Aetna Health Insurance

My insurance provider is listed as Aetna through my employer. Cool. So, when I needed to see a therapist for PTSD I searched the website, read my plan benefits and looks like it is covered. I go to a therapist, give them my insurance information (which they accept, and are in Network), and have several sessions. Yesterday I get a notification that my claims for therapy have been denied and I owe 1300.00. It is super great for my mental health to receive such news. I panic, and call Aetna. They tell me oh no! Those services are covered by Optum. What is Optum? Who knows! I googled, I tried to find info on Aetna's website, I did everything I could. There is no helpful information about this online.

I have to use Aetna since my company partner's with them. I pay into the top one available Aetna Choice POS. I needed a surgery because I have chronic sinus infection which cause me to have headaches, facial pressure and throwing up due to mucus. I also have one of the worst deviated septum so I cannot breathe at all out of the right side of my nose. This makes it hard for me to sleep etc.

My daughter paid out of pocket over $2,000 for medical work and the company kept promising to send her a check. They lied. The worst customer service with reps who like to argue with you. As a retiree I wish that my former employer never switched from Blue Cross/Blue Shield. Stay far away from this company. They need to be investigated.

STAY AWAY FROM THIS COMPANY. The plan coverage details listed are confusing. Their representatives and my doctor's assistants weren't able to decipher the information provided which resulted in the denial of an MRI that I desperately need. I'm experiencing severe spine pain with neurological symptoms and they expect me to wait up to 30 days for an appeal process. Wish I would have read these reviews before I became a member.

Husband had to have surgery. Did our best to get referrals for specialists leading up to it. Claims folks kept nitpicking but eventually paid. He was cleared by Aetna for surgery. He has the surgery and then the hospital submits the bill. Suddenly they start to second guess and we had to send his medical records. Now their nincompoops are claiming the surgery, which had been pre-approved, is now not medically necessary and we have to pay $45k ourselves. So now we have to go through a lengthy appeal process and contact doctors and meet with their appeals department. And all this to happen during the work day when I am supposed to be, you know, working.

Aetna deserted me in my hour of need. I am 75 years old and was very active till I started having back pain shooting down my right leg. I could not drive, bike, etc. About all I could do to relieve the pain was to lay on the floor. I could not even attend church on Sundays. My orthopedic Doctor requested an MRI to determine treatment and it was denied by Aetna. Aetna suggested physical therapy and I went. The first thing I heard at PT was "do you have an MRI." So it has been about 8 months of pain. Over the last 10 years I have paid into Medicare over $40,000.00 in monthly payments and Aetna denies a Doctor requested MRI.

Every bad thing you hear about insurance companies is represented by Aetna. I received an approval letter for a treatment. The medicine they approved was not carried by their required pharmacy. After many hours of contact trying to get an explanation of why they would approve a medicine and require me to use the pharmacy that doesn’t carry it I was told that there was a specialty pharmacy that did carry it but that they couldn’t find the approval. I offered to email them the approval I was sent. I was told that they would override whatever was out there and approve the medication.

I had 3 different doctors recommend an MRI, it was declined by AETNA EVERY SINGLE TIME. I had it done anyway, because I care about a Dr.'s recommendation. They clearly don't. BASED ON MRI FINDINGS, a CT Scan was recommended, which obviously was declined. I had to file an appeal in order to get it approved by AETNA. Total waste of time over and over again. I have been requested approval for the MRI since April 2022, we are in July, 3 months later, Stella L. is not working today... Or any other unacceptable excuse.

This is the worst plan for providers to become credentialed. I have credentialed 6 providers over the last year and only 2 have just been approved. Credentialing is easy but waiting on Aetna is the worst. They credential fast. You see the patients then they won't pay the provider stating they are waiting on the contracting specialist to add them to the roster. So if you plan on being a provider expect a waiting period to get paid way over 1 year then they stale date your claims.

Tried and failed 3 times to get a simple cardiac stress test authorized. I had to cancel THREE appointments. They will blame their vendor Evercore, but I contracted with Aetna, not Evercore! The worst! Would not recommend to my worst enemy!