Consumer Complaints and Reviews
I went to a doctor who is part of John Muir for a routine check. Before going, I inquired with Aetna about the Insurance coverage and got the response that John Muir and the doctor is part of Aetna In-Network. A John Muir Doctor wanted me and wife to do the routine test, and suggested me to go the lab in the first floor. The tests the doctor ordered were mentioned in the document with letterhead saying "LabCorp." Me & my wife went there, and once again inquired LabCorp whether the Aetna Insurance can cover our tests. After seeing my Aetna Plan 80, the LabCorp person said "Yes, all the routine tests are covered by the insurance.”
Out-Of Pocket Payment for Routine Tests (there are couple of test which are not routine I think): I just mentioned one Claim ID (429.99) here on my Wife. There are two more in the received claim status (429.99 & 432.66). For mine, the amount to pay is 244.77. Why should I pay this exorbitant amount "when the doctor who is part of your network referred me to a lab in John Muir facility". I am really shocked and frustrated... All OUT of MY POCKET. Please let me know if you can process all of these in IN-Network, and help me alleviate the burden.
For some background, if you use 30mg ** solutab the Aetna medical bureaucracy will charge $1000 a month copay that must be allowed by the Obamacare monopoly. Aetna offered to mail order my prescription for $1000 for 90 days. If you lower the dose to 1 or two 15 mg pills per day over the counter ** is available for with a doctor prescription. If you take less than 30mg, you can buy it over the counter for $30 a month via insurance for $7 copay. Aetna insurance went berserk and resent me an offer for $1000 copay via mail with 90 days at a time. I refused it and they cut me off at 1 per day which extended me out until June.
The stupidity of this argument is that I can walk in and buy $60 worth over the counter and not use my insurance else pay the medical conspiracy bureaucracy $1000... I assume people simply pay this copay because they don't know that it is sold over the counter. I will being doing this until I am allowed to opt out of this scam. I would prefer not having any insurance than to stay with Athena.
In 2016, I paid this fraudulent outfit $1000/month for health insurance for my wife and me. Our deductible was $6800 each so it was literally no coverage except in the event of something catastrophic. But under Obamacare, we were entitled to one yearly wellness visit each. Aetna has just denied the cost of that visit. On top of that, they decided there wasn't enough cash to lap up in all of Florida so they dumped every Floridian from their roles. Really? If this is what they'll do to screw a customer for a lousy $125, what will they do if you were forced to make a real claim? Wake up voters. Insurance companies are in business to make money off you for their upper management and stock owners. SINGLE PAYER is the only way you will ever know the stress-free safety of having health insurance you can rely on. Ask Canadians - it really works.
When refilling a heart medication at CVS which they make me use, pharmacy does not have a 90 day supply in stock. Aetna will not approve for less days and then pick up rest when it comes in. I had to go 3 days with no heart meds due to this practice. When I called Aetna to complain they told me I should have checked other pharmacies to see if in stock. WTF.
My son needed his vaccinations and a first time doctor's visit for school. We picked a doctor through the Aetna network. When it came time to pay, Aetna didn't have us in their system so I paid out of pocket, anticipating reimbursement. My claim was submitted months ago and I have to keep following up to resolve disputes since they refuse to reimburse me first time stating the doctor is out of coverage, and the second time stating there are multiple network providers.
Supposedly they sent a check for less than 1/3 of the costs paid out of pocket which is a lot of money shortchanged. Weeks later, I'm awaiting receipt of the check simply to return for proper compensation. Never have I EVER dealt with such scandalous behavior as Aetna. Given I've spoken with numerous agents at any given time, it appears this is not the employee practice but the overall provider policies which encourage refusal of payment for promissory coverage. It would be a mistake to choose Aetna coverage over any other provider.
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My husband was denied coverage for a spinal fusion. Not a rocket science type of procedure. Since the denial, I have received nothing but poor service and run around from AETNA representatives. I have requested the documentation twice that AETNA says it will provide for "free" regarding the basis for denial. I have received nothing. I have been told conflicting information from each rep I speak with from different clinical policy bulletin numbers to being told my denial letter must have a mistake because the type of procedure is covered and can't be denied. All of this I feel is a stall tactic to discourage members and have them give up on seeking coverage. Meanwhile, they have no problem covering pain meds for same condition. Hmm, married to the pharmaceutical companies perhaps? I pay a high premium and feel AETNA is not holding up their end of the deal when it comes to a significant procedure. This is nothing other than a scam to me.
I have a dental insurance with Aetna through work. In October 2016 my wife had some inlay done and we submit the invoices, they were not processed till now (we are 9th of March 2017), though that time Aetna has requested information that was sent by myself personally as well as my dentist as well. Nevertheless they keep changing the delay reason from asking for X-ray to asking for pre operative and post operative X-rays, to asking for the tooth number. Although all this was provided and they could ask all their question directly to the dentist and get all they want at once!
Now the claim show "We've asked your provider for more information. When we get this, we will consider this charge!!" I am not sure what more information is needed. It seems to me like they just don't want to pay. Any advice on how can I deal with this? Where can I complain? Is there a customer protection agency for these cases or can the insurance companies just drag us like this forever.
They won't pay for migraine injections that at least two other insurances accepted. They told me my coinsurance for a migraine device was $40 and I called again because I don't trust them, and voila, after my deductible, they will pay only 50%. I'm opting for an device they don't cover at all because it is cheaper.
Forced to take Aetna through my company. Got medical and Dental. Worst plans on earth. Had oral surgery scheduled for today. Aetna denied the surgery without informing me or provider. Found out 5 minutes before appointment. They still cannot tell me why. They don't even know whether an extraction is medical or dental. They keep bouncing me around from one department to another. At times, when I call the number on the card, I get an endless stream of ads and surveys. Other times, connected to some job thief in Mumbai. They make murder seem appealing. Complaining to the state this afternoon.
This company has some of the worst customer service I've ever dealt with. My son receives therapy once a week. I submit the same claim from the same provider every time. It goes smooth for a month or two then they start screwing up the claims. They aren't processed correctly or they're not processed at all and require me to call them. Now they won't cover the therapy and it's taken me over 2 months to find out why. Their only response is that there has been no measurable progress yet the report from the therapist says there is.
They've promised documentation that I have yet to receive. I've had better experiences dealing with an Indian help desk. I can get different responses from different people on different days on the same question. The only reason I have this coverage is because this is the only option from my employer. Next year I'm going to find my own coverage on the open market. Even if I have to pay more it would be worth it for the stress I'll save. 1 star is too good for them.
My husband's policy was cancelled after Innova/Aetna received and cancelled the monthly check payment. However, Innova/Aetna said that it was the incorrect payment. I submitted the payment the Affordable Care Agency (ACA), Obamacare told me to submit. I have been in conference calls with the ACA and Innova since September 2016, but to no avail. I even suggested that I would pay whatever amount they wanted but again to no avail. I decided to file a complaint with the Commonwealth of Virginia (COV), Health Division. Due to the complaint, on January 2016, the health policy was reinstated. The irony is that my husband has never used this health ins. plan but since it's the law, you know how that goes.
I made a payment from an invoice the Innova/Aetna submitted to me and by phone on January 2017. A few days later, I received the 1095 from the ACA with the information as if the policy was never reinstated so I proceeded to call ACA and they continue to say they will submit another 1095 but they have the policy as cancelled by Innova/Aetna, so what would be the point. I called the Commonwealth COV again with this update. The COV gave Innova/Aetna a call. Yesterday I received another call from Innova/Aetna, saying that I should pay an amount owed, an amount totally different from what I was previous told. However, wanting to end all ties I gave them my bank's information. After talking to them about one hour, they told me that they weren't sure the payment was processed. Innova/Aetna said they will call me today to ascertain if the payment went through.
Today they called me, again I gave them the bank information, I even told them I could pay with a credit card. They took all the information again, but could not process the payment again. After two hours of waiting Innova/Aetna called again to tell me that this time I should send the payment by mail because they cannot process any payment by phone. However, they did process the payment two weeks ago by phone. Afterwards, I called the Commonwealth again and left message for the Senior Insurance agent. I probably will hear from her tomorrow.
I have been waiting for six months to solve an issue which should have never taken place. I cannot file my taxes because the 1095 is incorrect from the ACA. I was told that because of the incompetency that is going on between the ACA and Health Ins. Companies that they might have to extend the deadline for filing tax returns.
In essence, if you have Health Insurance through Innova/Aetna you have no idea of the level of incompetency of all these people. Then to make matters worst, you have ACA with tons of backlog and every time you call, you need to explain the situation again and again. In addition, you obtain different versions of agents' opinions of the issues. No two people versions of the problem are the same. This is the most scary and difficult problem I have ever dealt with in my entire life. Don't be a victim, do not get health care through Innova/Aetna. Mr. Trump please REPEAL ACA!!!
I wish I could give negative stars... As of Jan 1st 2017 ----these idiots banned all the meds people really need and then want you to use different meds that they made under table deals with... and say it's the same meds but when you ask them to put in writing... they can't. If same meds then why are you charging more for it? People get used to a medication and then you want to lock it down and charge more for it. Useless people over phone keep transferring you from # to #. What a joke and then we get fined for not having insurance. People are already pay check to pay check then they really want to stick to us. Ok. I'm have vented but this company still a joke... and the puppets working for them.
My husband was recently diagnosed with malignant melanoma of the left ear and required surgery to remove the cancerous site. A graft was put in place. It was apparent within a couple of days that the graft wasn't taking well, and the physician asked us to get a hyperbaric oxygen treatment consult. We did - on 20 January. The hyperbaric facility quickly sent information to Aetna for approval, and as of this morning, 2 Feb 2017, the case is still pending.
My husband's graft is now dead and getting ready to fall off, and his ear is somewhat disfigured. On top of that, he developed a massive MRSA systemic infections and has boils everywhere, all of which would have healed perfectly well with the hyperbaric oxygen treatment. When I was finally able to get in touch with the case manager, Mia, she tells me she can't speak to me as I am not the patient (the patient is my spouse, under my health plan) - which I get, due to HIPAA. She was not sympathetic at all and couldn't tell me anything. Magically, within 10 minutes of my call with this Mia character, my husband's claim was approved - about 2 weeks too late. The graft didn't take, his infection is insane. WE will do the hyperbaric treatment with the intent of him healing before his NEXT oncology surgery. I am absolutely disgusted and disappointed. Shameful, truly.
Aetna calls me one day to request approval on a refill for $375 due to the high cost. I declined the charge and they processed anyways. We had insurance with a new company for 2017 and so I immediately returned the medication because my new company had processed the prescription. Aetna now refuses to refund the charge even though the medication has been returned and I no longer have them for insurance. How messed up is that! Their customer service is so horrible. One star is too many!
Aetna finally recognized their error and has paid this bill.
I have been diagnosed with Stage 3 Multiple Myeloma and pretty much been given a life expectancy of only a couple of years. Part of the "Standard" medical treatment is stem cell transplantation after high dosed chemotherapy. I was in the hospital for three weeks, throwing up, nauseated and lost 20% of my body weight, not to mention all of my hair! The hospital billed me, and I of course, sent that to Aetna for payment. They refused, even though this is a life saving procedure. To make matters worse, I needed the same treatment again in January, but since the bill has not been paid I had to turn the treatment down. Oddly enough, the U.S. charges over $80,0000, here in Germany it is only $19,000.00.
Calling or writing Aetna about the issue only makes matters worse. Either you get someone that just wants to appease the situation or a complete incompetent person that lies over the phone asking you to call back a week later. My take on things, this is NOT a major medical Insurance company. Bills that require hospital care or stay are extremely scrutinized and turned down based on the amounts. What really gets my goat is the fact that Aetna paid for my Stem Cells to be taken and frozen, what did they think that was for? Our company provides us this coverage. It is my goal for 2017 to speak to as many of the 45000 associates we have asking them to change insurance companies. I will be leaving them in November once our open enrollment is active.
I don't even know where to begin with this review. I had to go through Aetna through the marketplace for health insurance and from the moment I signed up I've had nothing but problems. First off, let me tell you how idiotic the workers are there. I don't know where they find their employees but most of them are completely uneducated. I've probably had a total of three good experiences.
Since beginning of December I've been on the phone with them at least 20 times trying to get things straightened out. I was never called back about an issue. I paid my first month's premium but I'm still getting letters in the mail that it was never received. Aetna contacted my insurance agent telling them that I never paid the premium when in fact I did. I actually called them again to confirm and once again they said I paid it so I don't know why I'm getting letters and why the insurance agent is getting phone calls that it was never paid. I don't know if they have multiple systems that send out letters or what but it has been an absolute nightmare dealing with them. My husband and I had Aetna through Costco and never had problems with them But the Aetna through the marketplace is HORRIBLE. I no longer want to even give them my business.
Obamacare is the least American plan passed, then you get companies like Aetna that does exactly what is said in my subject matter (PRIOR) to the Obamacare Obama CRAP. I had good health insurance for 296 per month, $20 copay, $5000 deductible. Now with the help of Obama Crap (care) through this despicable company I have a $804 month premium, 0 copay, and a $7500 deductible. Anyone that thinks Obama Crap (care) is good is a Welfare **.
I no longer receive healthcare from Aetna. I just received a $9 bill for a Dr. consultation from over a year ago. When I called the Dr office they said "Aetna made a mistake and you owe us ~$9". After spending literally hours (phone/emails) trying to have Aetna clear this up, they have informed me I must file a second appeal, in writing, on paper. Imagine your plumber sending you a bill for the work he did over a year ago (which you already paid for) with the explanation that he made a mistake back then and didn't charge you enough. Yes, this is for $9. How many people just pay it?
Recently my company changed our Aetna insurance to one that requires me to use Aetna Specialty Pharmacy. I have been on ** for almost 5 years as a treatment for rheumatoid arthritis. Since we were changing pharmacies, I started the process of ordering my monthly dosage 12 days prior to my necessary "shot" day. After calling everyday to make sure there were not problems, and being told on 4 different separate days that all was in order, I would receive a call to tell me that it wasn't shipping due to -- no prescription, order never entered, need an authorization script (twice). After 2 weeks, 2 days after my shot was due, today I received a shipment of **. Unfortunately, it was sent as hypodermic needles instead of an ** format. What a completely frustrating experience. I am sure tomorrow when I call, the whole screwed up process will just be exasperated.
I have had difficulty with Aetna covering claims multiple times in the past, so for this past visit related to birth control I called Aetna to ask about my coverage and preferred provider. I was told birth control is covered through contraceptive services 100%, so I went to the office that they instructed me to. Afterwards I received a sizable bill and when I called Aetna to ask why it was not covered, I was told that the contraceptive portion of the visit was covered but every contraceptive visit has an associated medical visit (although I did not seek ANY medical care or advice) and that this office was not my preferred provider for medical visits.
I ordered RX (3 month supply insulin must be on ice) on Dec 20, 2016. The delivery was held at UPS warehouse because someone at Aetna changed the delivery which was supposed to be sent to my doorstep. I called Aetna Dec 28th to have the insulin delivery changed and they told me that it would be delivered 7pm that evening. It never arrived. I called again Dec 29th and talked to a pharmacist Ruth that told me they would re-send new insulin because the medicine would have gone bad. I was told it would be shipped Jan 4th because of the holiday. I never received the medication and now the company will not retroactively send out the medication as my insurance has changed. This is so wrong!!!!
Aetna is an unethical, non-responsive, non supportive medical insurance provider. Their customer support is just awful. Incorrect and inaccurate direction and different answers depending on what day you call or who you talk to. In addition it is rare that anyone at Aetna does what they say they are going to do or even call you back after promising to do so. Just terrible. I submitted for approval of a vein ablation procedure for both of my legs. Aetna approved the procedure for the leg that had less issues and refused to approve the worse leg. The provider tried and tried to communicate with Aetna with absolutely no success. I tried multiple times and just got frustrated and gave up. So I changed providers effective Jan 1st 2017 and resubmitted the exact same paperwork that Aetna had denied. And within ONE week the procedure was approved by new provider. Moral of the story... DON'T BUY AETNA insurance. It is just an AWFUL company!
I have Aetna insurance through my job at work and I had to go off of work at the beginning of December 2016 due to a medical condition. My first attempt to be put on short term disability was not successful. Not because I did anything wrong, but because the agent who I spoke to and whom I made sure to let her know this was for short term disability and not for FMLA *due to my knowledge of my business not approving FMLA until a year on the job* made sure to only put my claim through as FMLA. I got an online notice letting me know that my claim had been denied after 6 days. I diligently followed up and found out what happened, so my claim was already almost a week late in being started correctly. After this I have done nothing but jump through hoops, follow up and do literally everything I possibly can to make sure all information needed for Aetna for my claim was provided to them.
I've had nothing but issues with my claim manager being available. Literally I've had him call me, leave me a voicemail and I call back within a few minutes only to be told he's gone for the day. I have had to call them every single time I know that the doctor's office has sent something over, otherwise, I found out the hard way. They will wait 10 days before they even review my claim (again, only because I had called at that point). Finally, I have a follow up with a specialist this coming Friday in regards to my health and I had spoken (for the VERY first time) to my claims manager on last Friday and he let me know that at this time that they would wait for that doctors’ information before they would be able to continue with my claim, only to wake up and find that in the middle of the night they sent me a letter denying my claim altogether.
So, now not only am I facing horrible health issues that according to them does not hinder me from doing my job but they've now made it so now I have to appeal this. My doctor has taken me off work for a reason. I have done nothing but follow up with my doctor, be put on medications, go to specialty testing and now am seeing a specialist, yet none of this is clear enough for Aetna to substantiate my claim. They are a joke! And unfortunately for me, right now I'm the punch line. Thanks to their determination. Now lucky me gets to not only appeal this decision, but worry about how I'm going to pay the bills that I've been holding off on, while awaiting this decision from them. Can't eat from air or pay rent with no money, yet that isn't their concern. Glad, I'm fighting a health issue and now I get to fight the insurance company as well. Thanks Aetna... Thanks for helping deteriorate my mental health as I battle my physical health!
In August of 2016 my fiance had back surgery that was very necessary because of a disc pressing on his spinal cord. He had to get the hospital put in network because the doctor (which was in network) needed to use the robotics at a certain hospital. After doing just that and having the surgery, Aetna refused to pay the $91000.00 bill saying it wasn't in network. After the first appeal, Aetna then claimed it was experimental. There was nothing experimental about it. After the second appeal, Aetna now resorts back to the hospital not being in network (which had to be approved before the surgery). Aetna will do anything to avoid paying even after you pay your premiums for years. We should all get together and start a class action lawsuit against those crooks.
My doctor took me off of work. I provided Aetna with my doctor's information, location, fax, e-mail and phone number along with a medical authorization. After 30 days they denied my claim because they said they were not getting the medical records and told me to get them. I talked to my medical provider who said they sent everything Aetna asked for. When setting up an appointment to see my doctor it is done through the internet only allowing for a few letters so I was brief and stated my arm was sore and decided to talk in person about what was really bothering me. Aetna just saw, arm sore and denied my claim based on that, they never looked through the entire record and notes from my doctor. I have asked for copies of my file including all e-mails and still after 4 requests they do not even acknowledge receiving my request.
Coventry which is owned by Aetna is no longer offering healthcare coverage in Iowa so Aetna took over those plans and rates increased dramatically because of this so called company within a company swap. My experience with Coventry was good in 2016. It has been nothing short of a major disappointment since Aetna took over my health coverage. The customer service is awful and the login to access to your plan has been a nightmare to say the least. Tried using Walgreens for a generic 1mg prescription that cost $10 a in 2016 and my bill was $177.00 because Walgreens did not make Aetna's preferred provider list? This is very disturbing how much control Aetna has over filling a simple generic prescription. My advice to you is simple. Find another carrier if you live in Iowa. I am.
The worst experience I have ever had with an insurance company. For three days all I have gotten is the runaround from one department to the other in an effort to have anti-rejection medication filled. Depending on who you talk with at Aetna you are covered and then rejected. Do not use them for your insurance needs.
I had open heart surgery in August 2016. Since then it has been one fight after another to get paid from these people. Currently they are 3 weeks behind on my case again. My last pay was in December 2016. Still waiting. Do these people think that our bills don't exist. My paperwork gets lost, I have resorted to making my doctor send me all the confirmation letters that the documents were sent and received on certain dates. Oh and don't expect a callback from your case worker. I have left numerous messages and never received callbacks. Now my case worker not receiving messages at this time. That's what I got today when I tried to call her. I even went so far as to write a letter to the CEO of the company that just got some public relations person to call me but guess what? Nothing changed. Still waiting.
Aetna will make every effort to deny your claim by sending a letter saying that procedures are experimental. My wife got stuck with a 2400$ bill for genetic testing when she is pregnant because Aetna considers genetic testing as experimental. NEVER GO WITH AETNA.
Aetna is the worst for everything. I went to urgent care for my wife and they billed me for $612.80 for emergency charges and $12 for doctor which I was able to see in my claim list. Then I got a bill of $482 which I paid assuming that it is the adjusted amount of $612.80 (I may wrong in my assumption). After sometime I got a call from the hospital that you have the amount due to paid. I said I already paid, then they said "no that is from different department."
I said ok but whatever bill should come to me will come from Aetna and I should be able to see that in my claim list, which I was not able to see of the amount 482. Then I called Aetna and started having mail conversation then they said "no, you have to pay $612 + $12 + $ 482." I asked them why I am not able to see the claim of $482, the billed charged to me and they didn't answered me. They cheated me. So I will not recommend anyone for Aetna. Please be careful with them.
Joseph BurnsHealth Insurance Contributing Editor
An independent journalist, Joseph Burns is the health insurance topic leader for the Association of Health Care Journalists and contributes to AHCJ’s Covering Health blog. He has also written about health policy and the business of health care for a wide variety of publications, including Healthcare Finance News, Hospitals & Health Networks, Managed Care magazine, Ophthalmology Management, TaxACT.com, and The Dark Report.
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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