About Aetna Health Insurance
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Wow! Aetna has been a nightmare. I pay extra for the PPO plan so that I can see specialists without a referral, as well as visit out of network providers. The out of network feature is very important to me, considering a lot of doctors in the DC area do not accept Aetna (probably because it's so horrible), and instead, they operate on an out-of-network basis. As a result, I frequently have to submit my own claims. Unfortunately, every single time. the claim is processed incorrectly. I then have to spend hours on the phone each week fighting with representatives for a simple reimbursement. It's to the point where expect it to take around 2 months and 10 phone calls to finally get my claim processed correctly. After that, it takes a few weeks to finally receive a check in the mail.
To make matters worse, a majority of their customer service associates do not understand English very well. As a result, I have to re-explain the issue around 3-4 times before they finally understand correctly. Then I get transferred to someone else, and the whole clown show starts over again. All in all, Aetna is a joke. If they are going to try to operate in the United States and use an electronic claim form to make things easier, maybe they should invest in a software that actually works, as well as customer service associates who speak English.
This company’s practices should be illegal. They are in the insurance business not in the business of determining prescriptions. They are rejecting a medicine I have had for 20 years. Just try to wear you out.
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An AETNA sales person called my elderly father and convinced him to change insurance companies from one he had for 40 years. Then AETNA would not pay what his other insurance company paid - even though they claimed they would be less expensive. We are now looking at a bill from them for thousands of dollars that say he owes as a co-pay. There should be something done about this company preying on the elderly. I filed a claim with them and they dismissed my claim. If anyone knows of any kind of action I can take - I would appreciate the information.
As I have read on this site from others, I have had similar experiences with Aetna denying claims from their In-Network Providers. In 2020, I went to see my heart Dr which was in-network, Aetna denied the claim as in-network and tried to bill me for out of network coverage, this was after while on the phone with Aetna their representative stated that the provider was in-network. I had to file 4 appeals and get my HR department involved as well as our Insurance advocate to finally get them to cover this claim as in-network.
Now in 2021, I seen the same doctor for the same check-up and I am being billed an additional amount. After 8 phone calls with Aetna claims and being told that this was being corrected in phone call 7, I am now receiving past due notices from the provider. I am back on the phone with Aetna and them telling me the same things that I have been told in phone calls 1-7. I have elevated this to a Supervisor to get this resolved hopefully. I have also contacted my HR department in hopes that we might CANCEL this insurance and find a company that actually covers their claims and has customer service. If you are considering Aetna or have options other than Aetna, do anything other than Aetna.
Health insurance is about peace of mind. Aetna was nothing but frustrating experience. They will go above and beyond to decline your claims later. In my case, they were declining my Minute Clinic shots (shots, then clinic visit) after I switched health insurance (two years later). They will mail you a letter in writing with disconnected response telephone number and bad URL webpage. Complaining to California Department of Managed Health Care is a waste of time. You may eventually pay for whatever services you used out of your pocket. To sum up, you could use Aetna to avoid health insurance penalty, but don't expect more than that.
If you are searching for a health care plan for your employees stay far away from Aetna and Altius plans. This company is fraudulent and doesn't care about their plan members, especially in their time of greatest need such as emergencies. The back of the insurance card says go to any emergency room in the event of an emergency. However, this is fraudulent and a lie. If you go out of network they will refuse your claims and turn their back on you after all you and your employer have paid them. They will leave their participating members with huge medical bills and offer no support.
Your employees will be suffering life changing challenges and Aetna/Altius will add to their life stress by refusing to help with their medical bills. What can be more critical for a health insurance to do than help in the time of an emergency? Your employees will go bankrupt while still being asked to pay their premiums. Avoid this company. If you care about your employees, do not use these health plans.
One would think calling the appointment number, one would be able to cancel an upcoming appointment. NOPE! I chose the option for them to call me back instead of waiting 10min. WOW! what a clown show! Received a call back and of course you need to go over all the ridiculous questions to verify who you are. After that was established they couldn't find anything. On the ridiculous phone for 25min. Then I chose to speak to a supervisor, there was another 8min and still no answer. Too many fools who should not be working in the customer service capacity. EMBARRASSING! Horrible Customer Service.
I've had Aetna for several years through my employer. I barely use my health insurance at all. But the two times I had to use it (one for a cavity) and recently for the ER (for a gallbladder attack) I was sent surprise bills in the mail, which upon reviewing, looks like they didn't cover much at all. Thousands of dollars in bills. The time I had a cavity, I had to pay for this procedure and that procedure and this is not covered and that is not covered. And this recent ER visit, I'm paying out of pocket for radiology.
This plan is OKAY when it's something like getting your teeth cleaned once a year but other than that, these people are GREEDY and don't communicate what they cover and don't cover. Instead they send you stupid little cartoon calendars that say "track your health daily!" and 14-page documents of general garbage information regarding in-network out of network. Send me that when I'm feeling okay, not when I'm out of the hospital and you decide now to have some semblance of customer service. Instead, out of the hospital, send me an itemization of the breakdown of my entire bill and show me what you even covered. Call me and ask me what the specialists even did, because swinging through in a white lab coat with a stethoscope and talking to me for 2 minutes shouldn't equal 400 dollar bill that Aetna pays then hits me with this or that charge.
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.
Unless you have mind reading capabilities, as far as I can see, there is no way for a new user to know that Optum is a separate entity from Aetna and who you go through for mental health care. I'm not trying to get in touch with Optum to see if my care is covered. Whomever came up with this system is insane. I shouldn't have to dig and dig just to figure out who to contact, what company covers what, etc etc. Absolute **. Run! Elsewhere.
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.
I was going to have surgery to have this corrected and Aetna said it was not a necessity! It is not a necessity to breathe? It isn't a necessity to work? Because the sinus issues keep me from being able to work a full work day sometimes and most weekends I am stuck in bed in a dark room in a fetal position in pain or nauseous. My doctor appealed, I gave my side of things and they still said they would not approve! All this 5 days before my scheduled surgery! Why do I pay the most for "premium" insurance if it does nothing for me? I am glad me not breathing isn't a priority.
Aetna author 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.
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