they could nor care less.

In October 2008 Aetna forced me to switch to an HMO (I have for several years been a member of Aetna but I paid high premiums in order NOT to be in an HMO). But since they told me I had to be in an HMO I accepted their decree. Ever since then, I have had nothing but trouble: over-charging of monthly premiums, over-charging of prescription fees, when I call to try to things resolved no one is competent enough to help me over the phone at Member Services (I speak with many, many different customer service people and none of them have the same answer to any questions).

So now I am owed over a hundred dollars for the over-charging of prescriptions. I think someone finally got the the monthly premium charges straightened out but we'll see next month when the bill comes. I just never, ever seem to be able to go to the doctor or the drug store without some kind of hassle from Aetna. I spend at least 4 to 5 hours a week on the phone with Aetna and things never get resolved. I am starting to feel like something is fishy at Aetna. If I didn't keep a very good eye on all of the bills I get Aetna would be receiving hndreds of dollars from me that I don't owe them. What should I do? I cannot get things straightened out by myself.

I have been faxing my information receipts to AETNA for years in order to get my reimbersement of funds spent on Medical needs. Recently, they have become more and more annoying with their refusual to pay due to stupid things. It is not my fault my receipts from doctors are not as clear as they want them to be or do not have the specific information on them. The bottom line is I spent the money on medical needs and should be reimbursed thru the FSA that I contribute weekly to.

I have requested a call from a supervisor in order to get issues straightened out but they have not called. I am currently fight over two claims. One for $65.00 which includes on prescription @ $20, 2 prescriptions at $10.00, One payment to my dentist for $10.00 and one Copay to my family doctor of $15.00. All of these claims are definately within the guidelines and should not have been questioned. Only the $20.00 prescription has been approved for reimbursement. The second claim was for $14.49 for OTC medications including scalpicin, Vicks vapo Rub, and Cortizone cream.

What is so hard to approve in this list? I have two parents who suffered strokes this year, I work full time, and I go to school full time. I do not have idle time to spend trying to clarify the obvious. What can be done to eliminate such time consuming delays?

I visited my local in-network family doctor after vomiting blood the night before. After giving me a brief exam he said I needed to go to the emergency room. I drove myself to the hospital, walked myself in to the emergency room, and was processed immediately. A 15 minute procedure to put me asleep, stick a tube down my throat, and wake me back up cost $4,500. AETNA refused to pay ANY OF IT. They said my coverage only covered emergencies. I (and my doctor) told them I was sent to the emergency room, and AETNA responded with the same.

Apparently, because I wasn't dead or nearly dead and rushed in an ambulance, my procedure wasn't an emergency. Now I'm stuck with the bill. I cancelled my coverage but several of my coworkers also have ridiculous complaints about this sorry company. I see the numerous complaints on your website and figure it certainly can't hurt to add one more.

$4,500 was finally submitted to a collection agency because I (as well as AETNA) refused to pay while we argued.

I called Aetna the first week in November, to cancel my Dental plan (not medical) so I could switch to my wife's, since we go to the same dentist. The current plan I had did not cover anything with that dentist. I was told it was cancelled on Nov 17th, but I still have not received a 'loss of coverage' letter (STILL no idea why that's needed). Until I get it, I can't switch to my wife's insurance and therefore, can't go to the dentist (I need to have a tooth fixed from previous work they did). I was told the letter should have arrived last week, but did not.

At the risk of spending another hour on the phone (5 total, so far), what else can I do to put a fire under these [reps]? I don't understand why it takes this long for a letter to be mailed (or faxed, which I also provided to them). No one I spoke to could confirm the letter being sent out.

I have some work that NEEDS to be done soon on a previous root canal--a new crown and some infection that needs to be cleaned up. Until I have new insurance, I can't have it done. It needed to be done a month ago--I have so far canceled several appointments. The pain is increasing, but I can't afford to pay the costs myself and risk getting no coverage at all. What is going on with sending a letter?

I don't understand how Aetna is allowed to operate the way they do. In 2006, I had a problem with Aetna paying a bill that they clearly owed. It took two years, and the involvement of the state's insurance board to finally get them to pay. However, it took a lot of stress and grief on my part to stay with it. MY ADVICE: Put every request to them in writing. I called Atena repeatedly over those two years, and everytime, I was told that it was their error and they would fix it. They never did until they were forced to pay. It's now Nov. of 2008, and I was just denied the cost of a visit to an Express Care facility, even though I had an immediate medical need. This time around, I am sending my compliant to the Bureau of Insurance immediately and I will put all complaints in writing until they pay the bill. Why are they allowed to continue these practices?!

In January 2008, when my husbands employer switched medical plans from United Health Care to Aetna, I called Aetna to ensure that the medical group I was seeing Pediatrix-Obstetrix Medical Group was covered in my insurance plan since I was pregnant with triplets and was considered as a High-Risk pregnancy and had to be seen by a Doctor specializing in dealing with multiple pregnancy. I was informed by one of [their] representative that they surely were In-Network and that I could continue going to them.

It was only in March that I started seeing bills pouring in from Obstetrix and on approaching their billing department I was told that Aetna only paid them 70% of the billed amount since they were outside network. I called Aetna right away to inquire what was happening and they then told me about the medical group being an outside network for them. Had we know that Aetna was that unreliable, I would have noted Customer Rep names, contact information and may be recorded the whole conversation. I dont understand why I was given false information to begin with.

I as a member of Aetna Medical group did my part by calling in and verifying the information but was still given incorrect information. I explained my situation to the representative and they asked me to have Obstetrix resubmit all the bills and was told that Aetna would take care of it and I could look for another Doctor within network. To avoid any further complication I went ahead and changed my Doctor even though I was almost 7 months far along in my pregnancy. It was very stressful for me to go ahead and have the doctor changed at the last minute but there was no way I could afford all the bills. Pediatrix forwarded the outstanding bills over to the collections agency.

As such with triplets, We are under a huge financial burden. My husband had to take a loan against his 401k and pay the disputed amount (approx $4500) so that his credit history is not messed up because of Aetnas fault. I would really appreciate if you would Please look into this matter at the earliest and take necessary action in resolving this issue at the earliest.

During my high risk triplet pregnancy, I was running around switching around hospitals, had to pay $5000 from my own pocket because of mis-information provided by Aetna.

My husbands company just switched their health insurance coverage to Aetna. We have had only used our coverage twice in the last year and both times Aetna refused to pay.

The first time my husband had a fever and it was a Sunday. There were no doctors offices open. He went to the immediate care in Plainfield. He was treated. We received a bill for the entire amount. I called Aetna to ask why we were responsible for all of the charges and they said it was a coding issue of the immediate care facility. I contacted the immediate care facility and they said that everyother insurance company accepts their coding and said they couldn't change it. I called Aetna back and they refused to pay the claim because of coding.

The second experience was that my two year old son had a 105 degree fever while we were on vacation. It was also a Sunday and we got in the car looking for the nearest hospital. It turned out my son had an ear infection. After about a month we got a bill in the mail from the hospital but we assumed that the insurance hadn't posted payment yet. 11/18/08 we got another bill and an explanation of benefits from Aetna. They wanted us to pay the entire $777.00 and they would not cover anything.

In the general remarks it stated Aetna covers emergency treatment when the member has a medical condition that causes sudden symptoms that are severe enough that a person with an average knowledge of health and medicine could reasonalby expect that not receiving immediate medical attention would put his or her health at serious risk. After review of the clinical documentation submitted, a Medical Director has determined that the emergency room services received do not meet these criteria. I immediately called Aetna customer service and they said I could appeal.

I don't know one person that would ignore a 105 degree fever in a toddler. I have also read numerous other reports on this sight and it seems pretty apparent that Aetna does not want to pay their claims.

There is obvious stress involved. Also we had already paid upwards of $200 for the first claim that went unpaid and now we face paying another $777 out of pocket. What is our health insurance for? It also could impact our credit score.

I went to a network doctor for a plantar's wart removal. That's it, simple. I used a network doctor even though I have a PPO, so I could save money. The doctor said they checked and I was covered for the operation. The doctor did the operation in his same office.

I was fine after the operation - until I got the bill 3 months later. It seems the doctor was in the network, but not the hospital i was sent to for the operation. What hospital? I was in the same office at the same address. I have explained this to Aetna, but to no avail. They keep saying I went to an outside facility.

Also, I have a PPO so I don't have to be pre-approved to have the work done. Aetna says the charges are not reasonable yet they haven't even tried to work with the doctor's office or explain what reasonable is. They just say they won't pay because the hospital was not in the network. Again, what HOSPITAL? if they have a problem they should check with thier network doctor!

Somehow, even though I pay my premium on time every month, Aetna feels it is my reasponsibilty to pay the WHOLE bill - they won't even pay the 60% they owe. I am now in 2nd appeal but I already know what the response will be. I've asked them to speak to the doctor but they just keep telling me I have to appeal - no help at all is forthcoming from them.

I have two children insured by Aetna, both fall in the same age catergory as far as premiums are concerned, yet one was billed $167 a month and the other $176. I assumed this had to be an error as the numbers were simply reversed and we had the plan for the older child at $167 for a few years now. When I called to inquire about the error and request the premiums be corrected, I was told that one child lived in zip code 85242 and the other lived in zip code 85243.

I politely noted to the operator that they both have the same address and live in the same house... the policy was opened under 85242 for the older child, however when the younger one was born, our town became larger and divided in to two zipcodes.

She said 85243 is more expensive than 85242... our home never moved, our town just got bigger, yet they want to charge me $9 more because a digit changed in the zip code. She politely thanked me for the call and let me know that I now owe them $9 more per month... that's what I get for calling the error to their attention.

How is it legal for them to declare a zip code more expensive when our home didn't move?

I left ups on a short term disability. They wanted information from my doctor, he was on vacation, when they did not receive medical information fast enough, they denied my insurance. Why does the patient have to suffer. I sent an appeal and so did my doctor, explaining the seriousness of my health. The appeals department says it takes up to 45 days to act on an appeal. I have no medication for my illness because they dropped my coverage. I will have serious seizures when my medication runs out on october 25. My doctor claims he did call Aetna for a form to fill out and he never r3eceived a call back. Then they cut me off.

My depression has worsened and so has my panic disorder. I am running out og food because they won't insure my pay from Ups. As I said, I have four medications waiting at the drug store Aetna wont pay for. One is Lamictal. If I don't get that medication by Saturday, I will have serious seizues. I called and explained this, I was told I have to wait for a decision on my appeal. My doctor says I may have to enter the hospital for my own protection, since I have no medication.

I was charged for student health insurance, because of a clerical problem and AETNA refuses to refund my money and cancel my insurance, which i don't need because I am insured by EMPIRE BLUE CROSS

$615.00 plus late feels from my school, Pratt Institute.

My 16yr old daughter was injured in a sport at school. She is unable to stand very long, bend, sit, lift, can only turn her head to one side and has sharp pains shooting down her legs. An x-ray at the emergency room indicated that nothing was broken, but that she had scoliosis and spina bifida, in addition to a sprained neck. She is on very strong pain meds and muscle relaxers, and still cries herself to sleep in pain every night. This is unusual because she has a very high threshold for pain and never cries! Now she is also experiencing problems in her arms and her spine is swelling.

Her doctor ordered an MRI of her spine and much to our surprise, Aetna denied authorization. Her doctor called them personally and they are allowing an MRI of the bottom of her spine ONLY, due to the discovery of the spina bifida. The doctor has already filed appeals. What about the rest of her spine and neck? If there is damage to ANY part of her spine it could affect the rest of her life! Do they not even care about children? Why do we even pay for insurance?

Does everyone know what the top aetna execs got paid last year while their customers were struggliing to get adequate healthcare and pay the denied bills? We will be changing insurance companies in January and if there is permanent damage to my daughter's spine....aetna will be in court. I don't know what has happened, as I used to think that they were a good company. I warn everyone I know now to STAY AWAY FROM AETNA!

A simple flu shot at my local pharmacy turned into a 4 hr marathon one day and 2 hours the next. I had an easily-solved problem, but Aetna's service department was so uninformed, they couldn't help me or my pharamacist. I haven't really used my plan, so can't say it's a bad one, but their customer service is simply so awful that I wouldn't recommend Aetna to anyone.

Basically, what I found was that the lowly service people MUST protect their supervisors to the point where the customer spends hours talking to various people, none of whom you can call back, none of whom can help. When I demanded a supervisor, threatened to report Aetna to my employer, Insurance commissioner, Florida State elderly rights and my local TV station, I finally got a person who gave me the simple following answer. The drug store had no way to bill Aetna on line for my flu shot under my medical coverage & it wasn't covered by my Rx because it wasn't a prescription. I went somewhere else for my shot. No biggie except for Aetna's customer service ineptness.

Two trips to my pharmacy after Aetna promised to unblock my name. Six hours on the phone. Their bad information led me down this frustrating path. I just want to warn others about how Aetna will treat you once they've got you as a customer.

My husband had begun suffering from a severe and unusual headache that would come on suddenly, lasted for hours and was so severe and unsual that whenever it occured, he would literally have to grab the side of his head on which the head is and go down in pain. At first we were scared and not sure what was happening or going to happen.After several attacks of this kind we decided to go to the emergency room. We didn't want to take the chance, thinking it could be a stroke, or some other serious problem. The ER diagnosed him, with a pinched nerve in his head after several hours of testing.

However, in his medical records, it was mistakingly recorded as a Headacheby the ER doctor of South Lake Hospital (Clermont Fl). has tried to re-code the visit and resubmit it back to Aetna but they ignored that and billed us an invoice for $984.00 This ER visit was 10/29/2007.

To date, I have been trying patiently with customer service reps and supervisors from Aetna for help, explaing every detail - from the severity cause for the ER's visit to the doctor mistake of putting the wrong code but they all refused. They have stated that - we choose to go to the ER for a headache and that will not be covered! Sure, I totally understand that concept - but this was not done with intent as they are stating, and it is very obvious that they prefer their patients assume and put their lives in danger, by staying home even when the systoms seemed so dangerious, instead of being sure and safe.

i cant get my son seen by any doctor for his adhd because aetna wont cancel his plan. i have insurance of my own for him and doctors wont see him now cause he is covered by 3 insurance plans now.

my son cant get the help he needs and its interfearing with school and his daily life

2/27/08 Went to ER late night with severe strep throat. Was already diagnosed but antibiotics were not working. Instead of getting better my throat was completely white (no longer jsut spotted) and more alarming, I was having difficulty breathing as the swelling was causing my throat/airway passages to close. Once seen at the ER they immediately gave me a steroid shot and something else to help open my air passages. They suggested admitting me... I declined since I had 2 young children at home. They switched my antibiotic to a more potent one. I went home and 1 week later it finally resolved.

I am the primary card member and had coverage on this date. My ER visit should have been $75. Instead I have a bill for almost $1500 because according to Aetna I did not meet the criteria for an emergency visit I've appealed their decision and have not heard back. It angers me that my throat was closing and I was having great difficulty getting air... yet they do not see this as an emergency. I wish I had agreed to being admitted... this is absolutly ridiculous!

One more thing... I had several throat cultures for myself and family in relation to this illness. We went directly to the lab where we had throat swabs taken. WE DID NOT SEE ANY DOCTORS, yet Aetna charged each of us office visit copays since the building that houses the lab also contains medical offices, so they use a code saying it's an office visit though it obviously isn't. Aetna is the worst company for covering any type of claim. I feel terrible for all those people that are not capable (old, impaired, unable to speak english, etc.)of jumping through all hoops that Aetna uses to avoid paying legitimate claims.

I updated and renewed all of my insurance information on time, however, when I went to the pharmacy over a week later to pick up a prescription, I was told I was not covered. When I called Aetna, I was told that they are very busy, and that it takes time to process the renewal. I would have to wait until they could process it to pick up my prescription or pay out of pocket and attempt to be reimbursed later on.

Considering the amount of money I pay for comprehensive insurance for my family, this is unacceptable. I paid, on time, and stopped receiving benefits because they are too busy to process my information in a timely manner! I was told that since I called, they would attempt to expedite the processing of my information, and would let me know within 48 hours if it was successful. I wonder how long it would have had no benefits that I paid for had I not called.

My health insurance was terminated as of June 30, 2008 because my payment for July was received on August 4, 2008 exceeding the 30 day grace period. My issue is that I was never made aware that my health insurance had been terminated. I scheduled a non-urgent doctor appointment in August that could have waited. I was made aware a few days after my appointment that I had no health insurance and was billed for over $300.

After calling Aetna on August 19th and asking what the problem was they said I had been terminated and not covered since June 30th. I asked and demanded to know why I was not told and why a termination letter was not mailed out. I also inquired as to where my check was since it was the middle of August and I had not yet received a refund. They said that an invoice was created on August 14th. On August 20th I received the termination letter and refund check, almost a month after the 30 day grace period.

I have no health insurance coverage and I am stuck paying a bill of almost $400 for an office visit that was not urgent or necessary this month.

I just want to give some advice to people dealing with Aetna: 1.) Always ask to speak to a supervisor. Have you claim dates/amounts with you. Also, have a copy of their coverage info on hand. 2.) Tell them you are going to call them every day or week until the bill is resolved (even if you are not). 3.) If there is a liason at your work or school for the insurance company, be very persistent with them. 4.) Let them know you filed a complaint with consumer affairs. Tell them you are going to speak to a journalist at your local newspaper about them (and actually maybe try to do it)--I got payment after offering this. 5.) Check with your state laws. If they are being violated by the attorney general, you may be able to file a grievance with your state. 6.) Put in an official request for your health insurance records.

America's life expectancy rate is lower than most other developed nations...our pitiful lack of adequate health insurance coverage. Health care is a human right.

refuse to have upper mgr. contact me after many attempts email phone, we are nowhere. i cannot understand why the fsa people, rx home del., healthcare cannot work together, it has been 6 weeks + they cannot get my rx order right, ineed my meds MY LIFE DEPENDS ON IT.

My credit cards are maxed out . i am a diabetic, prone to siezures etc.no meds = hospital=lawyers

after being told i had to use mail order to get my meds,no longer able to use local drug store due to some policy, they have been unable to get my order correct, they sent me a 30 day supply of meds, said it was a 90 day supply will not refill because they say i have 90 supply allready , no mgr. will return calls, i went a week last month without meds, cannot happen again

i am a brittle diabetic i test my glucose 10+a day,inject insulin 5-7 times aday, i suffer from hypoglycemic unawareness,high blood pressure,etc....i am prone to seizures and loss of consciousness, not to mention the economic impact of over charges, billing mistakes etc,

Aetna/Chickering Group student insurance is deplorable. I am convinced that their rule of thumb is to either pretend they never received a bill or reject paying a medical bill and hope you won't argue them. Every single medical claim filed with them has at first been rejected by them, and then re-processed several times over several months. First, I was diagnosed with growths in my uterus via ultrasound after having pelvic pain. I had surgery to have them removed and biopsied to rule out cancer (which it luckily wasn't).

Despite the fact that the diagnosis was performed on-site and I have no medical history of polyps or fibroids, I was informed for months that it was a pre-existing condition and so not eligible for coverage. I had my doctor forward his tesimony to assert origin of diagnosis twice (and still was told by Aetna that it wasn't received). I had to argue with them on a weekly basis for months. It is worth noting that every time I called them, I got a different story about how they came to the determination that it was a preexisting condition. Finally, after threatening to write an article for the newspaper and testify at my University review of them, they paid. It took them 6 months to cover this surgery.

But then they didn't pay my anesthesis, also claiming it was due to a pre-existing condition! How can you cover the surgery, but not the anesthesia? Again, many weeks of arguing. It's exhausting.

Since then I have had notable other problems with them. I have a medical issue that makes my daily life difficult. My doctor wants me to get a durable medical advice that is expensive but would offer me relief. It would allow me to work on atrophied muscles every night to make them competent again. They put the prescription through for a predetermination. Months later, I still didn't have an answer either way from my insurance. I called multiple times and each time was told they were processing/reviewing the claim. Then, finally I was told a letter rejecting my claim came out weeks ago and was mailed to me. I never received it. They said they were going to mail it out again, and again, it was not received.

Each time I inquired over the phone as to the reason of my rejection, I got a different answer. Currently, they are refusing to pay my acupuncture bills, even though their coverage very clearly states that they will pay 80% of an acupuncture visit for a confirmed medical disorder with a doctor's referral up to $300 PER MEDICAL ISSUE (granted the acupuncturist is in network). Now, I did max out treatment for one medical issue, but then started receiving treatment for another. When I called to clarify this, they said the billing codes suggested the two disorders were similar (note: my two disorders were endometriosis-a gynecological disorder-and tendonitis). However, I gave them the benefit of the doubt and my acupuncturist resubmitted these bills after making sure the billing code matched my diagnosis (I think a number was off). That was over two month's ago and they still have not paid.

Every time I call to follow-up, they at first say they never received those resubmitted bills. After arguing they always, miraculously, find them. Then they tell me they will reprocess them and will get back to me in a few days or a week. They have told me that 4-5 times in the past two months. They never get back to me and when I call, it is always like I never even put that request in in the first place. And, as usual, I keep getting different explanations for why this is. One insinuation I received from representatives is that they want to make sure these health issues exist. My referrals are in the database by the doctors of these two very different conditions! It is astounding!

I have to put off acupuncture treatments until the situation is resolved (until they cover me). Acupuncture offered me serious relief from health issues that at times severely impair my day-to-day function. Furthermore, the medical device was denied to me, and I have to again live with a health issue that affects my daily life and makes it hard to perform my duties as a graduate student and research assistant. I got a B+ on a class I should have gotten an A on but was suffering these disorders due to lack of the proper treatment my doctors deemed necessary for my health. Finally, I have spent massive amounts of time on the phone in an attempt to resolve these matters and get the coverage I am clearly due.

I had a Surgical procedure-Thromboendarterctomy,on 11/24/2004 which was approved by Aetna, and a year later they claim that I wasn't covered. Now if I wasn't approved there is no way I would have had the operation and of couse I would be died today, and now I'am being sued for the second time by bill collectors.The first sute was paid by Aetna, now allstate is suing me and I can't afford an attorney. Idon't know what to do I live on a fixed income.

Dr. then on my first visit after surgery, he told me that I was his first mistake that he cut the nerve to my tongue and, that I WOULD NEVER TALK THE SAME AGAIN and I would have to go to a speech pharmacist to learn to talk all over again, I was devastated , and I trusted cause he said that he had done over houndred of these surgical procedures, how dare him do this to me.

I had used Aetna home prescription delivery for previous medicine. Apparently the doctor knew to write the prescription for a 90 day supply that time. For a second set of medicines a few years later, he only wrote the prescription for a 30 day supply. I had no idea Aetna required a 90 day prescription, so they sent me a 30 day supply at the 90 day cost.

If you look on their website to find copay amounts, it says a 30 day retail supply is $35 and a aetna mail order supply for 90 days is $105. But if you only get the 30 day supply from them you are still charged $105. Well, apparently you get fried for using Aenta prescription home delivery for anything. It's totally not worth it. Just go to your local favorite pharmacy and have your prescription filled. Aetna home prescription does not save you money, in fact it might cost you considerably to use them. My advice: STAY AWAY! from Aetna Home Prescription Delivery.

I've lost over $250 due to the inflexiblity of Aetna Home Prescription Delivery.

I had a 20th week ultrasound performed to check for abnormalities in my baby (I had this same thing done on my first baby). After having this ultrasound, my doctor determined that the baby's nuchal fold thickness was on the higher end. She referred me to a specialist and I had another ultrasound done by the specialist. Aetna rejected both of the claims stating that it was experimental and investigational.

When I had called aetna initially when I found out that I was pregnant, they told me that ultrasounds were covered at 90% for my plan and that there were no limits on the ultrasound as long as it was medically necessary. I did not perform these ultrasound for any other reason other than medical reasons. I'm being given the run around by aetna and my doctors office, both of them are blaming each other and i'm left in the middle.

I had to pay my doctor $500 for the ultrasound she did, and I'm sure a bill is being sent to me by the specialist for $572.

Aetna's new way not to pay the claims is to apply copays to everything. When contacted, Aetna reps say there is no changes to the policies, however there is a clear difference in claims processing. The same identical policies with the same identical in network procedures now have copays applied as a way of lowering Aetna's portion of the bill. While it might seem a small issue, all copays do end up into nice sum of money Aetna does not pay.

Patients portion of the bill is considerably higher.

I was asked to see a patient employed by Starbucks Coffee in Exton, PA by his mother who lives in the UK. The patient had been suffering for 5 years with recurrent, chronic gastritis. As an employee of Starbucks, the patient enjoyed health insurance supplied by Aetna. His Aetna aproved PCP had referred the patient for endoscopy. three years later, the endoscopy needed to be repeated. Unfortunately, Aetna had refused to pay the bill so the patient suffered for a further two years unable to access proper health care because Aetna had not paid the bill. His mother, in desperation, asked me to see her son in the UK and Starbucks, very kindly, agreed to let the patient have sick leave in order to visit the UK.

I telephoned both the Aetna aproved PCP and the Aetna representative at Starbucks, Mr. Franada. Mr. Franada agreed that Aetna was wrong in not paying the bill for the Main Line Endoscopy Centre as the patient had been referred by an Aetna aproved PCP. (The doctors name appeared on the pathology report as the referring physician!)Mr. Franada also agreed that the patient would be covered for treatmant in the UK, (less his co-pay). Needless to say Aetna have not paid the Main Line Endoscopy Center invoice as promised and are only paying $164.10 of a $1201.94 invoice for the treatment the patient received in the UK.

Aetna's treatment of the patient is a complete abrogation of their duty of care. The patient suffered for two years because Aetna refused to settle a bill at the endoscopy center. Indeed, had they settled this bill in the first instance they would have saved themselves the cost of multiple ER admisions, doctors' office visits and would have saved the patient two years needles suffering and risk to his health. Furthermore, the patient's visit to the UK and my involvement would not have been necassary.

The patient suffered from a chronic infection of the gastric mucosa with an organism called Heliobacter Pylori. This is a simpe condition to treat but, because the patient was unable to undergo further endoscopy, (because the invoice for the first visit was unpaid), the patient suffered for a further two years and, eventually, had to visit the UK to access proper health care. The bill for the Endoscopy Center remains unpaid and, should the patient suffer a relapse or reinfection, he will again be left without access to proper medical care. H. pylori infection is a major risk factor for peptic ulcer disease.

Research has indicated that infection with H. pylori increases the risk of gastric cancer, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and possibly pancreatic cancer. These risks were increased by Aetna's unacceptable treatment of this young man. Of far less importance, my invoice for $1201.94 remains unpaid! I can stand the loss, the patient is a young man of limited means and with inadequate health cover.

My PCP recommended that I undergo a colonoscopy for screening purposes. I contacted AETNA and was assured that the procedure was fully covered. the physician also told me that it was his understanding that it was covered and that it was, in fact, illegal in the State of Maryland for him to charge other than what AETNA paid. The procedure was performed on February 6, 2008. AETNA paid nothing.

Now, I am being billed over $700.00 for the procedure. AETNA denies having ever spoken with me. Plus, each time I call I get different answers. The physician denies any knowledge and says that there must have been some sort of a misunderstanding.

Bad feelings. I am in the process of filing an appeal.

paying for health insurance from a ghost. I have called, asked my management in KBR, went on line and still I have had dead end street after dead end street. I have paid for coverage for 6 months and I still can't get any information from the company about my benifits or how I can prove to a health care official wether or not I have health coverage. I went on line and filled out the registration form several times and each time it sends me to another link wich tells me the resource I am trying to reach does not exist.

Theft from my payroll deduction money's for longer than 6 months and also I was told I have no choice but to purchase the insurance or not work for KBR.

I have for the last 2 years been recieving medical bills from various labs and hospitals for medical work done. I have contacted aetna over and over and over again and even spoken with various supervisors who always inform me THIS TIME the problem is resolved. I have now recieved several thousand in medical bill that now state we have tried several times to bill your insurance company and they have not responded so this is now your responsibility.

I have now been notified that by 6/24 they will be sending the matter over to a collection agency . At this point I dont know what else to do or where else to go. I cant get anyone to just pay the bills they were responsible for.

The stress of this ilone is enough but now I am beong threatened with collection agencies and I have already recieved one letter from a collection company. Why can anyone resolve this problem?

I tripped on uneven sidewalk over 2 years ago and injured my knee. There was pain and swelling and I was sent for an X-ray which was unclear. My doctor wanted an MRI. He also brained the fluid from the knee. I went to an orthopedist who drained the knee again.

The request for an MRI was denied for the first time. The knee swelling was drained a third time and a second request for an MRI was rejected. The doctor requested a third time an MRI which was approved but for the wrong part of my leg and the nuclear medicine person could not do an MRI on my knee. My knee became infected and required weeks of antibiotics.

A second orthopedist was also of the opinion that an MRI was needed and submitted the proper request. Guess what! a 4th rejection from AETNA. I suspect the AETNA pays people in an office somewhere in the Carolinas to follow some rejection script that they don't understand and to reject requests based not on need, but on financial issues.

Don't know the damage since MRI would be needed to determine what is wrong. Emotionaly is wears away, and the pain continues. THANKS AETNA FOR YOUR COMFORT AND CONCERN

I have medical insurance with Aetna. When we first had the plan it was great and now they have not paid a claim from January 2008 and there are about 50 claims. I have 200 deductible per year. The plan that I am under is from Amtrak. I am a very ill man and need your help. When people check my medical coverage they report that we are well covered. The Doctors are threatening me with being turned over to a collection agency.

Dr's will not want to treat me with all of these bills going unpaid.

In my complaint with Consumer affairs dated 6/2/08, I would like to add the following written by my doctor yesterday: I evaluated your dental models again and in the transverse dimension, you have a 4 mm transverse deficiency in the maxilla. According to Aetnas Clinical Policy Bulletin on Orthognathic Surgery (dated 02/28/2006) you meet their criteria. On page 2, under C. Transverse discrepancies, 2. Total bilateral maxillary palatal cusp to mandibular fossa discrepancy of 4 mm or greater. You meet that criteria! Therefore, they must cover at least the maxillary surgery on that basis alone. In addition, you have a probable non-union in the maxilla on the left side that can be corrected at the same time. Obviously, both jaws need advancing to correct the airway concerns.

The complaint is my surgeries fell under Aetna's guidelines the entire time which was stated in the pre-certification and models sent to Aetna back in January. Aetna looked for every reason possible to deny the surgeries instead of looking at the facts that my case did fall in their guidelines. They have now put my health at risk with having to undergo another surgery along with financial hardship having to fund for another trip back to Texas for the surgery and more hospital fees that could have been avoided.

Meantime I have to suffer in pain while the joint surgery heals to undergo the jaw surgeries. I also have the risk that my joint surgery may fail due to the jaws not being corrected not to mention my restricted airway at 4mm is life threatening. This negligience on Aetna's part has put my health at risk and will cost further hardship both financially and for my family.

i went in for blood work on 8/10/07. i gave my ins info to the front desk lady. i have united commercial food workers union and aetna. 10 months later i get a bill for 62.20. aetna wont pay claims over a year old. i sent the information in the mail a second time about my insurance info. I keep getting these bills in the mail. it seems like busnesses dont bill ins til its too late.

I have been denied part of my surgery by Aetna Insurance. Dr. Larry in Dallas, Texas has diagnosed me with Bilateral TMJ arthritis and disc dislocation, Maxillary hypoplasia, Mandibular hypoplasia, pain, non union of jawbone, and decreased airway. Aetna approved the TMJ joint surgery which I had on 5/6/08 but still has denied me the remainder of my surgery which is Multiple maxillary osteotomies with bone plate stabilization and grafting, bilateral mandibular ramus osteotomies with bone screw stabilization.

I presently have a 5mm ROM and no lateral movement and a 4mm restricted airway which 11mm is considered normal. I have lost all jaw function and also suffer from non-union of jawbone that Dr. was going to correct with grafting. My upper palate is so narrow that it affects my speech because my tongue does not fit in my upper palate. My doctors feel my misaligned jaw is causing my joint problems and function problems and if not corrected my condition will not get any better. I am unable to eat because of my 5mm ROM.

At this time Aetna has just denied my second appeal using cosmetic reasons as the reason for denial and feels braces can correct my problem. I am in my third set of braces and each time have had a major relapse when the braces are removed. I had a Lefort surgery and Arthroscopic surgery which both have failed.

Dr. W is well known for taking on complicated cases as mine and has high hopes that he can correct my medical problems and improve my quality of life. He stated to Aetna that my 4mm airway is life threatening. I have also provided Aetna letters from five other doctors stating my surgeries are medically necessary. I contacted over 20 doctors in the DC area last year and all informed me that my case was too complex for them to handle and referred me to Dr. Larry W. Last week my local doctors updated Aetna that my 5mm ROM and no lateral movement has not shown any improvement. Despite all of this Aetna continues to deny my surgeries. I spoke to Virginia Insurance Commission and he informed me that under Virginia State Laws my surgery is required to be covered, but my insurance plan is self insured so he stated he could not help out.

This has put a finanacial strain and hardship on my family because I have endured over eight complication surgeries and now denied part of a surgery that is medically necessary to put these complication surgeries to an end. I have spent hundreds of hours on the phone with Aetna trying to get approval and now since they didn't approve my entire surgery when I get approval I will have to pay again a plane ticket back to Dallas, Texas, hotel accomodations for up to two weeks. I also will have to endure five more months of suffering in pain that could have been avoided if Aetna would have approved all procedures. I have been on continuous painkillers since December of last year and will have to continue on this medication since my jaws are not lined up properly causing major muscle spasms. At this point I feel Aetna should be prosecuted to the fullest for not approving me surgery despite the 50 or more pages of documentation that was sent in warranting why this surgery is medically necessary.

On Feburary 2nd, 2008, I missed work due to lower back problems and filed a short-term disability claim through Aetna, my disability insurance provider. I have had 2 lower back surgeries in the past, and suffer from chronic back pain resulting from degenerative disc disease. I saw my doctor and he requested a leave for several weeks to get my pain under control, and I was unable to return to work while I was taking the medication he prescribed me (Opana). At this time, I filed all of the necessary paperwork for my medical claim to receive my short-term disability benifits. The Doctor's office submitted office notes specifying my condition and stating why I would be off work for the time being.

I did not receive any contact from Aetna for several weeks, and when I did call in to check the status of my claim, my case manager, Judy Vasquez, was very unhelpful and rude. Several weeks later, I received a letter stating my claim had been denied due to lack of medical evidence that I should be off work. My doctor was outraged by this and said there was no reason for them to deny my claim. While I was still off work, I was injured by an accidental gunshot while removing a rifle from the gunrack of my pickup, and hospitalized for 6 days, from April 1st to April 7, 2008.

I was lifewatched by helicopter from Pretty Prairie, KS to St. Francis Trauma Center in Wichita, KS and spent the next 2 days in the trauma intensive care unit. I spent the next 4 days in the hospital with a chest tube in my lung, broken ribs, and slight liver damage. The gunshot had torn through my lung, torn my diaphram, grazed my liver, and shattered 3 of my ribs. We contacted Aetna to see what we needed to do to file another claim for this injury. It took MANY phone calls and almost 3 weeks before we got a straight answer from them regarding the status of my claims. They then informed us that all the time off would be filed under one claim, and that we would need to submit all new information for this injury and time off under the appeal for the first claim. We submitted over 50 pages of information. They requested all of the records from the hospital, including complete records, discharge summary, history and physical diagnostic testing results, progress reports, admission records, office notes, and restrictions.

After gathering all of this information from the hospital and trauma doctor, we submitted it to Aetna Insurance Company. I am still waiting to hear the status of my appeal. It has been almost 4 months since my origional claim, and over 7 weeks since my second injury and claim. They have not responded to phone calls and messages my wife has left repeatedly. When her or I do speak to my claim manager, she is extremely rude and unfriendly and seems to be bothered by our questions. When I saw my doctor again recently, he could not believe we hadn't received any benifits from Aetna Insurance Company yet. My doctor asked if we had involved an attorney yet and we are currnently unable financially to do so. Due to the lack of benifits and information, we have come under extreme finincial distress and are relying on donations and the goodwill of our church congregation and others to get by.

This has been an extremely stressful situation, physically, emotionally, and financially. We are doing everything we can to jump through the hoops that Aetna Insurance Company has asked us to do. I feel as though we are not receiving the attention we deserve to this matter. I also feel like Aetna is not taking our situation seriously. My doctor stated that Aetna is stalling, and that if they take long enough, we will just quit trying. That is not the case. We need every penny that is due to us from this time. Aetna is not providing the services that they should. They do not realize the gravity of the situation.

I get the feeling from Judy Vasquez, and others that I have talked to at Aetna that they don't feel like they should help us. They don't seem to act like this is a serious case that should be approved? I pay for this insurance to be covered for incidents like this, but they are NOT providing the services I have been paying for. I would like to see some sort of investigation to look into this case and see what the outcome is supposed to be. I am still off work at this time, due to the damage to my lung and to my ribs. It is unknown at this time when I will be well enough to return to full duty and work my normal 12 hour shifts. I am pleading for help from wherever we can get it. I need to know how to plan for the future and our continuing crisis.

Due to the circumstances caused by the inactivity of our insurance company, Aetna, we are in utter and complete financial distress. Since we have not received any payment since the beginning of February, we have fallen behind in everything. We have scraped by, buying only the necessary groceries, paying the minimum on our bills, and letting our credit cards and other debts fall delinquent. This could have all been avoided with prompt and accurate attention to our situation by Aetna. The emotional distress caused to myself and my wife has been extreme, and it is taking a toll on us mentally and emotionally. We can barely afford fuel money for my wife to go to work, providing the only income we have. I do not want their lack of attention to affect our economic future, but I'm afraid it has already.

I spoke with claims dept location at el paso, tx. I filed a claim from 8/2007. I received reimbursement for 8/6-11/30/07 and 1/1-1/31/2008. 12/1-12/31/07 was missing. my claim for the months mentioned was denied twice before and put in for a third approval after numerous calls. claims dept insisted that i was not approved for services received. After many e-mails and phone calls, they realized that services for the said months had been approved and they over looked that. each time my claim was denied , I had to wait 10-45 days between each time the claim was submitted (for 8/1-11/31/07 and 1/1-1/31/08). I received payment for that claim at the end of april 2008.

On 5/6/08 i sent in the missing month of Dec for reimbursement,by fax with a note attached that it was the missing month and please process. I was told Iwould be reimbursed 7-10 business. after those days passed I called member services and was told my claim denied. I asked why and once again they realized that the service was approved and I should get reimbursed. Aetna does not contact clients when claims have not been approved.

On 5/16 I resubmitted the claim by fax and cheked in 10 business days (5/27 and 5/28) and online the claim said in progress . on 5/29 today the claim was once again denied for no apparent reason. I spoke to Nakia in member services and after being on hold for 32 minutes was told that they were resubmitting my claim and this time it would go through. once again she admitted they had made a error and see where this claim was previously approved.I was told once again that i would have to wait 7-10 business days for my claim to be processed and I quote Ms Nakia Sophia from claims put your claim through and it will not be denied this time I will watch your claim and check the status each day until the check is done I wanted to know why I had to wait 7-10 more days. I expreesed to Nakia that there should be no wait time and that they do have a way to process this without the 7-10 days wait.

Managers and Supervisors do not want to talk to members, but force you to deal with Aetna staff that has no authority. I requested an address where I could send a letter to in reference to my claim and was told I could only have a P.O Box and that was all they are authorized to give members.

Currently my husband (he has Care first insurance) is getting 6 months of chemo for sarcoma( a rare cancer) We are not able to make ends meet as it is.I expected to get reimbursed, for my claim so I could pay bills that are piliing up. Aetna doesn't seem to want to reimburse members for claims , even if they have been submitted correctly. They seem to want to hold onto your money longer and hope you give up trying to collect on out of pocket expenses from claims that are constantly denied. Some people do not have it in them to keep on resubmitting and fighiting for what is right when they have sick loved ones to care for.

Aetna has repeatedly denied medication claims and has refused to pay for routine doctor visits. I have had to jump through ridiculous hoops just to get simple perscriptions paid for. They will not pay for vaccinations I need. When I first started with them six years ago, I was very happy with their service. Now, I am disgusted. I do not know what has happened to them internally within the last two years, but something drastic has changed. They deny even the simplest claims. How can a health insurance company deny vaccinations? Perscriptions? Doctor visits? Is there any recourse to this? I am looking for answers.

I have had to pay thousands of dollars in out-of-pocket medical expenses for a variety of routine doctor visits, vaccinations and perscriptions. I have had to use public resources usually only available to the uninsured because Aetna will not cover simple vaccinations. I have spent untold frustrating hours on the phone trying to sort through matters with Aetna. I have been without essential medications for long periods of time because Aetna abruptly discontinues covering these medications.

I am insured under a NJ Aetna Health Plan. Under the famiy building Nj law, I am enititled to infertility treatment. Aetna has denied this. They are subjecting me to preauthorization to see if I meet criteria to reproduce. This is in violation of the above law.

i cannot have a child w/o infertility treatment. i am not pregnant.

Delayed, Lost, then Delayed, then Lost, 3 more times for a Long Term Maintance Rx

Without Rx for several months, and out of Medication

I have sent a certified letter in October 17 2007 requesting a refund of my money. In January I sent another letter regular mail also requesting a refund. I worked for Delta Air Lines and I no longer work for the company.

On the 18 September 2007 I contact Aetna to inquire about purchasing insurance both medical and life for myself and my daughter. The package was sent to me and after reviewing the information sent, I was unable to pay for due to no longer working. (package received 26 September)

I contact Aetna 29 September 2007 and spoke with a gentlemen name Steven and explain to him at this time I am unable to purchase the insurance I had while working at Delta. I ask him if there was other options. While looking online I found the refund policy. Now I am sending this via email due to the lack of response from the department in which refunds are handle. I worked in the refund department for Delta, I know that there is sometimes a 90 day turn time.

I've had Aetna Ins. for about 3 years, for the last 2 years I've had to be on dialysis. The first year my bills were paid, now I find that none of my treatments for 2008 have been covered leaving me with 25,000.00 in bills. I've talked to serval people at Aetna and so has my wife and over the first years they were helpful and polite, now I find I get the run around and the rudest people I've ever dealt with and considering I was a police offer for 31 years thats a lot. I don't know what will come of this but if it does get settled and I have to stop treatments I will die . They also told me they don't have a clinic with 50 miles of my home they will cover.

I have hospital indemnity coverage through SRC, an Aetna Company which states that if any family member is hospitalized we receive a payment based on the total number of days spent in the hospital. My wife was hospitalized on February 15th, 2008. Since the beginning of March I've been trying to get the company to pay me the benefit they owe me.

Each time I call I get a representative that either doesn't know what they are talking about or they purposely say things to get me off the phone and when it doesn't happen I get frustrated. Either way, I eventually got through to a supervisor, her name is Tasha Hill and here is where my final and most legitimate complaint comes in to play. On april 14th, I faxed the exact form she requested to her direct fax number, got confirmation of the fax being sent, and then called and left a message stating that I had faxed the form and if there were any issues to please call me. I got no call, so I assumed my problems were over.

It's now April 30th and no check has been received. The reason i say that is in the intial welcome paperwork I received from SRC, an Aetna Company it was stated that your payment will be mailed to you approximately 7-10 days after receipt by SRC. On top of not receiving the check after 16 days, 2 representatives this morning told me they don't even see the claim being processed.

I have bills that are waiting to be paid with the money I was counting on from this benefit.

Aetna refused to cover my wife's Ultrasound of 20th - 1st and only 1 ultrasound of her pregnency. Most other insurance companies like Unites health cover pregnency and hospitalization cost 90% in true sesns..Aetna made us pay almost 30000 $. The whole American Medical system and Insurance companies are a bunch of thieves ! Poor people bear the brunt of this.. America needs to consider 'Outsourcing in Medical treatments' and stop suing doctors mindless sums . Its the only way to reduce treatment costs !

I have aetna as my health coverage carrier. The problem that i am having is I took my son for his 24 m well check up on 3/27/08 that was the soonest that the doctors office could get him in... My sons birthday is 2/13/08.. The insurance company has Denied the claim for service because he was 25 months old at he time of service even though the whole reason for taking him there was so he could get his 24 m check up and shots done..

When I call the insurance company they told me that the y do not cover 25 m check up just 24m and i try to tell them that this is his 24m check up and that i could not get him in any sooner. Are insurance companies really allowed to do this.. Cause now i am stuck paying the 200 dollar bill that should have been covered fully by the insurance company.

200 dollars might not seen like a lot to some people but in a middle class family that is a lot.. Now i will have to struggle to pay this bill so i am not turned over to the credit bureau. I just wish i knew how to make this aware to more people so the same thing doesn't happen to them.

It all started in 7/06. Yes, almost two years. After realizing I would need to seek some treatment for my unexplained infertility, my eyes were widened to the fact that Aetna has not one employee who does their job or tells you the same thing twice. Initially I was told I had no benefits at all for infertility treatment. After much crying and not understanding, I asked for a supervisor. It was then that I was told I did have coverage. Two stories there. As my treatment progressed, I realized I would now need to inject myself daily with medication. I wanted to see if it would be covered. Again, I was told no. After pursuing the issue further, as usual, it was confirmed that I did indeed have coverage for the meds. Again, I must note that this is after MANY hours of phone time and MUCH crying on my part.

Now it's on to the pharmacy. They couldn't manage to ship my meds in time, which are time sensitive, of course. My doctor was fortunate enough to have other patients who no longer needed treatment and they donated their meds until the ones that were due to me finally arrived. That lead to another problem. The next month they said I couldn't have them yet because I just got some; didn't I have any left? Well, because they mailed it late, now they were denying the next round of treatment. Hence, more tears, anguish and stress. Really not something who is trying to have a baby needs, which I did tell them.

I finally get pregnant-yeah- but unfortunately I had a miscarriage. Here is where it gets crazy. I had to treat again, obviously, and they told me that I should have medication left over from before the miscarriage. Well, I did, but only until I found out I was pregnant. It was then that I threw them away since I no longer needed it. I was denied any new meds and was told to pay out of pocket, thousands of dollars, and maybe I would be reimbursed on appeal. Thank God I didn't do it. My appeal was denied. They told me it was considered lost or stolen meds. Of course, it was neither. Next round of meds they accidentally took $130 out of my checking account for co-pays they said. I have been on these meds for months with no co-pays. They said my plan must have changed. It didn't. They finally figured out that I was due a full refund. That was 2/19/08. I still have no money. They claimed they gave me a refund on 3/4/08. Apparently they had a system glitch, yes, that's what the supervisor called it. They were going to overnight it 9 days ago. still no check. I called today and was told they are still working on it. Of course they always say sorry, but is that paying my bills?

I'm out $130 and countless hours of time. I would like a copy of my notes on file by Aetna. Of course they won't give them. Do I have any way to resolve this? It's completely horrible that this is how people with problems/injuries get treated. I don't need to be reminded all the time there's something wrong with me.

Most recently, went to Williamsport Hospital for a possibly broken ankle. My claim was denied with no reason and I just received a bill for $447. Every claim I have made has been denied (Aetna claimed I did not have coverage when I did or they claimed it was a preexisting condition) and when I fought it they changed their mind.

My son fell and tore ligaments in his right ankle. We visited the emergency room the night it happened and made plans to follow up with an orthopedic doctor as soon as possible. I called my insurance company, Aetna, after I found that no ortho doctors were in our town. Denisca (sp.) in member services verified that the closest ortho doctors in-network were around 70 miles away from me. She said we would apply for pre-certification because of limited availability. I gave her the name of the doctor I had an appointment with, and she said to call back before the appointment to see if it had been approved. So, I called this morning to find that it had been denied because Aetna says there are providers in my area--a direct contradiction to what their own employees told me a few days before. I called the doctors (two in the same practice in my town) provided by Aetna. Neither one of the doctors is an ortho. Of course, I have to go pay out of pocket to the ortho doctor and get his office to try to get Aetna's decision overturned.

This is the first time I've used this policy, which I got through my job. I'm not impressed at all so far with the customer service. No surprise to me that they'll take my premium money, but won't be there for me when I need the coverage. I'll be paying out of pocket for at least one visit to the ortho doctor. I can afford it now, but if Aetna continues to deny coverage, it could be an issue. I'm a single mother and earn a decent wage, but it only goes so far.

I have a BIG problem with Aetna Insurance company for my health coverage. This has been an ongoing problem since 07/28/2005. They have consistently refused to pay for medical bills incurred for my daughter (1) charge; (28) charges for my wife Diane; and (38) charges for myself. Now as of today, 02/19/200, I have received notice I am being turned into a collection agency. Aetna uses the excuse that they have not received EOB, or explanation of benefits, or that I did not get a referral to see another doctor from my primary physician. I have done so on every count, and they continue to deny me coverage to see a specialist for my Rheumatology. My insurance card which Aetna issues states no referral is necessary. When I do get a referral they deny and state no, it's out of network. I send in the EOB's myself by fax, and still they drag their feet. It's ridiculous. As always I keep copies of these, too. I have always been in good standing with my credit, but this will not help me--getting turned into a credit agency.

This was for a billing of $725.00 from my rheumatologist which was okay'd last year after I had a referral from my primary doctor. This time, as requested, I had a script from my doctor and faxed it to Aetna to show them. They then informed me that they couldn't okay the coverage since it was out of network. Now they are refusing to pay this bill from 08/24/2007. This was turned into CB Accounts Inc., Nat'l Communication in Peoria, Ill. Ph. Number is 866-867-0179. I have always had good credit, and this will affect it greatly. I am in dire need of assistance and hope and pray you can assist me. This stress has caused my rheumatitis to flare up more than once and have been put on two medications since being diagnosed last year. Please help me or direct me to someone who can help me. Thank you.

This has caused me to incur bills of $725.00 for this last rheumatology visit in 08/24/2007, and a current bill from Carle Clinic in Bloomington of $1,818.62.

Aetna Medical insurance will not pay for oral surgery that is medically necessary even if their benefits documentation says they will. Last Summer my twins had impacted wisdom teeth removed under general anesthesia. This procedure was recommended (by my dentist after x rays) to be done by a surgeon as soon as possible since the teeth were causing pain and in danger of pushing their teeth completely out of alignment.

Upon arriving at the surgeons office for the preop visit, I even asked the administrative personnel to make sure this procedure didn't need to be precertified or anything. Their response was that for Aetna insurance no precertification was necessary. However Aetna has refused to pay these claims for 8 months now, stating that the prodedure was not a medical necessity. What they tell me now is that they don't consider this a medical necessity because it wasn't damage done by a car accident or something.

During my husband's recent open enrollment, we switched from Keystone to Aetna. We were told when we called Aetna to confirm coverage for maternity care that they had a program similar to Keystone, and we would be paying a copay for the doctor's visit only once. I then asked specifically about ultrasounds because I would be almost 6 months along with a twin pregnancy, and they said they are covered when referred by your doctor. Later after enrollment I find out: yes, they are covered, but each time I have to pay a $40 Copay. The same goes for any diagnostic testing (ie. the Non-stress tests or blood work). I am very glad I had Keystone for the beginning. Now I am angry and think everyone who knows they are pregnant or is planning a pregnancy should know about Aetna and how they use terminology to cover up what is very bad maternity coverage. It has made us rethink whether we really need tests our doctors order, and we have canceled appointments hoping that everything will be okay.

Please don't make the same mistake we did. Aetna does not have a Maternity coverage program that is any different than the regular coverage they offer. Mom's to Babies is a joke; it has nothing to do with financial coverage. Just some nurse calling you to ask how you are. I have a doctor and friends to do that.

All of the diagnostic testing and ultrasounds will result in over $1000 more in copays then if we had stayed with Keystone and enrolled in their maternity program.

I called Aetna before I took my children and myself in for flu shots to find out if they would pay. The girl told me yes, 100%. I asked if I went in to my doctor's office flu clinic for just shots and not to see the doctor would I be charged a copay? I was told NO Charge for just shots when the doctor was not seen. Then I get billed copays for all 3 of us.

I called Aetna back was first told that the doctors billed it as a doctor visit. Called the doctors and they told me no, it was just billed as shots. No doctor. Called Aetna back and was then told that they charge a copay no matter what. So I ask for a supervisor. Got her voice mail and left a message that said she would call back in 24-48 hours. Two weeks later I still had not heard from her. So I emailed the Customer Service. I was sent this email:

Thank you for using the Aetna Navigator website to contact Aetna Member Services. This is in response to your claim question on Cheyenne for October 23, 2007. Your plan requires a copayment be taken for any office encounter even if no office visit charge is billed. It appears that your doctor's office policy is not to take a copayment when there is no office charge billed. However, this is not your plan of benefits. You were told 2 times that the shots would be covered at 100% after the $20.00 copayment was applied. I have forwarded your request to the supervisor of the account. However, you did not provide a phone number that she can return your call and we do not have your phone number on file. If you have questions, you can reach Member Services by logging on to www.aetnanavigator.com and select Contact Us. You may also call the toll-free number on your member ID card. Sincerely, Internet Response Team Aetna 12159058.

I told them that the first 2 had said no copay charges for shots only, and asked for a supervisor to call me. They emailed me back:

Thank you for using the Aetna Navigator website to contact Aetna Member Services. I am sorry you were dissatisfied with Aetna's service. We strive to give our customers the best service possible. I have sent your return telephone call request to the supervisor of this account. Please allow 24 hours for a return call. If you have questions, you can reach Member Services by logging on to www.aetnanavigator.com and select Contact Us. You may also call the toll-free number on your member ID card. Sincerely Internet Response Team Aetna 12188095

It has now been another couple weeks with no calls from Aetna. The first time I called before going in for shots in October I asked about a copay so that I wouldn't have to go through this. So I have had 3 different stories about what and why I am being charged. I didn't write down the exact dates I called, but for any future things I will write down everything and have them send me a email to confirm what was said. The fist call after I was billed was about December 21 2007. Then I emailed Jan. 4 2008 and Jan 7 2008. I just emailed the BBB and complained so I am now waiting to see what happens. I also want now to drop Aetna and find a different insurance not through work, but have been told I have to wait to drop it until next December.

We live on a very limited budget. If I have to pay the $60 in copays it has to come out of my food budget. I stress out now about having to go to the doctor at all. Because Aetna ends up making us pay for everything.

The dr wrote all new prescriptions for my mother, and my mother gave them to me. I called Aetna and was told I could fax them to 1-800-416-9264, but to put my mom's ID# on each prescription. I did and sent the fax right away since she was almost out one of her medications. I called my mom a week and a half later to see if the medication arrived. She said no, that she had just received a call that there was a problem. When I called to inquire about the problem, I was told that Aetna does not accept faxes from a non dr office, that they would cancel the order. This took over one week to notify us that there was a problem!

Bottom line, Aetna has poorly trained employees, they treat you like you are at fault (they told me this), they don't take initiative or follow through, and things don't happen the way they tell you they will happen. I'm livid, and not done dealing with them. I will definitely file a complaint, but I'm sure that will fall on deaf ears...they just don't care that they inconvenience you and delay needed medication, because they say it's not their fault. This is the edited version.

I have been insured with aetna through my job for over two years. I started having dental problems and found out that they only pay $500 dollars per year and they denied most of my claims, so I tried to cancel the insurance in October of 07 and found out that aetna had automatically dropped my coverage on May 8th, 2007, but were still taking it out of my paycheck. I have been calling since October to get them to stop and trying to get a refund. It is now January 21st 2008, and it is still being taken out of my paycheck and I haven't received a refund for those eight months that I paid and had no service. Every time I call all they say they can do is send emails for a call back but I received only one call since October. I was told to contact the state insurance comm. and a lawyer which will be my next step.

I've lost money that I could have used because they don't want to refund my payments, bad credit because of medical bills I cannot pay out of pocket, and constant pain because of dental problems that are getting worse.

I have Aetna Home Delivery for all my maintenance prescriptions. I filled out and mailed the reorder form and my check. On 01/07/08 I received a automated call stating there was a problem with my prescription and they needed to contact the doctor. I received another automated call on 1/09/08 stating that they could not contact the doctor's office so they would not be filling the prescription. I called and was told since the doctor office couldn't be contacted they were cancelling my order. I asked which one and was told it was for a new prescription for Soma (muscle relaxer). I told them I was in a traffic accident and this was prescribed the following day to help with the pain by relaxing the muscles. I was told the only thing they could do is for me to go to the doctor for a new 30 day subscription and take it to a local pharmacy. So, it is almost 3 weeks since the prescription was written and it still has not been filled. This is a continual problem with Aetna and their home delivery process.

Aetna tries to get out of paying almost every claim we submit with the exception of our PCP. I have spent and wasted many hours and had many stressful moments because of this horrid so called health insurance company. They even tried to get out of paying for my hubby's emergency appendectomy...took me 2 months to get them to pay. This is not acceptable; they have been sued for not paying claims in the past. Guess they don't learn lessens easily! What goes around Aetna, comes around! I also reported them to Dept. Of Banking & Insurance!

Undue stress and money we put out which we should not have had to!

I have had this insurance for a couple years now. Every time I have used it they have denied my claims. I have had to fight for the benefits I pay for. It has taken me months to get bills straightened out because they claim not to receive paper work or proper referrals. They have gone after me for preexisting conditions, which I have proven are not, and then they turn around and denied the claims again for the same reason. I am mortified to use my insurance. I have stayed up many nights stressing about my coverage. Right now I am going through a high risk pregnancy. I had an ultrasound done when we first found out I was expecting. I had an IUD in and we had to find out if it was a tubal pregnancy, etc. I was shocked to find out it was paid first time billed.

Early November I had another ultrasound done, my 20 week ultrasound. The day before I had it done I called Aetna to make sure all paper work was in order and that the provider was in network. They told me I would be fine. Well, the ultrasound was denied for being an experimental procedure. I called told them it was not, it was a normal ultrasound. The gal that works for Aetna said give us 10 days to get it reprocessed. It looks like it was a mistake on our part. Then today I called them to see why it is being denied again; now they claim that they cover only one ultrasound per pregnancy; and now I have to go back and make the place that did my first ultrasound re-bill them under different codes, then get the 2nd ultrasound re-billed as well. Then they claim they will pay for both. Now I'm afraid that they will put up a fight to pay either one. I am saddened to say that I am not the only they give so much trouble too; many of my co-workers are going through similar situations.

I am physically ill over all this. I have prenatal care pending. I need to get all my bills up until now covered before I get more things done.

Aetna Health are not paying my primary care doctor any money since she is out of network. I have $2,500 & $7,500 for out of network use. The charge was $800.00; and they didn't pay her a dime--no money to my back specialist.

I have to pay these medical bills out of pocket.

I applied for health insurance for my family and an agent contacted me. She received my application and check payable to Aetna. She said my check will not be cashed if my application is denied. I received a letter from Aetna Oct 3, 2007 saying that my application is not approved but I found out on Oct 17, that my check was cashed by Aetna. I've been trying to contact Bridgette and she does not respond to my calls and email.

I have cronic back pain that requires injections to my back which Aetna covers they even cover the doctor that will perform them however the trouble is that the surgical center that the doctor uses is not covered. I am not sure why you would cover a doctor that can see you and diagnose you but cannot treat you. I called to find out what to do and they gave me a number for my PCP to call to get an out of the network approval to try to get the surgical center covered so I called the PCP to get it started.

The PCP called and try to get it approved but they were asking for surgical codes which they didn't have because they were not the doctor that was performing the procedure so she thought that she started the claim but what I later learned is that according to Aetna she didn't. I then called the doctor that was going to do the procedure to let them know that they needed the codes and to call them with that info which she did. Then they called me back to tell me that the claim wasn't started so I called the PCP back and she called again this cycle went on for three days.

Finally I called Aetna back and said that this system isn't working and they needed to figure it out because everyone was calling them and they had no record of it. They also told my PCP I had been terminated for my health care which was not true. They are laughing all the way to the bank cashing my premiums so I should not be terminated.

Aetna/SRC has been delaying the processing of my claims and in some cases, not processing at all. I've been going through this with SRC/Aetna for over 8 months. I contacted my state office of the Commissioner of Insurance. At that point, Aetna/SRC processed some of my claims. However, once Aetna/SRC realized that my employer is based in Maryland, the have continued their non-processing. I keep filing and each time I follow up, I'm told they will be resubmitted, but when calling back, they never have record that I spoke to anyone.

All of these claims were for mental health maintenance prescriptions. I was diagnosed years ago with Bipolar Disorder, ADHD, and General Anxiety Disorder. As a result of not getting reimbursed for prescriptions, I am now not able to afford these medications. This has impacted all aspects of my life. My job performance has suffered; my mental health is at an all time low. I was engaged to be married but my fiance has since called off the wedding. All aspects of my life have gone downhill as a result of this.

I was in the process of starting allergy injections and was not familiar with the insurance. I called to verify my coverage and they said that I would not have a Co pay due to it was not an office visit. I all the sudden started getting bills for my Co pay. When I called Aetna I was told that it was very unclear and did not come out and say that there was a copay and she did see where i was told that there would be no copay and that she would re submit the bills and if any problems she would call me. I waited a week and never heard anything.

I called again and was told the same thing that this women saw where there was a note saying i was told there was no copay and sent a message to please process the claims and she also said it was unclearly stated in my coverage and not to stop getting my shots that i needed them and it should be ok. I called today and was told no they are not covered and it was an error and they were not going to pay for them and the lady laughed at me as i was telling her that i dont have all this money to pay to catch this up, but would find a way.

I went into the doctors office and told them what had happened and they looked at the notes from billing and said the billing person had also called aetna and was told yes she was told there was no copay but that was and error and we will not cover the injections fully.

Now I have one bill and will be getting more to pay for the days that I did go and have to stop getting my allergy injections. I was tested for over 60 things and had reactions to all of them. I am taking medicine for my allergies and alburterol and advair for the asthma that i suffer from that the allergies contribute to. I now wasted all this money for treatment that I can not continue to afford to pay for so can no longer get.

Aetna has repeatedly denied/ignored requests for medical services and medications needed to treat two herniated cervical discs. They claim they have not received proper request forms in spite of repeated submissions of requests. It has been 4 months since my initial injury and I have filed two formal grievances.

Ongoing severe pain and emotional stress related to lack of responsiveness of Aetna. Inability to access services needed for physical therapy. Inability to access medications prescribed for treatment of condition and pain management. Need to spend countless hours of time in trying to resolve these issues, and still finding no resolution to the issues.

My son is insured through my ex-husband's employer, United Airlines, with Aetna HMO. He switched from BCBS PPO during open enrollment of Oct. 2005. The policy was effective 12/01/05. As of February 13, 2006, Aetna has yet to provide an insurance card. My son had a doctor's appointment a few weeks ago which necessitated a lengthy phone call by my ex to both United Airlines and Aetna. He was told at that time that the policy information would be expedited. He paid out of pocket for my son's prescription on the promise that he would be re-imbursed for the expense.

When he attempted to settle the issue, he learned that his policy was indeed expedited but that of his two sons was not. At that time, the policy information did not indicate the two sons were covered. This was 5 mos. after enrollment, 2 1/2 mos. after the policy was effective. My son has an appointment with the specialist he was referred to during the previous visit. This appointment requires a precert which I am unable to get as the insurance company still does not indicate my son is covered.

After talking at length with United Airlines, I was advised to have the doctor's office contact the insurance company as research would show that both boys were indeed covered. Not feeling confident this would work, I attempted to verify coverage myself beforehand.Sure enough, when I spoke to the rep at Aetna, I was told my child was not covered. After spending more than 45 min. (something a doctor's office will not do) on the phone, I was finally told that it did show my son was covered but that he was listed as pending. I was told by Aetna, to have the doc's office call for verification despite that yet another attempt revealed that this information is not readily available without a prolonged conversation, hold time and in depth investigation into the matter. I was then told that if this did not work, I could pay out of pocket and Aetna would reimburse me although she would not fax me a promise of this.

To follow this advice is to set myself up for the insurance company to deny this claim. Ultimately, I am unable to take my son to the specialist unless I am willing to pay as an unisured pt. or wait until they have sorted through this and issued a card. It has already been 5 mos. since enrollment and 3 mos. since coverage was effective. This is inexcusable for a company so large as Aetna to provide such incompetent customer service.

I am paying my son's bills as an uninsured patient because I am unable to provide proof of coverage and although Aetna does confirm this by phone, the amount of time necessary greatly exceeds the reasonable amount any doctor's office will spend.

I received a computer call about my Rx. I was told to call them or respond at that time, I was then put on hold for 45 mins. Heidi came on and was very nice but couldn't help me. Then Barbara came on and she also was polite and told me they were out Of my medication - AVANDIA - that I take for my Diabetis. I also am out, they do not know when they will get a delivery. I will have to now try to get it locally, but Aetna wants you to use Home Delivery so how long will the local pharmacist have to wait to get approval if I was on hold for 45 mins and they called me. I know why people are upset witht the medical insurance industy and the drug industry, not is it expensive, it is time consuming and difficult to even deal with them. I may try Canada. A trip up there every three months may be worth it.

My daughter was quite sick while we were out of state on vacation, so we took her to a walk-in clinic. We were told by the clinic that they accept Aetna and our copay would be our doctor's office copay of $10. After 3 months, we received a bill and collection notice from the clinic indicating that we still owe $90. Apparently, walk-in clinics are classified as urgent care and Aetna's copay soars to $100. Aetna was very unhelpful when I called for clarification; apparently you just can't get sick when you're on vacation, or you'll pay for it - they had no other suggestions.

I am also upset with the walk-in clinic which misled us and I will never visit one of those again. I think Aetna should have paid the claim as a standard doctor visit, which is what it was. They have way too much red tape, so no normal person could ever figure out all of their loopholes, and I suspect most other Aetna members have gotten stuck with such an unexpected bill at one time or another; I wish someone had warned us (which is why I'm filing this complaint - I hope it helps someone out there avoid this mistake). At $1000/month for insurance, I think the least Aetna could do is pay a lousy $90 doctor bill for a sick child.

I have been diagosed with fragments of torsion dystonia and torticollis nonspecific.I was treated with botox(date of service was May 3, 2004) but aetna refuses to pay. However this treatment is covered for this diagnosis.This stated in their policy, they even sent me a copy. They stated they would not pay for botox for investigational or experimental services, specifically tension/migraine headaches and myofascial pain. My doctor sent a letter explaining my diagnosis of fragments of torsion dystonia and torticollis nonspecific, and that this was the reason botox was given and while I have the headaches this was not the reason the botox was given.

She resubmitted office notes and highlighted salient portions of the record. She asked them to reconsider. They sent a letter denying the appeal. They gave no reason for this and a phone number, above mentioned, and I called, a operator answered and could not tell me why. This is a legimate claim and I just want them to pay. Included in this claim is the medication, shot on left side, shot on right side, and an EMG. They say they won't pay for services or supplies determined by aetna to be experimental or investigational, however they paid for the shot on one side but not the other, nor the medication botox.When I asked why the operator could not tell me why. They have given me no further answers.

An attorney stated something about the plan being self-insured so I could only sue for the unpaid amount not any other damages. He said the other damages is how you can pay attorney fees.The current bill is $1846.00. The attorney said it would cost me more than that for the attorney alone. He stated Aetna knew that and knew it would cost more than the claim to get the claim paid if we took them to court.If I had that money I could pay the claim. I can't pay the claim nor an attorney.Not counting the principle of the matter.Please help.If they have done it to me they have done it to someone else.I am now covered by my husbands insurance which does cover this, the same company I had before my employer switched to Aetna.But I can't get treatment until this claim is paid.

Aetna would not pay for my medication as it was not called in by the doctor himself. I will now have to wait 72 hours or longer to have this filled! Yet. what I do not understand, this was called in by his office. Okay Aetna, kill me. Even though it is not cheaper, you insurance companies have a very distorted outlook that paying an exorbitant amount of money is better than paying a few dollars!

I am lining your pockets while you are giving me horrific care! I hope you all suffer at some time in the future!

My husband was treated at Riverview Hospital in Jan and Feb of 2004. The hospital billed his primary insurance company (BCBS) and received payment quickly. Riverview then sent the remaining bill along with BCBS explanation of benefits to Aetna in March 2004. As of today 10 Aug 2004, Riverview has sent the same bill to Aetna 5 additional times. I have spoken to AETNA myself and was told on 20 May that all paperwork was received and the claim was in processing. We received a bill from Riverview requesting payment because they had not yet received anything from Aetna. A couple more phone calls to Aetna were placed. On 30 June, I was told that all paperwork was received and being processed.

Received another bill from Riverview on 15 July saying that we were now 120 days overdue. Contacted Aetna on 26 July 2004 and was told that they still didn't have the BCBS Explanation of Benefits from Riverview. Talked to Riverview Hospital that same day and was told that they faxed everything over again. An Aetna rep (familiar with what has been going on) confirmed that they received everything. Received a notice on 5 Aug 2004, that Riverview is sending the payment to collections.

I contacted Riverview on 9 Aug 2004 to find out what information they had on file about this bill, how many times they have faxed things to Aetna and how many times Aetna has claimed to be processing this bill. In the meantime, I have found that BCBS has also sent over the EOB to Aetna. I contacted Aetna on 10 Aug 2004 and was told that they were still awaiting the Explanation of Benefits from Riverview. Aetna's rep claimed they were going to contact Riverview again. I explained to her that Riverview has faxed the bill along with the EOB several times over the past 6 months.

I also pointed out that how can an insurance company keep losing all the paperwork. It seems that everytime this bill went to Aetna - it magicaly disappeared. I also explained to Aetna that now all of this was going on my husband's credit report. Aetna's rep told me that there was nothing they could do until they received the EOB and bill. The rep also told me that they have no records of ever receiving all the paperwork from Riverview Hospital. And that if Riverview had to report us to the credit collection agency then that is what they have to do. It was not their fault.

I have had the worse headache that has been going on for the past 3 months trying to get this resolved. Now because of AETNA, this bill is going to go on my husband's credit report. This is hurting our chances of getting a house because of this. How can they get away with this? No one in Aetna seems to care....

I had Aetna health insurance for years and really didn't have any trouble until I had a large claim. When i only used the insurance for basic health visits they were great. In September of 2001 I found out that I was pregnant. I called Aetna to find out all of my benefits and to find out exactly what I needed to do. They told me that I would have to pay the copayment and everythig else would be covered. I paid the copayment to the doctor and continued my monthly visits that were over an hour away from my home because that is the doctor that Aetna had approved in my area.

In late December my company laid me off. I immediately called Aetna to find out what I needed to do . They company representative told me that I had already paid my co pay and that part of my severents package they would keep my insurance for six months this would be until June 2001. I was contacted by Cobra in April of 2001 and again called Aetna to make sure I did not need to purchase anything that I was covered for my pregnancy. My husband had full coverage at the time with another health company however Aetna told me that I did not need to do anything. I did call my husbands insurance and they told me that my pregnancy was preexisting and so not covered by them. So anyway I figured that was ok because Aetna had told me not to worry everything was ok.

This is my first child and I was young and believed what they said. I was so worried about not having insurance in June that we induced my son so if there were any complications I would still have health coverage. Now they won't pay. Orange Park Medical is calling me everyday to get the balance which is something like 10,000. I can't buy a house or a car because they have put this on my credit. Aetna refuses to pay them. When I call Aetna they tell me that OPM did not file with them in a timely matter that why they won't pay. OPM has a different story.

I am a middle school teacher and thus do not make a lot of money. My family cannot get a home loan because of this and we are in dire need of help.

They refuse to pay for Provigil for my son's behaviour problems. After complaining about this to the state insurance board, Aetna put most of my medical claims on hold as a revenge. They say they are waiting for info from me about any other insurance I may have. (I don't.) I answered this on their website. I mailed the forms in. I called them with the info. I mailed the forms in. I mailed the forms in.

My son's prescription costs are $380 a month. The medical bills that they are supposed to cover, but have on hold for months now, total several thousand. The doctors have started demanding payment from me.