Aetna Disability Insurance Reviews

I ask why wouldn’t that request be apart of the original paperwork that the Dr signed , because it’s better to have more info than not enough. I was told by a supervisor that they will only request it if needed, 15 days puts me into the middle of August and I don’t believe my apartment complex will wait that long so there is a high possibility that I will be served eviction papers and my car repoed all because Aetna didn’t want to ask for more info than they needed. 3 years ago they paid a claim and didn’t ask for any medical records? So when did the process change? Or are they looking for a way to deny my claim? I’ve paid monthly premiums for the last 15 years and this is how they treat a customer. The supervisor apologized but offered no solution to my dilemma. So what is the purpose of disability (replacement income) if it is not received in a timely manner so bills can be paid.

I have two children in middle school and they cared nothing about keeping a roof over their heads and food on the table. Also, both times they requested paperwork it was on a Friday so nothing was going to be done until the following Monday. A good company would have some kind of professional relationship with the Dr.’s office so you wouldn’t have to wait 15 days! If they really cared about their clients. This will definitely be the last time I have Aetna as my disability insurance.

Fast forward to Mid June, 2019. Have to go on STD. Again, it has been issue after issue. They request more and more of the exact same information. Even though they confirmed on several phone calls I made to them, that they had already received. Every call I made was met with "a decision hasn't been reached". Spoke to multiple representatives, escalation managers, claims "specialists", all with the same result, "we are still reviewing". To the point I have been calling every other business day to check. Miraculously, when I call today (one week shy of my return to work date) they approve, but only at 50% of my pay. Absolutely not, insisting they check again. Had I not continued to pursue, I still might not have an answer and been forced to accept less than what I was owed.

After the 4th or 5th "brief hold" the rep got back on the line to tell me that I was correct in 100% of my pay. She tells me I should get my regular paycheck and back pay within 5-7 business day. Again, absolutely not. They've already cost me over $300 in overdraft fees, due to all of my bills being auto draft. I will be contacting an attorney this time around, as I'm not the only one within my my company (thousands of employees) to have met the same issues when going on STD.

I contacted them through their website several times (their customer service 800 number is not listed anywhere on their website; the 800 number that is there is not for customer service) and they literally told me every time that they had no record of me as a customer. I even brought up the possibility that maybe there was a different department in Aetna that did have my information, but they never did contact me and acknowledge me as their customer for the last ten years until I instructed my credit union to disallow their automatic monthly withdrawals.

It turns out that they did have my information, because IMMEDIATELY after I did not allow them to keep taking my money directly from my checking account, they somehow miraculously found all my information and they began calling me and sending me things in the mail to try to get me to continue paying them for exactly nothing. They gave me an 800 customer service number to call, which I did, and after navigating through endless menu prompts, I was put on hold for ... well, forever, basically. I gave up on that number.

So, it turns out that apparently there are two different departments, one labeled Long Term Care (for those who need long-term care because they are unable to care for themselves, due to Alzheimer's or some other disability) and Long Term Disability Care. To me that is the same thing. In my emails to them, I had referred to Long Term Disability Care, but apparently I should have called it just Long Term Care. I do not understand how no one at their company could manage to figure out that that's what I was referring to (even when I literally told them that maybe it was a different department within Aetna that would have my information about my having been their customer for over a decade).

I also don't understand why those are two separate departments. If you need Long Term Care, it's because you can no longer care for yourself; you are UNABLE to do it, because you have a disability (mental, physical, or both). It's the same thing. They couldn't figure out their own ridiculous semantics and realize what it was that I was talking about. I have demanded ALL of my money back from them that I have ever paid them, since clearly they never had any intention of paying out any of my claims since they never even acknowledged me as my customer, and they have refused. And why in the world would they not have their customer service 800 number on their website, but would have an 800 number that is NOT for customer service featured on their website?

The customer service reps who emailed me kept referring me back to that paper card they gave me a decade or more earlier, saying that the number I needed to call was on that, even though I kept telling them I no longer had that card, which also apparently had my customer number on it, which I needed to get answers from them via email. I gave them my name, birth date, Social Security number, address, phone number, email, and they still "could not" figure out that I was their customer until I finally stopped paying them, and THAT got their attention.

I will be going to the Better Business Bureau and the FTC about this and keep trying to get back all the money that I ever paid them for exactly nothing. From these other reviews on here, I can only infer that they would never have paid my claims even if I did wind up needing Long Term Care and had contacted the correct department. They seem to not ever want to pay out any claims no matter how valid they are. I am done with Aetna.

On 6/28 the rep leaves a voicemail, claiming my payments would not be processed due to a 3rd party being involved and my retaining an attorney for a separate issue. I needed a copy of my disability plan coverage and Aetna Customer service told me a request for my disability plan would need to be submitted by an attorney. On 6/31 I received another voicemail from the rep asking me to call customer service and verify my reduced schedule for return to work which covers 6/24 thru 7/15, so he could then process my payments properly. This info was submitted with my doctor updates on 6/21, yet the rep hasn't processed anything at this time. (I still have received no payment since 6/20).

TODAY, 7/5 I get a voicemail from the rep who states he does not have doctor information explaining my reduced schedule, even though he was updated on 6/21. He also says he got the letter from a law firm asking for copies of my disability plan but is refusing to send it. He says the attorney needs to contact my HR department for it. This contradicts customer service telling me to have my attorney send a letter directly to them for a copy. He also told me to call back the same night and ask for him specifically so my call would be transferred to him. I did so and he flat out refused to accept my call. Customer service came back and said he told them to take a message.

Another stalling tactic to continue hindering my personal finances and medical recovery while being harassed! I do not understand why his demands change on a daily basis. Why the difference between the voicemail he left on 6/31 and 7/5? He waited 10 days to NOT process my claim and ask for more documentation YET AGAIN? My doctors have always submitted return to work dates for mid July. This info was submitted in April, May, and multiple times in June. The Aetna rep is the only one ignoring doctor’s orders and deciding for himself if I get paid or not. I have suffered financially at his hands, but I am going to follow doctor’s orders. I still have rehab going on, and trying to recover through the mess Aetna is causing is very stressful and downright harmful to a person’s health.

If they have my correct address on file how could you send payments to the wrong address, then when I go online 6/6/2019 to check the status of these payments, which was clearly listed as being approved upon checking before, it now appears they have pulled that info. Down and it is now 6/6/2019 no payments, don't know what happened with the payments they suppose to have re-issued. I can't return to work right now, can't use my hand after surgery and all Aetna is doing is sending documents after documents and giving me the run around while my bills continue falling behind. What happened to them caring so much for their members, they take our money every month but screw us over when we need them.

Now I'm in limbo, my doctor is trying to help out and get the forms in as fast as possible, but I'm already in a bad spot. I haven't been to work, so I haven't been paid, which means I'm facing homelessness (not to mention the other bills that have piled up). I'm just defeated, and given that my claim is related to mental health, this is only making it worse.

I'm trying to gather my thoughts here, so bear with me. Getting through to anyone through phone is a gamble, and I find it is only possible within an hour of their business hour start time. After that, they won't even bother to pick up and you get a voicemail that sounds as though it was recorded in a tunnel while driving an old pickup. Someone will call you back though, in 24-128 hours.

I filed an Appeal on 3/19/2019, and in return Aetna responded with a letter from THEIR Doctors stating that my Vision is back, and that I don't have any psychological issues. My vision is not at 100%, I still have Neurological problems such as migraines which I receive nerve block injections for, neck stiffness, lower back pain, and nausea. I have been on Steroids for over a year, and they have created symptoms such as insomnia, irritability, anxiety, depression, weight gain, and bone loss mass in my hips. Doctors need to taper me off the Steroids, and on an immunosuppressant through Rheumatology.

The last time my Steroid dosage decreased I was hospitalized in the ER on 3/2/2019. I sent Aetna 56 Pages of Doctors notes from my Ophthalmologist, Neurologist, Rheumatologist, and Primary Care Physician, on 5/2/2019. Lina ** said she would have an answer on the appeal by 5/24/2019, which when I spoke to her today she needed an additional 21 days. I called last Friday on 5/17/2019 to speak to her Supervisor, only to have her call me back today. On 5/21/2019 I received a phone call from an Aetna Representative "Karen," and only, because I went on Social Media to plead my case.

Upon review of my claim it was discovered that a Doctor "Norman **" sent over clinical notes. I don't know who this Doctor is, it's obviously not one of my own Doctors, and I never received his clinical notes. During the Second Appeal it was discovered that Lina ** sent my Medical file to be reviewed by a Psychologist. I have FOUR Doctors I work with in terms of my disease: Ophthalmologist, Neurologist, Rheumatologist, and my PCP.

Lina ** didn't think it would be beneficial for someone who has such a rare autoimmune disease that maybe it would make sense for any of the above doctors to take a look at my case? Her reasonings were, it's because my physician notes stated depression, anxiety, insomnia, irritability. But if she would've looked closely at my medical record along with the Aetna Psychologist they would've seen that I am on Prescription ** for Depression. Those are all symptoms of my disease along with side effects of chronic usage of Steroids. You don't need a Psychologist to tell you about the side effects of Steroids, hence why they are illegal in the sports world. Upon review of the notes conducted by "Jeremy **" a Residency Psychologist who has more than likely never heard of my VKH Disease, didn't mention the fact that I had a Flare up on March 2, 2019 where I was hospitalized for days.

Ophthalmology noted that I had new nodules in eyes, disc swelling, new inflammation in both eyes, that my Steroid dosage increased to 60mg. Residency Psychologist Jeremy ** also failed to mention that Neurology attempted a Lumbar Puncture during my hospitalization, and they also noted that I had Ocular Inflammation in both eyes. Neurology also prescribed a muscle relaxer for neck stiffness, lower back pain, and nausea. On 3/29/2019 Rheumatologist noted back pain, so they ordered a bone density exam on 4/3/2019. Results came back with low bone mass in hips, due to chronic usage of steroids.

On 4/16/2019, Bradley ** the Aetna Ophthalmologist stated that my vision is back, however my medical records on 4/16/2019 also express that there are small spots and the Optic Nerve slightly hyperemic, hence my photophobia and blurred vision that I will deal with for the rest of my life. I don't understand how when I first got diagnosed with VKH I was approved for Disability, and a year later with more Doctors, and medication I'm getting Denied. I don't understand Why I haven't received benefits that I pay out of pocket for every month. Aetna keeps prolonging the appeals process hoping I would give up. I have been out of work since 1/27/2019, and obviously behind on my bills. I have filed for Bankruptcy due to Financial Hardship, and I can provide proof of my Bankruptcy case if needed. I have 5 Doctor's appointments coming up, and I am not able to afford the copay.

I tell them they sent you the info 3 times. Aetna sent me a letter which I took to the hr and was in her office when she called you. The lady gave me another number to call. Now it has been over a month; my case is still suspended. Every time I call they put the blame on my employer or the doctor. It is like they don't want to pay. Hoping I will forget about this benefit my employer pays for. I work for manufacturing plant which is owned by a investment group. I am contacting corporate tomorrow and letting them know how this company is treating one of their employees. They own about 20 plants with well over 1000 employees. Also I am thinking about turning Aetna into my state's insurance commission.

On February 18, 2019 Aetna stated on the portal my claim was CLOSED. Not sure if that’s a Denial. They stated the reason for Closing the Claim on February 20, 2019 as “Disability Not Supported.” I don’t know what any of this means. I know my PCP and Therapist have not sent in their final medical records. Not sure what to do nor do I know what is going on. This situation with Aetna has increased my level of stress and depression. I’m a senior citizen and I’m unsure of what to do. My job approved me for FMLA based on my PCP’s medical reports. I don’t understand.

You’d think that would reopen my case. Think again. Appeals sent it over to the medical review department who then decided I did not meet the guidelines and there was no medical reason for me to be covered under the plan. Interesting since my situation didn’t change at all. So I appealed again. This time they requested an invasive amount of paperwork from my doctor. They gave her a deadline. They denied my claim PRIOR to the deadline that my doctor was given to submit paperwork, for “failure to submit paperwork requested” on the VERY SAME DAY my doctor sent the paperwork over. So now I had to appeal again and start the process over with the Peer Report team, with the paperwork she had sent over. She has sent in and provided everything she possibly could to this company and they are still not satisfied.

Every office visit note for the past 2 years, a 7 page questionnaire, form after form after form of the same forms over and over. She got a letter yesterday telling her that they have tried to reach her 3 times via telephone - her office keeps all phone records and they only called once during non operating hours - and that her medical opinion is not evident enough to support my claim and to supply them with something - anything else - that will help sway their decision in my favor. So now it’s been nearly 3 months.

They ripped my benefits from me right before the holidays for some falsified reasons - sole income with children - and now they are making any excuse to keep my case closed with ever appeal I open. This company is complete garbage. The way they treat disabled people is a crime. I have already been in contact with a lawyer. This is unacceptable. BEWARE - they constantly lie about contacting your doctor. They lie about not receiving faxes from your doctor. They lie lie lie to keep what is rightfully yours, hoping you won’t fight them all the way. DONT LET THEM WIN.

Finally after waiting since August 2018, I get a letter this week with the disability denial letter. Aetna is stating that since I have been in chronic pain and dealing with my medical issues for so long, that I should be able to continue to do so. My doctors have clearly documented that I am getting worse, I'm on more meds, I have a traumatic brain injury and vision problems. My neuro-optometrist recommends a 50-week treatment plan and Aetna is denying my claim. It's completely ridiculous because I can't possibly work right now with diminished capabilities and my condition only getting worse. They wrote a denial letter and cherry picked items from reports that favored THEM and made me appear unqualified for disability.

Second doctor sends in paperwork, Aetna says they need more information to answer their questions. He provides a clearly written paragraph answering their questions. Aetna comes back and says this still doesn’t answer the questions. I called them and asked what the questions were. They were three very basic questions that I got the answers to and submitted through the portal. This took me from December 22, 2018 to January 3, 2019 (which I thought was a very reasonable time considering the doctors were closed a few days for holidays).

Each time I sent paperwork, Aetna calls me with more questions. On January 4, the call again and ask the same questions again. They get the same answers again. January 9, they call and tell me they are making a determination. January 10, 2019 - they deny STD/FMLA due to “insufficient information and lack of response.” Stated I did not qualify for being “total disabled” which I never said I was anyway. Then AFTER STD is denied, they tell me that I’m not eligible for FMLA due to this lack of information - at which time I’ve already been off 4 weeks... So technically I could be terminated due to excessive absences. (I took the lesser of two evils and resigned on my own, that way I left of my own accord and not terminated.)

I applied for these leaves because my HR department told me to do so, and Aetna said there was no reason for me to have these. Just because two doctors certified it apparently isn’t reason enough. Let alone the fact that our HR department AGREED WITH THE MEDICAL PROVIDERS. I will NEVER EVER apply for ANY insurance with Aetna on my own, nor will I EVER use ANY leaves if Aetna is the provider. If you are considering paying for Aetna, think twice as they aren’t worth it at all. I deal professionally with rules/regs/risks all day every day, and I still have yet to understand how Aetna operates - they are the biggest risk out there... STAY FAR, FAR AWAY.

It seems incredibly unfair/unprofessional to take advantage of hardworking people who happen to fall ill but must depend on their income and benefits (which I also lost now that I'm without employment). All it would have taken is genuine concern enough for their agent's position to make sure I had a clear understanding of policies, procedures and expected timeframe, for this not to have been an issue and ending so badly for me!

All the people I spoke with at Aetna were kind and able to tell me what was still needed and why. The website on the other hand, speaking as a software engineer, is poorly constructed. Information that is supposed to be available is not to be found at **. The site doesn't show what documents have been received, only that "a document" has been received on some date. Also it is not clear when Aetna is requesting information from you the claimant. After completing questionnaires online the website shows the questionnaires are still needed.

My short term claim was followed by a Long term disability claim that was finally approved after the same extensive review, duplicate document requests and many phone calls to check that paperwork was received. Overall my experience was good. If I was more desperate for the payout it would have been more frustrating as the Std claim was filed mid Sept. and finally approved mid Nov. My Ltd claim was initiated directly after in Nov. and paid out mid Dec. My doctors and I were always prompt with providing all forms and documents.

Once again, no answer. So, the case manager from my doctor's office called. They told her they did request it. She said it is electronic, and no request was ever sent, and they can't send information, they don't know is needed. The CSR told my Dr "well, we were going to request it today." I ended up calling and speaking to a supervisor. Who read through my file and saw how many times I called and doesn't understand why the request was never made. He said my date was auto calculated to the minimum, due to not having all the information. Only after that, was the request sent to my Dr. But I did not receive a payment on time. And my calculated percentage was not correct, since they did it as the minimum. So, I never received the full amount I was supposed to, and was canceled, early because my case worker, never requested the information, and never explained why, even though I called 2-3 a week about it.