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I would give Zero stars if it was an option. Our family pays full premium for our primary dental through my military retirement with Delta Dental. We opted to take Aetna Dental as a secondary through my husband's job to pick up what Delta doesn’t cover. After paying them hundreds in premiums, I used Aetna for the first time on a dental crown, they only paid $37 for my crown leaving us with a $450+ dental bill. They told me if they were our primary, or if we didn’t have any other insurance, they would have covered the whole amount of the crown less a $50 deductible. What’s the point of paying full premium for a secondary insurance if they only pay out a small portion of the cost that didn’t even come close to meeting their maximum payment for the procedure? Absolute waste of money to have them as secondary! Canceling our policy with Aetna immediately.
My aged mother has healthcare insurance with Aetna Senior Products. Her premium is paid automatically with a VISA card provided as a retiree benefit to her from her former employer. The third party administrator (Conexis / Wage Works) was delinquent in distributing new VISA cards to its clients. The card arrived on the 18th of May and the former card expired that month. Since my mother's premium was automatically charged to that card, and the new card did not arrive in time, Aetna placed my mother's insurance policy in a lapsed state. Aetna required me to provide (by surface mail) a new credit card authorization form. This form was mailed from the post office on May 21.
As of today, June 18, Aetna has not been able to locate this form. The address to which it was sent was correct; it is a P.O. Box, and evidently there is no person to answer a telephone at that location. After sending this form a second time, it has still not been located, and in ten days time, mother's health insurance will again lapse. I have been told by 4 different Aetna customer service representatives that no other form of transmission is acceptable for this form - neither fax nor as an email attachment.
Today, after threatening to involve either my attorney or my congressman, I was finally transferred to a kind supervisor at Aetna. He readily suggested that I fax the form. This has been done. I had asked to be allowed to fax that form multiple times. Why did it take threatening action to agree to a fax transmission? Aetna is irresponsible in the way it trains and manages its customer service staff. Its callous disregard for its good customers, allowing their healthcare policies to lapse through their own inept document handling must change.
I have their short term disability insurance through work. I’m on a disability leave. They call and send letters constantly that they’ve not received required information. There are confirmed faxes that they have. Also they look at the wrong dates. The earliest possible improvement date was interpreted as a return to work date. The problem is with my ankles and there is no sitting whatsoever and no breaks for the 5-6 hours I work daily. I’d like to see them standing, walking and carrying things with a bad sprain on one ankle and a tendon tear on the other. Aetna is a nightmare to deal with. I feel harrassed by them.
I changed to Aetna because my doctor retired and the new doctor would not accept the insurance I had. The insurance I never had any problems within over 6 years. I should have had a clue that Aetna was not the right choice when the Teacher's Retirement System of which my mother is a part of moved their account from Aetna. Since being insured with Aetna, I have had to change 3 of my medications because of their Tier system. The medications that I had been taking for at least 3 years were all a Tier 4 medicines with a cost of over $100. Then today 6/12/18, my doctor gave a new medication and refilled my inhaler prescription.
They were sent directly to the pharmacy during my office visit. Before I could get out of the parking lot, the pharmacy called to let me know Aetna would not approve my inhaler or my new medicine. I called Aetna and was told that my inhaler was a Tier 4 and would cost me $100 or I could change to a lower Tier medicine. I got the names of those and went back into the doctor's office to ask to change to one of those. For my new medication, Aetna did not have an alternate. Aetna does pay for any medicine for this condition I have. I am changing as soon as I can. This insurance does not appear to care about their clients.
My son needed oral surgery, prior to the surgery I contacted Aetna to find out if the sugery would be covered. I spoke with a claims representative, who told me that "yes, the removal of impacted teeth" would be covered. She gave me instructions on how to file the claim, since the oral surgeon would not file the claim with Aetna (this should have been a clue). I submitted the claim after the surgery and several weeks later it was denied.
When I called to find out why the claim was denied, I was told that the original claims representative that I spoke to was not trained in Oral/Maxillofacial Surgery coverage and that she should not have told me that the procedure would be covered. This new Oral/Maxillofacial claim specialist said that in fact, my Aetna plan does not cover the extraction of impacted teeth. However if I had taken my son to an approved facility, such as the local hospital, that they then would have covered the facility and anesthesia. So none of the $1000 we paid will go towards our deductible and it is too late to investigate a different treatment option or location, due to untrained personnel.
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Doctor sent my Rx here for a 90 day supply. They never sent it because of some sort of error, but also never called me to notify me. Was blocked from filling the Rx because they had already run insurance, even though they never sent the medication. DANGEROUS AND INCOMPETENT.
Ironically, I gave Aetna reps a 5 star rating when I was signing up. They were pleasant, informative and gracious. Unfortunately, the rest of the company doesn't facilitate the same efficiency. I take only a few drugs and was very pleased the first year. The second year, you better hold on to your pants. The 90 day price I paid last year for one drug was $232, the same drug now cost $864. ** they won't even cover any longer. Man, what a difference a year makes. I'm currently searching for a new company.
I have been trying to submit a claim to Aetna for over 6 weeks now. I have spoken to 4 different Aetna claims representatives who have all given me different instructions and different places to fax the claims request and invoices to. Every time I fax the information I receive a confirmation that the fax went through. Then I have to wait at least a week for Aetna to supposedly scan in the claim documents and start the process before I can check on it. Every time I call to check on the progress they say they can't find any information on the claim and I have to re-fax it to a different number. I've asked to speak with managers and they won't transfer me. The whole process is absolutely absurd and it makes it impossible for anyone to be reimbursed.
Denials - Since we have been with Aetna, we have had trouble getting MRIs, prescription, and medical procedures, that I need for my neck and shoulders. Test have been done like EMG with physical therapy, and narcotic medications that are not helping with pain. My wife plans to drop Aetna federal open house.
I retired from ArcelorMittal Steel in Georgetown, SC in 2006, disability. Since that time my medical insurance has gone through several companies. I have Medicare, several companies and now a Medicare/Aetna advantage policy. I have had a Medicare advantage policy for several years now. I have never had so many problems getting claims paid. I am also covered under my wife's medical policy and that company does not receive the proper paperwork from my insurance to pay claims so they are getting denied and I am being held responsible for payment. Now I am being told it is MY responsibility to get the claims information to the insurance company.
I was not given a choice to opt out of the Medicare Advantage program. I would rather have Medicare and an insurance company, not an advantage program. I have even had to pay doctors visits out of pocket because they do NOT accept Medicare advantage insurance. Also ArcelorMittal in Georgetown, SC has closed down and been sold to another company. I am extremely upset with this situation and honestly cannot afford to pay all of these premiums AND doctor/hospital bills that are not getting paid. I guess my fifth back surgery will not happen because I cannot afford to pay what the insurances do not/will not pay.
I don't really know where to start with our nightmare experience with Aetna Thailand! Your local staff are super unprofessional. Worse sales experience ever, the sales manager **, only wanting to get her commission form sale! Didn't inform us as customer any details in advance! We signed and purchased the insurance package, before we actually receiving the insurance detail package! How ridiculous is this? Never ever buy Aetna in Thailand, find an international company. Don't deal with Thai! Disgusting!
Aetna is denying our insurance claims in order to obtain information that we are not required to provide under our policy. Aetna is unethical and puts their business needs before people. They only will tell us what they cover and what is not covered under the policy so it is difficult to understand what a procedure will cost or be covered. It's difficult to get information such as what our primary care physician is assigned to our family. The Aetna website is down much of the time and when it is up it is so poorly designed that it is not useful...
Had Aetna Medicare POO Plan last year. Cost an additional $180.00 per month and I am still getting bills from providers for what Aetna wouldn't pay. I had to pay not only the deductible and the monthly payment plus what they get from Medicare and I still received bills months later, even for standard blood tests. When I would complain to Aetna customer service they would tell you it will be taken care of and a lot of times they would say, “You don't owe the provider any more money” and they would contact the provider and resolve the issue.
Then a few weeks later you get a letter from Aetna saying the time for opening an investigation has expired, of course you already left a review after the customer service person told you it would all be taken care of. So I call them again and they do the same thing over. Imagine doing this on everything from blood tests to regular doctors’ visits and it's overwhelming. I'm still paying medical bills from last year. Never had such a horrible experience from any other insurance company, not even close.
I am pleased to announce that upon contacting the Aetna, Inc. Corporate Office, they were very cordial in solving my problem. They did so promptly, restoring my coverage seamless. No gaps in coverage. Apparently I had no idea my premiums went up, which is true of all insurances. They tend to go up instead of down. Thank you for this site.
Aetna cancel my insurance w/o a warning. Then after cashing in my payments, 2 months after they sent me a letter along w/ a check for more than $200 saying I "have elected to let my policy lapse" giving a date of March 1st, 2 2018. During those 2 months I have gone to Drs. and hospitals, but they say there is a gap of months they will not cover me b/c the policy already lapse. So, now without a supplemental I will have to pay for the thousands of dollars charged during a fall I sustained in March, & my cancer treatments. Being on Social Security it pose not a hardship but something worst. Maybe this is the way is going to be in the era of Trump when death panels are set up by Insurance Companies instead of the government.
Between what my employer pays & what I pay, we're giving Aetna $2,200 a month for health insurance for myself & my wife. We have their "platinum" plan. It's almost impossible to find a doctor or facility in their network. Many providers say they take Aetna but Aetna always comes back with they're out of network. Also, Aetna's Navigator sucks!!! Absolutely the Worst! I have never hated a plan more in my life!!! Buyer beware!
I pay for insurance thru my employment. I'm in good health however recently caught a flu. I get to pay 100% of the Dr. appointment because of a $2000 deductible. It's cheaper not to pay for insurance that does not cover any part of Dr. visit. Shame on you and the government requiring me to spend money for nothing. I assume this was due to Dr., lawyers and politicians needed more of my money. I am waiting for the IRS now.
If I could give Aetna zero stars, I would. Aetna is an absolute disgrace and total waste of me and my employer's money. They have third party boards deliberate whether or not a treatment plan prescribed by your doctor (like a specialist, that you pay more money for) is appropriate or not. They deny simple prescriptions such as high dose ** and require unnecessary x-rays that the doctor knows won't show what they need, exposing you to more radiation, in order for them to approve the tests such as MRIs that the doctor knows will provide proof of a diagnosis.
The "customer service" number is a joke. They clearly do not keep notes on cases and refuse to provide information to the policyholder regarding case status. I have been on the phone for a total of 5 hours today, being bounced around from Aetna to their third-party evaluators and have NO more information than I started with. I was even hung up on when I requested to be transferred to someone who had a better connection (the person I was talking to was incredibly hard to hear either because of the connection or because they were just mumbling). I, nor my doctors staff, have time to deal with this circus. Which I guess is Aetna's tactic, to exhaust and frustrate you to the point you give up and cancel all tests and appointments. Why is an insurance company allowed to prevent care? If they know whats best for me, why am I going to a specialist in the first place?!
I took my daughter to a follow-up appointment yesterday with an in-network orthopedic surgeon to review MRI results. It appears she has a small broken screw fragment or metallic debris from a prior intervention that causes her knee to lock and makes it difficult for her to walk. The doctor recommended arthroscopic surgery and scheduled her surgery for tomorrow. Today, I received a call from the surgery center letting me know they were canceling her surgery because they are not in-network. After spending an hour and forty five minutes on the phone with Aetna, I was told the surgery center was in-network. Of course, that made sense - if the provider is in-network, clearly the facility where he performs surgery is in-network. Well, that was not the case. The surgery center informed Aetna that they had canceled their in-network contract in 2010.
Our choices now are to wait over two weeks for the same surgeon to perform the procedure at a hospital (and risk having my daughter miss her high school graduation), or search for another in-network provider to perform the surgery within the next week. Of course, I now know that I have to ask what surgery center the provider uses before I waste our time at another appointment - and make sure it is in-network (no guarantees, obviously). We had to enroll for coverage through Aetna this year due to my husband’s employer. In prior years, we have been covered by Blue Cross Blue Shield and UnitedHealthcare and never had any such issues. As soon as open enrollment comes around, we will choose a different option. And, as a senior HR professional with significant experience administering health plans, I will never consider Aetna as an option for our employees.
My husband was discharged from a skilled nursing facility for rehab on a partial hip replacement. The surgeon did not recommend that he be discharged on the date set by Aetna due to some concerns. The facility filed for an appeal to keep my husband longer based on the surgeon's findings but it was denied by Aetna. My husband was discharged without medical equipment and home health care in place. It took one week to get wound care through home health care. Physical therapy took one week also. In the meantime, muscles atrophy if no PT/OT is administered. It took 3 weeks for occupational therapy to get started. I bought a walker and shower chair on my own. My husband broke the shower chair from a fall. I had the PT and surgeon order one and am still waiting - it has been 3 weeks. I have contacted Medicare but they do not know how to resolve the home health care issues. I guess it is time to seek an attorney.
Health insurance is a scam - Just not worth it for the money. These companies and this one in particular. I meet my deductible right before the end of the year. And then start everything over again so I have to pay more. You should keep the covering the 80%. Especially because I've been giving money to this company for years, without a single claim, that they had to put any money too! The worthless company, worthless healthcare system!
This entire process has been nothing but a nightmare. Countless claims have been opened then closed, opened and closed. They constantly tell me that they are missing documents that they adamantly state have been sent to me. I receive nothing from them except letters telling me that the claim has been denied. Each time I call, I have to start from scratch, providing information that I've given to them over and over again. I can be looking right at my account on my computer screen, showing the documents I've submitted and they will tell me that nothing is showing up. In the meantime, my last medical bill has now been sent to collections in the all the while Aetna reassuring me that they had reopened it. This entire experience has been exhausting and frustrating, all things one does not need while battling a medical condition and trying to recover from surgery. Their policies and practices need to be investigated.
Currently have two elderly patients, 86 and 91 years old, that are in need of acute rehab and skilled nursing placement. Medicare AETNA has denied one patient who has had a stroke and had great rehab potential, but has now declined due to her not getting the intense rehab that was recommended by our hospital physical therapy team. MD did an appeal on behalf of patient and was still denied. The other patient is 91 and needs Skilled Nursing to improve mobility and safety prior to going back to her home environment. The discharge planner has been told it may take up to 72 hours before the medical director approves the transition. The lack of services in timely manner and denials are an ongoing problem.
As a provider, it has been a nightmare trying to get reimbursed for services from Aetna. Each follow up phone call is routed to a different department and each inquiry has gotten different answers. Aetna is delinquent with payments, stalling, then denying previously paid services for no reason. We are a small solo medical massage business now forced into taking legal action to collect over $5000 for unpaid services rendered as an in network provider. No explanation has been provided as to why mid-year coverage for these patients was suddenly was stopped. They are processing my claims as "provider reimbursement" "$0.00" WHY? We now are no longer willing to accept Aetna covered patients into our health care practice.
For anyone considering using Aetna for health insurance, please read this message and avoid Aetna at all costs!! My hope is that this message might help another family avoid all of the suffering we have endured because of Aetna! At the end of November, we received a letter from Aetna, our health insurance provider, that they would no longer cover occupational therapy sessions for our 7 year old son, who has an autism diagnosis. They stated that occupational therapy services for a person with autism should be short-term. (What?? I would hope that a company that provides medical coverage would understand that there is nothing about Autism that is short-term!) My husband, Jay, and I were shocked because our plan allowed for 90 occupational therapy sessions a year, so we couldn’t understand why Aetna would deny this type of service, especially when we were well within our number of allowable visits.
And what was even more shocking, was the fact that they were deeming autism and sensory needs related to autism to be a short-term necessity. We filed an appeal with Aetna to try and overturn their denial of future coverage. At one point, Jay called about our appeal and an Aetna representative told him that a doctor had never actually looked at our file! How can they deem a medical service an unnecessary of a doctor hasn’t reviewed the case???
4 months later, Jay and I have spent hours and hours on the phone with Aetna representatives and managers. Recently, a manager promised Jay that our son’s file would be sent to us so that we could review it while we awaited their decision. Of course the file was never sent to us. We were told we would have to wait 45 days for Aetna to make their determination about our appeal. So when I called today to find out the verdict, I was told that they only looked at one specific Occupational Therapy (OT) service date for our appeal, instead of considering the fact that we were appealing their denial of all OT services, not just ONE!!
It is absolutely disgusting to think that families have to go through all of this... It is challenging enough to help and support a child with a disability, but to have to fight the insurance companies about coverage of services that they claim to cover in your plan is downright appalling. Jay works in this industry, so he knows the way that these cases work and the appropriate measures that should be taken when customers are calling in and requesting information about claims. But not Aetna, they have made so many errors along the way, they are completely unreliable and responsive, and the bottom line is that they simply do not care about the welfare of their customers.
This entire experience has been so distributing and taxing on our family and 4 months later we are no closer to a resolution. We were just told that we need to resubmit a new appeal because of way their appeals work and this is due to their “process.” I encourage every person that is considering switching to Aetna for insurance, to never ever consider using them!!
I wish there were 0 star rating. Aetna is my company's choice, and the monthly premium is $1,600 for my family of 2. I only have one daily medicine for HepB. And that is the ONLY drug we need. We are both, thank God, otherwise healthy. It used to cost $30 co-pay per month. Then in 2017, Aetna adjusted the price to 30% co-insurance or $321 per month. The reason, they claimed, is that a generic version is becoming available. Now 15 months later, there is no generic version of that medicine. I look forward to Amazon/JPM/Berkshire and joint-effort for better medical insurance product. Before that, I am lobbying my company to ditch Aetna. A terrible company!
Customer service worst. Customer service people doesn't know what is covered and not. Every time you call for the same concern needs to explain from the beginning and they don't track or maintain and will get different answers. This insurance and customer service is horrible.
My mom is now on Aetna managed Medicare through Boeing and I can certainly say that Aetna is ruthless and worse than Medicare. At 80 years old my mom fell in her assisted living home and was hospitalized and got the flu all in a couple of days. After the hospital she was then transferred to a skilled nursing home and in less than two weeks Aetna managed Medicare is kicking her off the usual 100 days of covered skilled nursing and now my mom will need to pay over $600 per day out of pocket for skilled nursing care. They say she was refusing to get better. When you are recovering from the flu, dehydrated and in pain anyone would refuse to do physical therapy!
For anyone who is on Boeing’s Aetna plan I would warn you and your parents not to get put on the Aetna managed Medicare. They are cold-hearted, profit-only oriented thieves who would rather cut off an old widow than help her recover. Great job Aetna and the morons at Boeing who shoved all the Rockwell retirees onto Aetna.
MRI denied prior to a Parotid Deep Lobe Tumor Surgery. Why would someone be denied an MRI when there is a tumor present, especially around the head and neck area? My surgeon didn't really know for sure until he went in to remove the tumor that it was a deep lobe tumor. Had I had an MRI he would have been better prepared. Thankfully I had an excellent surgeon!
Aetna did not charge me for Xolair treatment all last year, then, as of January, they levied a $630 fee per shot but only notified me of this after I received 3 of them. When I asked for the reason for the charge, they never got back to me in 10 days as promised. I spent an hour on the phone to finally discover their only explanation was that it was billed correctly at the Medicare Advantage plan rate of 20% of the gross amount in 2017.
Furthermore, the Aetna senior analyst informed me I had been incorrectly billed last year and Aetna may very well hold me financially responsible for all last year's amount! The doctor showed me their statement from last year showing I was responsible for a 0 charge, but the Aetna analyst said they have the right to audit their bills for two years after the fact and hold me liable for past billing amounting to $4,000+! How can they do this? I went ahead and took the prescription on the quote the doctor originally received for $0. Can they get away with this? This is corrupt!!!
Aetna is refusing to pay a claim for a surgery I had in October 2017. I had a hernia with complications and needed surgery to repair it. It is now March and the doctor and I have appealed their decision (that there was no reason to repair a hernia) and they are still stalling on paying the claim. Research has shown me that this is a common abusive tactic on Aetna’s behalf meant to cheat and defraud their customers.
Aetna expert review by Joseph Burns
Aetna has been providing health insurance to Connecticut residents since 1853, and today covers people in all 50 states. It is a pioneer in health care legislation and is responsible for making coverage of genetic testing and counseling an industry standard.
Highly customizable selection of plans: Aetna allows consumers to pick and choose features such as the deductible amount, type of coverage and ability to choose a provider.
Health insurance bundles: Consumers can easily add dental and vision insurance to their basic health insurance and can bundle insurance with other plans like life insurance.
Large provider network: Aetna allows consumers to choose from over 587,000 doctors and 5,700 hospitals throughout the United States.
Offers Medicare Advantage plans: Aetna offers Medicare Advantage plans.
Best for: Heads of families, senior citizens
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