Aetna Health Insurance

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.

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.

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.

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 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.

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.

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.

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.

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!

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.

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.