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I have always had a positive experience with Aetna. I had one overnight hospital stay a couple of years ago for monitoring. All I had to pay was my $60 copy for emergency room. I visit my PCP two or three times a year with a small copy. I do have to pay a deductible for blood tests, but that is it. Overall I am very satisfied with their service.
I recently enrolled in Aetna Coventry Freedom Plus plan as my wife had previously done so. It has proved to be perfect for our needs, as a PPO it practically covers every medical care provider we would require including dental and vision. Although getting questions answered online via messaging can be a bit difficult for those atypical requests they do a fine job. I don't know why anyone would ever want or need to enroll in Part D.
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I've been with Aetna for over six years and have full supplemental coverage. Claims from my providers have always been paid fully and promptly, even the humongous charges associated with a heart attack and medical, flight. As with all medical expenses, premiums have skyrocketed while most of us retirees have fixed incomes and that is starting to present a problem; but, that would be the same with any company. There have been absolutely no hassles and I'm happy.
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).
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My doctors at UNC hospital recommended TMS treatment for my severe, treatment-resistant depression. Aetna denied coverage of this treatment because I am 20, not 21. I turn 21 later this year, and the FDA approved age for TMS treatment is 18 years old. I am within the medically recommended age limit provided by the FDA and doctors at my hospital and in the field. My doctors attempted to file an appeal, and were denied a peer-to-peer review for my case.
After learning this, I attempted to contact Aetna twice about my case, and speak to whoever made the choice to deny coverage and a peer-to-peer review for this treatment, so that I could self-advocate. Both times, I was met with resistance, and was not put on the phone with anyone who had made decisions about my case. I had an extremely hard time understanding and hearing the people I spoke with on the phone, and they gave me no new information whatsoever. I spent a total of over 30 minutes talking to various customer service representatives who refused to transfer me to someone with medical knowledge or who was involved in the process of denying my coverage, despite my doctor's approval. I spent a lot of time on hold.
I have never filed a formal complaint before, but seeing as this was the worst decision-making and customer service I have received in my life, I found it necessary to do so. I would like to make sure that this does not happen to any other Aetna customers in the future. This review is also going online, so that potential customers have an idea of what they are getting into. I would not ever voluntarily receive Aetna care after this experience.
Can't get straight answers. I have Humana and never had these problems. No one recognizes my member ID when filing claims including flu shots as well as blood work. I have tried calling customer service and cant get a straight answer.
I was calling from a provider's office regarding a claim that was denied because of 'gender-mismatch.' This patient's claim has been accepted and fully covered for 6 times in a row and this 7th claim is suddenly denied because of the patient's gender is mismatched? This is a terrible excuse for not getting jobs done properly. The patient's coverage has not expired, still eligible, and the representative kept repeating the information I gave him in arrogant manner. Clearly did not know what he was doing and didn't even have willpower to look up what went wrong. Name of the Representative: Richard. Ref#: **.
I have been using a generic version of my asthma medication for months now and paying a reasonable $15 copay since I switched jobs this past summer. I received notification in December that this generic medication would no longer be covered and that I would have to use a brand name versions that are now going to cost me $200 a month. I called and spoke with a representative who couldn't provide any valuable information about what my other afordable options were. The call with their rep was a complete waste of time. Two of the three drugs on their "preferred" list are for COPD only and cannot be used for Asthma, so these are NOT even alternative options for my condition. So, even though there are generic, reasonably priced options available in the market that I used to be able to purchase (with the same plan), I now have to use the most expensive options on the market, so they can all make their money by taking mine. Beyond frustrating.
Floridians DO NOT CHOOSE AETNA insurance especially if you already have AV-Med Insurance in South Dade County. We have been fighting since Jan 1 to get to our Cardiologist, as both my husband and self also have loop recorders. No Doctor is monitoring us since Dec 2019. Doctors have cancelled appointments due to lack of PCP showing on our records. Our Primary DR. Cindy Mitch ** is in their plan, but technical difficulties stop her referrals. Our agent after over a month can not help us. The customer service no. refers us to that special Florida customer service no, because of all the problems with this new Florida Plan. No help there either as we are unable to register and no one in the meantime is watching, listening to us.
My husband has had triple bypass heart surgery and I am not allowed to drive for 6 months because of last hospital visit and loop recorder which specialist in both our cases are not monitoring. We are beyond desperate at this point. Additionally my husband, a recovering Cancer survivor must have a procedure every 3 months to ensure no new cancer cells have developed and requires a referral. Has no way of obtaining the referral required. Our new cards and Not. DO NOT WORK.
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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