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Aetna Health Insurance
Aetna Health Insurance
Overall Satisfaction Rating
1.21/5
  • 5 stars
    4
  • 4 stars
    3
  • 3 stars
    6
  • 2 stars
    3
  • 1 stars
    99
Based on 115 ratings submitted in the last year
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Aetna Health Insurance

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831 Aetna Health Insurance Consumer Reviews and Complaints

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Page 1 Reviews 1 - 30
Rated with 1 star
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Verified Reviewer
Original review: Dec. 10, 2018

The cost is roughly $240.00 monthly, however I pay a whopping $85.00 co-pay at Doctors for visit. A person without insurance pays $90.00. How is it better? The deductible is $6000,00. dollars. Is difficult to find specialty area doctors to take this insurance.

2 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Dec. 6, 2018

Where do I start... 11/15 I had a bad car accident that caused me to have bulging disc. I've sent police report, MRI bill, etc 3x! It just a never ending vicious circle of ignorance. First they never got the paperwork. Then they didn't get all of them. Then I sent it a 3rd time and the paperwork was too dark on the copies. Well turn the contrast down on the printer technology savvy people! I have an accident, not at fault and clearly the police report says it. So now the paperwork will be "escalated to processing department". You get insurance to be secure when life happens. They probably should hire retired people that have lived life and can understand doing one thing fully at a time and life does stop because of unforeseen events happen.

2 people found this review helpful
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Rated with 1 star
Verified Reviewer
Original review: Dec. 5, 2018

So, I found out why I was charged twice in the same month. They didn’t tell me that they bill a month in advance. It was November on the 5th and December on the 23rd. I would have never agreed to that. Because of that I lost half of my social security for November. (Bank let it go though not their fault/I didn’t have the money so the charges and overdraft fees cost me dearly.) I tried calling Aetna last Friday but couldn’t get through. Also tried on Monday. I spoke with another Medicare supplemental insurance company and found out you can cancel the supplemental insurance plan anytime (I’m working on doing that now) during the year. An Advantage plan only yearly at open enrollment time. I hope that I helped someone with this information.

5 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Dec. 4, 2018

My wife and I signed up in 2017 initially for the Aetna Medicare advantage hmo. We wanted to be sure that our primary care physician of 25 years was in the plan. However, after receiving our Aetna ID cards, we noticed a different doctors name. When we called Aetna, we were told that while our doctor was in their network, he was only categorized as a gastroenterologist specialist and could not be our primary care physician. We then were forced to switch our Aetna HMO plan to a PPO plan, as we were already into 2017 and past the Medicare cut off date. Aetna after reviewing our complaint regarding the misinformation we were given about our primary care physician, agreed to switch our plan to a PPO. The cost of the PPO plan was to be approximately $75 per month for each of us.

After several months we began to notice that the $75 premium was not being deducted from our Social Security deposits. We called Aetna 3 times to resolve this issue and were told that the deduction was being taken. We then made multiple calls to Social Security and were also assured that the premium was being deducted. We knew that both Aetna and Social Security were wrong, but after several attempts to correct this problem, we gave up. To add to our frustration, even though we were now covered under the Aetna PPO plan, our doctor was still being considered a specialist and not a primary care physician. Several attempts by us and our doctor to get Aetna to correct this issue were unsuccessful.

Fast forward to June 2018, and now Aetna wakes up and determines that, yes, we were not being billed the $75 per month and we were to now pay for the premiums for all of 2017, January to June 2018, and they would finally begin to deduct the payment beginning in October 2018. Aetna even sent us a payment book to begin the back payments. So the bottom line is, we never did get the PPO coverage we requested because our doctor still was not being recognized as a primary care physician, and we have pay about $2,000 in PPO payments. Needless to say, beginning in 2019, Aetna will not be our health care insurance provider. We will also be taking legal action to deny Aetna the PPO payments.

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4 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Nov. 21, 2018

Aetna/MHBP no longer allows a wife or any dependent to receive their personal information or monies from their insurance company. ALL information regarding dependent's PERSONAL information is mailed directly to the primary holder on the insurance. Aetna has not yet figured out that women have achieved equality in most avenues of life, and at the very least, able to handle their own health details. Discrimination.

10 people found this review helpful
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Rated with 2 stars
Verified Reviewer
Original review: Nov. 20, 2018

Updated on 12/01/2018: So as I wrote previously I’m being charged for both Medicare supplemental insurance plan and Medicare Advantage plan. On the 5th of November 2018, I was charged 240.74 for my supplemental and 20.00 processing fee For supplemental insurance, I have life insurance also 36.00 taken out. I went to pick up my pharmacy prescriptions November 29th and my bank card was declined (I’m on social security/disability). I was confused so when I got home I went to my banking site to find out why my card was declined. Aetna had taken out another 240.74 and 36.00 life insurance on November 23rd.

I’m so angry right now, I can’t see straight. They took money out twice. I’ve tried calling. Was on hold so long I hung up. I need help?? These people have screwed me over so bad. I just want disenroll altogether and start over and find another company to go with. I thought I was doing the right things trying to make sure I was covered. It’s now a nightmare. I’m new to Medicare so I’m not as smart as I thought I was. I relied on them knowing what they were doing. I don’t turn 65 until next year. Help Me!!

Original Review: I spoke with a person and signed up for the Medicare Advantage plan. I immediately started looking for the doctors I needed, I wasn’t able to find a doctor who could give me the medical attention that I needed. I called Aetna and explained the problem, and told them a supplemental plan would best fit my needs. I could keep my doctors I have, I explained I had signed up for the advantage plan and wanted to cancel it. I was told, "Sure. We can do that. I’ll transfer you to that department," so I signed up for the supplemental insurance plan. When it was all set up I was transferred to the department that could cancel the advantage PPO.

Talked to a woman who told over the phone it was no problem to do, she told me, "You’re all set. The PPO plan is cancelled." I said, "Good. So now all I have is the Supplemental insurance plan so I can keep my doctors", "Yes. The advantage plan is cancelled." "Good. I feel so much better." (Keep in mind the phone calls are recorded.) Now it’s November. I have found out I’m signed up and being charged for both plans the Supplemental insurance plan and the Advantage insurance plan so I call Aetna to find out what’s going on. Why am I on both plans? Advantage started in October 2018. The Supplemental plan started November 2018. I’m told I have to submit in writing to cancel the Advantage plan. I say I’m being charged for both.

I say I spoke with someone who told me over the phone they cancelled the Advantage plan. Suddenly no one knows what I’m talking about. I say you tape the conversations. Pull the tapes. I was told the Advantage plan was cancelled. I’m told I have to fill out a form and mail it in to cancel the Advantage plan. I spoke with a different Medicare company who does the same thing help find Medicare plans they told me and I quote. It is illegal to be signed up for both the Medicare Advantage insurance plan and the Medicare Supplemental insurance plan and the last plan I signed up for was the one that is the valid plan.

I’ve called Aetna. Now I’m waiting for them to send me a form to fill out to cancel the Medicare Advantage plan. I have both plans in front of me. What a headache I didn’t understand the difference between the plans. Now I’m stressed out about what’s happening and feeling very sad that no one over there gets what I’m going through. I’m writing this to help anyone who is reaching the time to start looking for a plan that will work best for you. I wish I had understood, that 20% that we have to pay had me worried I wanted to protect myself. And this is what happened.

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12 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Nov. 15, 2018

I am a licensed psychologist who is appalled at what can only be described as Aetna's relentless effort to find obscure reasons to kick me off the panel, in effect ending treatment for my patients who need it. For some, it is literally a matter of life and death. On two occasions now I have receive an EOB in the mail letting me know that I am no longer in network and that all of the recent claims I submitted were denied. This leaves the patient who is already in extreme distress in the difficult position of having to fight with Aetna to have the claims reimbursed. Almost always Aetna is unwilling to reimburse and the client ends up not only needing to pay but also hesitant to continue treatment.

The reasons I have been kicked off out of the blue include minor non-compliance issue and nonsensical red tape. For example, the last time I was kicked off because I didn't reply in time to the constant prompts they send to providers to update their practice info. I get that you want my updated info but it seems unreasonable to gamble with a person's life to get it. The worst part? I don't think Aetna cares one bit.

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17 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Nov. 14, 2018

Newly diagnosed adult type 1 diabetic. I didn't have years to prevent or a diet to change because it was developed as part of failing thyroid disease. I don't understand how Aetna could continue to deny and delay approving life threatening need for insulin. I don't have a thyroid and produce no insulin. While Aetna is waiting on paperwork pushing 90 days prescription, I could go into diabetic shock. I'm very upset with the politics of also telling us which drug to use when some generic brands have failed me for years. I want someone to understand that I'm just trying to live longer than 45 years old.

16 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Nov. 13, 2018

Customer service is horrible. They don’t know why they didn’t cover my bill. They have to figure out and explain why they didn’t cover it, but they just said “I don’t know why”. I and my husband had the exact same insurance but they only covered my husband’s bill. They didn’t cover mine at all for the same dental office with the same insurance coverage.

17 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Nov. 10, 2018

I tried to enroll in a part D two months prior to the end of my employer insurance and all seemed well until I got a letter saying I had lied on the application and was terminated. It had no appeal number. I called to find that who had lied was Aetna, changing my start date to Jan 1 and opening up an uninsured period which made me ineligible. I applied again and got NO notice by the specified date (now < 4 weeks prior to the due date). Navigating to the right office proved impossible as no appropriate using Aetna's phone system. I was eventually shunted from one agent to another until I asked to speak to a supervisor on the evening of 11/8/2018.

This woman provided undoubtedly the worst commercial interaction I have ever experienced in 70 years of dealing with snotty, ineffectual and vicious personalities. Firstly, she refused to answer my question... It was not all that difficult... "Can you not hear me?" After waiting for almost a minute the supervisor admitted she could hear me. However when I started to speak so did she. When I stopped so did she, never providing any information or even acknowledgment of my problem. When I restarted so did she. This went on for several minutes until she announced that since I was not allowing her to help me she was going to hang up. This woman needs to be fired immediately and find a new occupation in Psychological Warfare Division of the Venezuelan Army or as one more lying cheating politician.

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16 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Nov. 6, 2018

Front line telephone service calls are answered by people for whom English is a second language. They also don't know anything. I used one of the providers they recommended by phone only to have Aetna later deny payment to that provider. Not only is their information incorrect, their back office is so slow that you can't count on their approval in reasonable time. I've had to reschedule appts because they don't respond to physicians either. I got better drug prices using a discount coupon from GoodRx online-- so much for Aetna's Rx insurance. I also bought medical supplies over the 'net at full price plus shipping cheaper than the 20% co-pay Aetna wanted me to pay. So, unless you want glacially slow response with information you can't trust and prices you can't afford, don't pick Aetna Medicare.

18 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Nov. 2, 2018

I had to pay $1800 freaking dollars because they wouldn't grant me a one day extension to submit my student health insurance waiver. My father was transitioning to a new job so his new insurance plan kicked in one day after the waiver deadline and they told me I still had to pay the FULL AMOUNT even though I'll never have to use it at all. These people have no compassion and do not care about you at all. How unfair is it to ask someone to pay $1800 for absolutely 0 service. This company and its employees are a joke. Please no one buy insurance from them and let these absolute low-life rot in hell. They are literally stealing money from people with their so called strict guidelines. Go rot in hell you scumbags.

28 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Oct. 13, 2018

We pay 14,000 in premiums, best plan we could get was with a 6,000 deductible. that's 20,000 out the door before one thing is covered. AND they don't approve tests that are needed - never once have we had tests approved. Our doctor is always fighting with them for tests he orders. Twice for broken elbows, once for chest issue that needed an MRI, once for a dislocated shoulder etc. etc. All tests that we had to pay for out of pocket EVEN if they had approved them - still hadn't met our deductible!! Will NOT renew - We've had enough of this company.

31 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Oct. 11, 2018

I have recently needed to help three family members get through cancer. At the same time, my spouse of 44 years abanded me. To say the least, things have been overwhelming. While trying to arrange for some STD and FMLA leave, I was put in contact with Aetna Insurance. The level of customer service I have received from Aetna borders on being criminal. While they seem attentive and focused while I am personally speaking to their reps on the phone, their apparent lack of internal communications has frustrated me beyond any polite words.

Extremely long times on hold; when I call back to their number that I was given, I'm put in contact with different reps who seem totally unable to help me, even after I provide my full name, SS#, address, existing claim #, etc. ad nauseam. And, I cannot even begin to understand some of their reps; poor grammar, poor phone skills and so much more. I keep being asked to provide info I have provided before, and still no progress.

Was told, twice, that claims documents would be mailed to my home; nothing. When I called to find out why, more mass confusion and the same, same, same requests for the same info, etc. Yes, I'm frustrated. Aetna should be ashamed of how they treat customers who are in need of help. I see on this website nothing, not even one single positive review for them. Mostly one star, many customers asking to rate their service with a 0. I would go past that, rating Aetna with a -- star. It is that bad.

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23 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Oct. 11, 2018

We have had this insurance for 3 years since living the majority of the year in the Turks and Caicos Islands. We are residents of the US and pay extra for access to US providers since care is limited on the island. The first year they covered routine care and a emergency service. Starting the second year they have denied and not paid for one routine visit, emergency treatment, etc. We have tried for 18 months to figure out why and have spoken endlessly with their account reps with no action. We are changing providers this year since thank goodness we have not had any major health issues but feel absolutely uninsured.

20 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Oct. 10, 2018

I’ve found that using Medicare Part D through Aetna is a total rip off. Every prescription that I’ve had written was TRIPLE the cost using Aetna insurance than using either Walmart Pharmacy or Good RX which is not insurance. I’m paying 170.00 a month for Medicare and Aetna and they sent me a bill for 121.60 for one RX while The Good RX app cost was 33.00!!! They must think medicare recipients are stupid... We are NOT and what Aetna does is downright criminal!!!

30 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Oct. 3, 2018

I'm a health care professional and I've been suffering from back problems for over a year plus. I've been through PT, MRI's, injections, and now all I have left is surgery. I have seen a surgeon and they wanted to do a procedure that would help relieve my back pain. Aetna has denied my procedure twice. I have appealed and lost. My doctors have said that surgery is my only option at this point. However it's clear that my doctor's assessments mean nothing when it comes to Aetna. I don't want to be on painkillers for the rest of my life but this is what Aetna is condemning me too. If you have a choice when it comes to choosing your insurance company, NEVER choose Aetna.

30 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Sept. 28, 2018

Pt. gets Medicare Advantage Plan through Aetna. If Pt has dual MedCare and Medicaid plan and Pt filled his deductible this year with Medicare/MedAid it will not be valid for Aetna. With new insurance for Pt.- Dr. will be victim of cut payments and not be paid second time in the year normal fee for services he rendered - fee they signed to be paid for, with Medicare. Aetna got idea how to use all those murky, uncharted waters in their advantage - to count it as deductible again, in same year, even if Patient filed his deductible for this year and, Dr. already got paid at Medicaid rates that are MUCH LOWER THAN 80% of what is agreed amount that Dr. should be paid by Medicare. So Drs will eat up loss and Aetna will gain - it's not called for nothing ADVANTAGE - I doubt that Medicare had that in mind when they offered those insurances chance to serve as their contractors - not to take advantage of Drs and patients any way they can.

14 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Sept. 28, 2018

Aetna approved an MRI for my back. They directed me to a provider that I must use in their network. The cost for the MRI: As an AETNA member: $425. With no insurance: $275. As an AETNA member, I'm essentially paying 50% more for the same service. You would think that AETNA would negotiate better rates for its members? I've had 5 different service calls with AETNA customer support. Each time they blame it on the "contract rate", even though it's their team that has negotiated the rate. AETNA is horrible. They're making me spend more money to get the same service if I never had their health insurance.

25 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Sept. 28, 2018

Only selected one because I HAD to. So a few years back our school district decided to switch to Aetna Health Insurance. BIG MISTAKE. My husband and I (previously) work for the same district. During the first year of paying for Aetna health my husband experienced a back injury that caused a herniated disc. After going through the necessary 6+ weeks of physical therapy his doctor decided he would benefit from an epidermal steroid to help the progression of healing. They never approved it after we tried and the doctors repeatedly tried. So we finally came to a point that we gave up on ever hearing anything.

Fast forward to this last year... My husband became extremely ill and then from the severe coughing did something horrific to his neck. He had apparently slipped a disk and was in so much pain we went to the ER twice prior to seeing his orthopedic doctor just so he could survive the pain. When seeing his orthopedic doctor they immediately ordered an MRI as he was losing feeling in his arm and was unable to walk hardly. They put him on pain pills after pain pills (** crisis anyone?) and hoped we would hear from the insurance company... Well of course they denied it... and denied it... a total of 3 times. Even at the presence of the doctors request. We tried calling ourselves and speaking with the company representatives only to get no answers and only to be connected to someone else who connected us to someone else and so on. The doctor even called himself to speak about the pre-authorization and why the MRI was so needed.

My husband is an artist and a teacher at that... His hands and ability to use them is our livelihood. We waited weeks, months, did everything they asked... and finally just like before, we gave up. He STILL struggles... If he ever loses function of that side of his body and arm... it will be a terrible day. They are a scam company and I don’t trust them at all. All I’ve ever heard from friend doctors and nurses is that they (Aetna) are the worst insurance company to deal with. Completely agreed... Take your money ELSEWHERE! For your own sake! Shame, they know EXACTLY what they are doing and what they AREN’T doing for their customers that pay GROSSLY for their “benefits”. Pffft.

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23 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Sept. 17, 2018

Prior to my doctor appointment, I called to verify if my visit would to fully covered. They assured me yes, it will be 100% covered. However, they billed me afterward. I called again and they said that how the hospital billed them so I have to call the doctor. Worst experience ever!! Customer service is also very impolite and unprofessional.

20 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Sept. 12, 2018

I had a medical claim on February 3, 2018 which was filed with Aetna in May. It is now September and they claim they have no paperwork which three telephone calls they did have the information. Now they tell me you cannot email a claim in but must have a claim form which nobody ever told me I needed. They went from inefficiency to outright lying when I have talked to the claim department. If you do not have to get Medicare from Aetna - don't!

18 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Sept. 9, 2018

Aetna's state employee health plan has zero out of network coverage. None. Unless inside a tiny network area - for us Oklahoma City only - you will pay full costs EVEN IF DR. HOSPITAL, or URGENT CARE says they take your insurance and processes your card. Aetna won't pay anything and you will get the full bill. When 90 miles out of town camping or on an out of state trip with an emergency they have denied all our claims and multiple appeals AFTER hours on the phone saying we were in fact covered. DocFind is not reliable at all. We've been denied several providers that listed as covered in network. Higher premiums than other options; terrible service.

15 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Sept. 7, 2018

It is a confused and deceptive health plan, badly organized and horrible, this plan has made me sick of so much stress, if you are reading this, I recommend that you do not pay a penny to Aetna because it is losing money.

27 people found this review helpful
Rated with 2 stars
Verified Reviewer
Original review: Sept. 7, 2018

Whether I get hung up on or transferred from place to place over and over again, I have the same provider relations difficulties time and time again. It is utterly the most exhausting time in my life trying to get things solved with Aetna. As a provider I have still not been able to submit several claims from 3 months ago. I call to get directions and no one sees a single note under my file from any of the previous CS agents. It's like starting over every single time. Today the person transferred me somewhere and instead hung up on me. I cannot understand anyone through their accent. Not being insulting, it's just the truth. I can only deal with this a bit longer.

22 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Aug. 30, 2018

This company is poorly organized. Physician offices go in and out of network at random, they claim. I have had 3 separate dr offices, including my son's pediatrician go out of network unknown to the dr office. They paid out for the whole year of 2017 to this office, and then told me 3/2018 that the office was out of network since 1/2017.

Last month (7/2018) I received an explanation of benefits showing how Aetna reversed the entire year of payments, and that patient responsibility was over $5000! It's been 3 weeks, I still have no answer as to why this is my problem. Their website is not accurate with the dr offices who are in network. I spoke to the Care Coordinator, and she said, "Even if a Care Coordinator tells you that a dr is in network, the list they are looking at may not be up-to-date." They take no responsibility for their lack of organization. I pay over $400/month for this insurance for my son and I, and I am baffled at how much this company has cost me with false out-of-network claims that take MONTHS to resolve.

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23 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Aug. 29, 2018

WHAT A WASTE OF MONEY/PREMIUM COSTS! You proportionately have insurance, but it just does not pay the providers so more costs back to the consumer,

Meritain Health cant explain their payment reasoning to the consumer. The adjudication takes months to settle a claim, and then it's really not settled to the benefit of the patient. Being a TPA allows these bandits to skirt all clean claim laws in the state I live in. Out of network consideration is below area averages and then the cost is thrust on the patient/consumer.

Their website lists providers that are not par/in-network. I was told that the provider must tell Meritain they are not par to be removed. Yet another brilliant statement...chicken or the egg. So, they indiscriminately list doctors as in network and even if they were contracted at one time cant modify their website to reflect who is and is not par... Meritain Health denies claims but is a TPA owned by Aetna...fox in the hen house. Yet another reason why nationalizing healthcare is a good idea since free market won't work based on the way these guys do business...

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15 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Aug. 28, 2018

I was diagnosed with DCIS. This year had surgery 7/19/2018. They didn’t cut me a check until July 25. I was off work since 6/25/2018 prepping for the surgery. Had to take 2 EKG before I qualify for surgery with heart issues and they denied my claim August 19. One month after my surgery and my body haven’t heal enough to even start radiation they claim they need more notes from my doctor when they clearly fill out all forms about my condition. I guess cancer go always after surgery. To them no more treatment is necessary!! This have kept me from healing as fast as I could. I believe because they have stress me out more than the cancer.

I’m seeking help from an attorney because I can’t keep my blood pressure under control. At this rate they are a terrible insurance company to deal with when you have been told you have to fight Cancer, I went to MD Anderson Cancer Clinic in Houston, TX. I live in Dallas, TX. They are the best in the world. They gave me a fighting chance and Aetna is fighting me every step of the way, case managers Nikki **, Ginger **, Michael ** these guys will not return your call. If one of them decides to it’s after your claim have been closed. It’s all a stalled tactic. They don’t care about the clients. They need to be taught a lesson.

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21 people found this review helpful
Rated with 1 star
Verified Reviewer
Original review: Aug. 17, 2018

I wish there was an option to give them negative 500 stars. Aetna has been an absolute nightmare to deal with. Never in my life have I had problems with a health insurance company until I went on Aetna. I have a few autoimmune diseases and treatment includes monthly infusions. My previous insurance, Medica, (which is wonderful and I highly recommend them) covered it with no problems. Aetna refuses to cover it, says it's not medically necessary, yet these infusions basically keep me alive. Aetna would rather pay for me to be hospitalized on a monthly basis and receive the infusions there than pay for them on an outpatient basis. Where is the logic in that? My provider's office forgot to call for a preauthorization and I got charged several thousand dollars for a service. My policy states that if the provider doesn't call for the preauth, I do not have to pay.

Aetna is arguing that the service was "exploratory and investigational" and won't cover it, even though the provider's office forgot to get the preauth (which if they had called, we would have been informed it wouldn't be covered for those reasons and been able to try to figure out other options). When my specialists order tests Aetna won't approve them. Aetna denies prescriptions that I need to treat my autoimmune diseases. They find any excuse they can to not pay for services.

Also, they deny claims for pretty much whatever reason they want and no one gives you a straight answer when you call customer service. I constantly get the run around and no one gives me the same information. I rarely get a customer service representative who is helpful. No one will ever direct me to someone higher up who can actually help me. This company is a complete joke (horror story is probably a better description). I cannot wait to switch insurance companies. Aetna is HORRIBLE. They screw their customers over and would rather perpetuate problems than try to help alleviate them. Avoid this company at all costs.

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22 people found this review helpful
Rated with 1 star
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Verified Reviewer
Original review: Aug. 14, 2018

I rarely go to the doctor, but anytime I have if my doctor prescribes me medication that I NEED, tests to be ran, procedures, whatever the case may be... I am denied EVERY. SINGLE. TIME. By Aetna insurance. I have shingles currently, I was denied antivirals today. I had bursitis on my right knee that grew to unusually large grapefruit sized lump, I mean it was huge. I had to carry this around, sometimes waking in excruciating pain because they kept denying for just the MRI to be done, which per their guidelines is required before the surgery.

A year later. After many peer to peer calls between my ortho doc & the medical director with Aetna, many appeal letters including pictures of my knee sent to the appeal board (for the medical director to review), prior authorizations, written requests, & phone calls begging... finally was approved. Then was denied for surgery twice before being approved almost 2 months following the long waited MRI approval.

I battle & struggle daily with endometriosis, but they will not approve for a scope to be done, which is required before surgery! The list goes on, medications, doctor visits. It is beyond ridiculous, unsafe, unethical, & morally wrong! If my doctor states the diagnosis, the medication or following procedure should go hand in hand to treat the diagnosis. I have been diagnosed, meaning by a doctor I have this or that, and the insurance company doesn't believe I need treatment or the medicine to become healthy again?!? If you are sick or in pain, the last thing you want to do is fight for treatment!!!

I should not have to wait weeks, months, years sometimes before receiving treatment! I do understand some situations in which a medical director sitting at a desk all day would or could trump what a trained doctor or nurse practitioner has stated, but this would be rare! Never go with this company! They are under investigation in California for a similar situation to mine. Research them! They are horrible. In essence, killing people. These medical directors are concerned with their financial gain or loss, not anyone's health!

I love the denial, "it is not medically necessary", get this one a lot. So, it isn't medically necessary to go to the ER when I have a 6 inch piece of glass through my hand... they stated, the above about not medically necessary, & could had waited til the next day & see a family physician. So I call my family physician after receiving this denial of payment letter, who tells me, "I would had sent you to the ER, and if you waited as long as they stated you should had, you would risk infection, unable to close up after so many hours, & that no facility in our local area in a 50 mile distance would even do it considering they do not do stitches, only at the ER (in my particular area!), & not to mention the glass sticking out of your hand both sides, all the way through would have been a little painful & in the way!"

I am in awe how much I have to dread going to the doctor for my HEALTH in FEAR that what I needed wont "suite" the Aetna medical director, how much I have to fight for what I need, & how many times they can deny a claim (small-big) that directly affects my health & life, sometimes it has been life or death! Shingles equals antivirals. Infection equals antibiotics. I have been denied every time. No joke. No exaggeration. The picture below of my knee is half of what it became before I finally was able to have surgery!

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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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Joseph Burns Health 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 Health Insurance Company Information

Company Name:
Aetna
Website:
www.aetna.com
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