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I had Aetna before I retired 12 years ago. Now that I have Medicare Aetna is my secondary health insurance. I never had any problems with Aetna before Medicare or after. The company I retired from pays 90% of my premium which was part of my retirement benefits after 30 years with the company which makes it financially easier for me. I find Aetna very reliable.
I passed out and fell on the garage cement floor that resulted in an emergency run and ultimately 4 days in the hospital and more doctors, tests and procedures in that short time than I could imagine! All in an effort to determine what had caused me to pass out and crack my skull. I was amazed at how little out of pocket $ we had to pay.
After reviewing provider plan options offered by my employer selected Aetna as it covered all doctors used as well as all Rx. Now 3 months into coverage they indicate they will not be covering one of the name brand drugs. This appears to be bait and switch and am not happy with this. All in all Rx coverage much better than last year's Express Scripts which was terrible.
It's an HMO with the attendant disadvantages, but Aetna teams with a local HMO coordination organization and things happen pretty fast, and I can call my primary care provider for a referral to a specialist usually (I've been his patient for many years, so he knows my background pretty well). In an area that is "doctor-challenged," I can usually be satisfied with the specialists furnished (recently balked at one and another - the one I wanted - was provided).
My name is Robin, I am 52 yrs old. I am currently suffering from a major depression disorder. Let me tell you I would not wish this on anyone. I was hospitalized inpatient for 7 days at Lindner Center of Hope in Cincinnati. I found myself "lost" when I came home. They did not have a magic pill or potion to make this depression, stress, loneliness, anxiety, darkness and gloom disappear (of course).
I was home on late on Nov 15th and my 1St therapy was scheduled for Dec 18. I was beyond OVERWHELMED. BUT, Susan **, an Aetna RN nurse was actually the support I leaned on, A true Godsend. She is kind, sympathetic, caring, empathetic, resourceful, loving, reliable, trustworthy, patient, understanding AND TRULY DEVOTED. She was and is my ROCK. The most compassionate person I have ever met. Without her I may ended up back at inpatient psych hospital or dead without her. I am so deeply grateful and forever genuinely thankful for Susan **, my Aetna case EMmy "Rock". (Hugs) I will never forget how she gives me hope and light when I cannot see any. She is my cheerleader and support. My "Life saver".
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This is the first time we have had medical insurance through Aetna where I work. I hope we never do that again. My MRI with our insurance last year had a negotiated rate three times lower than with Aetna this year. I appealed the claim a month ago thru the Aetna portal. The only response I've received so far is a postcard in the mail that tells me they received the appeal and will be in touch. After reading many other reviews of Aetna I doubt I'll hear anything. Don't bother calling their billing department. Their response sounded like they were reading cue cards to know what to say. The negotiated rates through Aetna should be renegotiated and get in alignment with other carriers. I feel Aetna only cares about Aetna and not their customers.
Do not I repeat do not trust these fraudsters. They will try to wiggle out from any and all obligations. Go without insurance before you trust these lowlifes. My daughter had to have an emergency C section and NICU follow up care and they denied it all.
My wife broke her back and Aetna declined the surgery. They claimed it was experimental. (You’ll come to find out they have a bottomless pit of excuses.) Her doctors were shocked and explained it wasn't experimental and was the only surgery that would apply to her condition. They'll ask for a pre-authorization on just about every prescription you hand into the pharmacy. This means you'll be stuck in a run around between Aetna, the pharmacy and the doctors trying to get them to re-approve the prescription before it can be processed. This process will delay you getting the medication and keep you tied up on the phone trying to get another authorization before your meds are filled. This entire process took over half a year to complete for a cholesterol medication!
During this period our doctor would provide free samples. Our doctor even ended up calling them multiple times and soon after he said he had worked his way up their bureaucratic ladder and finally gotten through to them – they said they never received any of his calls! This process becomes surreal and shocking – you almost feel like you’re in an episode of the twilight zone. The experience is something that still bothers everyone who was involved, from the nurses to our doctor and even us. After this long stint of not receiving the medication, they final acknowledge they received the pre-authorization, but six months later they cut the cholesterol medication off again for another round of their pre-authorization games.
Recently my wife went into the ER due to an allergic reaction to a medication. The doctors said she was close to a coma and they kept her for 3 nights pumping her full of electrolytes she had lost due to the reaction. Aetna is saying this ER visit is being declined due to it not being on their list of authorized ER visits. The amount of money I provide them for my family should cover any of these expenses… but if the procedure or medication is the least bit expensive, you’ll learn the pain of trying to get any coverage through them. I don’t ever write reviews – but feel it’s almost my civil duty to warn others of this company.
3 recent procedures have been denied. The hardest being for a CAT scan for a lung condition. Second it denied radiofrequency ablation for serious neck problems. One morning I spoke with 4 different people including one from the third party decision maker company. They all talk in circles and no one will take responsibility for an answer. After 90 minutes I just gave up. Initially a CAT scan was requested by my Dr because of a new large nodule appeared. He wanted a CAT after 3 months. Aetna said after 6 months. At 6 months they said a year. Have something growing in your lung and be told to wait. I later found out that they deny 40% of treatment requests.
I tried to make a claim two months ago, but the process was really slow, until now, the problem didn't solve. I called and messaged them several times, I explained again and again, while the customer service only told me that we will review the claim and process it within 10 business days. However, nothing happens, problem still be the problem. I do not want to waste my time on such company.
I have a chronic illness and they constantly give my doctors the runaround with needing extra notes. I had a resting heart rate of 180 for weeks and they’re saying the heart monitor my doctor gave me was not essential. No insurance company should be able to make that call, ever. They are reckless and terrible. I try to use community health services as much as often when I have a problem to avoid stress but that’s not always possible. I hate hate hate Aetna. Please beg your employees not to use them!! The will only make your life more difficult in times when you don’t need more stress.
Aetna declines any request for MRI OR CT based on nothing. They are the worst insurance company I've ever had. How does your clinical decision when a doctor sees the need for the test. But you have problem getting paid every month.
Preventative maintenance items that are supposed to be covered (mammogram) not being covered. Went out of network so expected to pay the difference and Aetna won't pay a single dime. Went in-network the previous year and that was applied to deductible since the order had a medical diagnosis. I was owed my one screening for that year but no they won't cover anything. The doctors and facilities in-network is minimal compared to Anthem. My next note is to our HR department requesting they start looking for other providers.
I have a private Aetna HMO plan through my husband's employer that we have had for years!!! I have seen the same doctor for the past 8 yrs! Well all of a sudden they are telling me they cannot cover and prescriptions wrote by my physician because he is not a contacted provider with Medicaid! I’m not even a Medicaid recipient so what does that have to do with me or my doctor? They are saying if I want my meds covered I will have to find a new provider and have him listed on the excluded provider list! What crap! Aetna is the worst insurance company I have ever had and will be switching companies come the first of the year!
Aetna is an absolute nightmare. A glitch in their system has caused me hundreds of hours spent fighting a claim. Long story short, I updated my PCP on their website. I received EMAIL CONFIRMATION that my PCP was updated properly in the system. A month later, I had a procedure done with my new PCP (I had called beforehand to confirm it would be covered - Aetna said "yes").
Then, a few months later I get a bill for the entire service - Aetna explained that they denied my claim because I was not covered by that provider. Um. excuse me? I updated my PCP online, I told them. Aetna had CONFIRMED this change. My insurance card had the name of the right PCP. This is ridiculous, I thought - how could they even fight this? I had documented evidence on their own website (through their Message Center) that my PCP change was received and approved. Yet, for MONTHS and MONTHS they fought, lied, denied, and harassed me. I have never in my life experienced something so absurd. Every single person in their call center was unhelpful, rude, and condescending. Every time I called, I had to re-explain my situation. They did not even keep notes on my case?!
I am not exaggerating when I say this has been a nightmare. I will never in my life choose Aetna again as my health insurance provider. I beg you to stay away from them. They will do everything in their power to not pay your bill. However, I am relentless and have been fighting back - FINALLY after a year of calls, letters, formal appeals, and emails, they have finally reversed their denial because their review "concluded you had changed your primary care physician (PCP) prior to the services being rendered. There was a system issue and the change did not updated in all Aetna's systems." Yes. I know. I told you this hundreds of time. You could have just looked at the Message Center and we could have been done with this. But instead I spent a year receiving final notice bills and threats of being sent to collections while I fought with the incompetent and dishonest people at Aetna.
Please - choose ANYONE but Aetna. I never thought I would experience an issue like this. It can happen to anyone. Aetna will pry on people who are week and will reject your claims unjustly. Don't just take my word for it. Read about the family that sued Aetna and WON for $25 million - the judge ruled that Aetna was reckless and didn't spend enough time reviewing a patient's case before denying her coverage for her cancer treatment (she later passed away from cancer). Bottomline: Aetna does not care about you. They care about money.
After being told from 3 different people where to get the system from, all of which were wrong, the so called SUPERVISOR told me how sorry she was and gave me the right number and company to call. Called it to be told I had the wrong company and they gave me the correct number. Hope to finally get a meter within the next week 21 days after it was approved. I think they should all get a referral to a Proctologist to remove their heads from their **!!!
My wife is a diabetic and was on an insulin pump. The pump was fantastic and helped her manage her insulin dosages with great results. Our previous health insurance providers always covered most of the cost for supplies but not Aetna. They cover a fraction of the cost of supplies, demanded that my wife use a different brand of glucose meter and then barely picked up any of the cost for the test strips. My wife is back to using a needle and manually calculating her insulin doses. My monthly premiums are higher than our previous providers, the deductible is much higher and the coverage is minimal at best. I am in the process of looking for a new job because the poor health care insurance. I recently went to the dentist; the bill was over $400.00 Aetna paid about $22.00.
Claim to provide services, they do not. Multiple accounts of Medicare fraud, 3 doctors who are under investigation for medical malpractice, Dr. Kendell **, Dr. Christine ** & Dr. James **. They refuse to provide home care even though I signed up for that specific plan, the doctors accept you as a patient & then refuse to provide any treatment, any prescriptions. Their medical negligence by the insurance company itself & the doctors nearly cost me my life in Feb. 2019 from major internal bleeding. Even after I got out of the hospital, the doctors refused post-op checkups & to provide the 4 meds the hospital doctors said were necessary to stop the bleeding. Colorado finally got the End of Life Options, thank God! At least now while we're being neglected & dying, we can choose to get the hell out of Aetna Hell.
I have high deductible group coverage through Aetna. Family $3000/year in network. $4000 out of network. On top of that I pay $300/month in premiums in my group plan. This year we had a baby so easily met both in and out of network deductibles. I visited an in network urologist for a vasectomy consultation and was told I have copay since my deductibles hadn't been met. I was asked to pay $30 copays for consultation and $100 deductible for the procedure. Their staff had contacted AETNA and were told that they were out of network and that I hadn't met my deductibles. Neither of those are true.
High deductible insurance plans are becoming very commonplace. It can be very confusing to understand all the variables that apply and a simple mistake by AETNA staff can lead to unnecessary charges passed on to the plan holder where AETNA should in fact cover a claim. This is a convenient "mistake" for AETNA to make that would be financially beneficial for AETNA. A very small percentage of plan holders are vigilant at tracking their own information and status and knowing where they stand. I'm 100% certain that after the mistake is made, it is up to the plan holder to catch it and rectify it, not AETNA. Like I said, it is a VERY convenient "mistake" that would lead to a financial windfall for AETNA. I will be digging into this much more thoroughly.
** you Aetna. You overcharge me. Like to went into debt. Hundred dollars to talk to my doctor for five minutes. Humana is just a ten dollar copay. Aetna charge me 50 dollars for one of my meds. Humana just charged me 88 cents this morning.
I’ve been Diabetic since age 11. I’m 64. Started using ** insulin. Was great product. All of a sudden, "Sorry we don’t pay for ** anymore. We pay for ** insulin." Yes, but ** is TRASH! It doesn’t work. Oh, you can still get ** but you’ll pay $250 out of pocket. Gee, thanks for switching to a product that DOES NOT WORK! Terrible.
Aetna is my secondary insurance and with my recent claim, they have denied benefits saying there was no preauthorization for the service - they are a secondary. Do I have to contact everyone to see if it's ok? Just one more way to no be liable. Dumping Aetna first chance I get!
Very slow to process referrals and not for people on fixed incomes as they have you going to urgent care or are with high copays as you. Need referrals to get treatment. This is the worst advantage plan I have been on and will not renew again.
I am in the gap coverage stage, I entered this stage on February 21st. I have realized the way they process my claims will keep me in the gap coverage a lot longer than it should. you would think that if a claim was reversed for any reason it would not affect you but it does. They list all the claims you pick up and what you pay and part of company's discount pays goes towards your out of pocket expense. They also list the prescriptions you don't get for whatever the reason is and that is subtracted from money that you did pay towards your out of pocket.
Here is one reason a claim might be reversed: the pharmacy started to fill the script and realized that they did not have enough in stock so they canceled the prescription, so $229.84 was deducted from ytd out of pocket expense. Another reason a prescription might be canceled at the pharmacy is if the doctor calls in the wrong prescription. My paid out of pocket expense has to reach $5100.00 before I am out of that stage. At the end of February my out of pocket expense that was paid totaled $1803.+ change ytd. The following month after purchasing more prescriptions and paying more money towards my out of pocket expense, it went down to $1507.83. It went down because claims for medicines that I did not purchase were subtracted from claims that I did purchase.
Some tips that might help with this that I am going to try are: 1. Take all your prescriptions off automatic refill and auto enrollment (you have to request them to be filled). 2. If you need a new prescription from the doctor, get a paper one. That way you know it is the right medicine for you and it is the right amount of pills. 3. Ask the pharmacy to make sure they have the medicine in stock before they try to fill it, otherwise it will be a reversal. 4. Ask the pharmacy to only put the claim through once and if it is denied work this issue through the insurance company making sure they take the claim off and don't reverse it. This one is going to be a little tricky but it is your hundreds of dollars going in their pockets for nothing to be gained by you. So don't get angry and DON'T GIVE UP. And I am pretty sure when they do away with gap coverage they will replace it with something either just as bad or worse.
From my experience as a member in N.J., if you have stock in the company good investment because they seem to be about profit first. But if you want needed coverage they will deny it if they can plausibly can.
Aetna has flirted with a plan for cost managed insulin that I really liked. It treated insulin like "tier 1", and then made tier 1 free through the donut-hole. I hate the donut hole! What happened to closing it?? Also, I like Highmark's national provider network.
I pay every month 120$ for Insurance coverage for single person for 5 years and when I had to go doctor in 2019 they say I have visited a specialist so it can't cover for me, the bill should be at least 1800 dollars out of my pocket to get covered. If Insurance isn't helping when I need why the heck do I need to pay first for Insurance and then for doctor visits. Aetna sucks for sure but I didn't try other insurances either so I feel there should be a comparison to tell how much Health insurance has a problem in US.
We are on Advantage Plan 0 premium but with co-pays. Should have stayed with paid premium Plan G. It is great but the out of pocket for services eats up what you pay in premiums. That about sums it up.
I have health insurance coverage with both Aetna (through my former employer) and Medicare. I am pleased with the coverage I have and find Aetna quite responsive when I have questions. I also appreciate that our coverage now includes prescription eyeglasses.
I just received a bill from a doctor's visit where I had some blood work done. I went to doctor's office that is in network but that doctor mailed the blood specimen off to a hospital that is out of network. Aetna just sent me letter informing me that I will be receiving a bill for 9,000.00. I have been on the phone with them all day and am not getting any help. I don't have control over where blood work is sent.
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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