About Aetna Health Insurance
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I have Aetna Max Choice Gold with a high deductible. The good thing is that Aetna is accepted most places. But all prescriptions and non-preventive office visits are subject to deductible which means you pay the whole contracted price of the prescription or visit instead of a copay or %. Another downside is that they seem a little disorganized on the back end at times. Overall decent insurance if you have the $ to pay your deductible.
I’m not sure if I’m doing the right thing by paying for Aetna with my Medicare coverage. From my teaching pension, I was getting BCBSM, and I see a big difference in the amount of copays, but I don’t know whether or not it’s worth it. I do have a lot of health issues which stemmed from breast implants, but I had them removed, and still have some issues leftover.
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The coverage has been decent. Customer service is another story. They don't know what they are talking about. I called in to find out the price of a drug that was not a formulary drug. I was quoted a price and as a result decided to use GoodRX. When I went to pick up the drug at the pharmacy the pharmacist informed me that my insurance price actually was cheaper than GoodRX. That was not what I had been told, this price was about $40 cheaper than what I was quoted. My opinion on this is quite simple. If you are the person on the phone quoting drug prices for a particular insurance plan GET YOUR INFORMATION RIGHT!!! Some of us out here are counting on that information. I was NOT HAPPY with my experience.
I have been with Aetna Complete Care for over a year. It has saved my life and has kept me out of assisted living so I can live at home. With this plan I have home delivered meals, a home health nurse and aid. The plan also includes a care manager with Aetna that helps me with anything I need. I suffered 3 mini strokes in the past 5 years and had a right knee replacement back in February of this year. I was able to get in home therapy at home instead of going to the nursing facility. I am very happy with the services Aetna has and is providing me with my long term care.
Aetna has a lot of pros & cons. They have a dental plan that pays back up to $1700, reimbursement for dentist. The specialist fee was only $20, with no copay for seeing your PCP. I didn’t like paying $200 for a MRI, but I needed it. Next year it’s supposed to be no charge a MRI. They also pay up to $100 for eyeglasses, and you have the option to join a gym and take advantage of the Silver Sneakers program. Not sure if I will keep them for next year, I need to see what’s being offered.
I have Aetna QCHP through my wife. For some unknown reason, they terminated my health insurance coverage in February, 2021. It is supposed to run through the end of June 2021. The State of IL tells them I should be insured, but Aetna continues to say I am not insured. I have been on the phone with Aetna, the State of IL Benefits, three times and all three times I have been assured the matter is resolved. After more than 3 weeks it is not resolved. This is very expensive insurance. I would give Aetna a zero out of ten rating. If I was grading Aetna, I would give them an F- or a lower grade if there is one.
Run from this insurance company. They are truly not forthcoming with their reimbursements!! I always thought reasonable and customary prices are the same across the board. Nope!!!! Aetna hires a third party called IData that decides what is reasonable and customary. Their reimbursements for out of network is absolutely the worst!
In network is no better. My gyn took a culture to check for infection. She used Quest, an in network lab. Quest billed $925.19 for the Sure Swab culture, the plan discount was $128.09, Aetna paid $24.47 and my total cost was $758.08!!!! When I questioned Aetna their response was they do not cover investigational tests!!!! Well isn't every test investigational to find out what your problem is?!!! Aetna told me I should have asked my gyn for the CPT codes and that I should have called Aetna to see if I was covered before she did the test. Hello!!! Isn't that ridiculous? While I'm in stir ups I'm suppose to say wait, give me the CPT codes first.
Don't even get me started on prescriptions. My GI dr prescribed **. CVS (affiliated with Aetna) only will give you 90 pills a year and I'm waiting 3 months for an authorization. So I buy over the counter ** and double the dose. Aetna will not give you any information ahead of signing on with them and even when you do you will not know how much they will reimburse until after you have submitted a claim. Run from this insurance company. I cannot wait until this year is over and I can switch companies!!!
I have now come to realize that Aetna is an evil company. I started a new job and had to change my health insurance. I picked Aetna, knowing nothing about them. I didn't realize that was a mistake until six months into the job. Suddenly, they stopped refilling one of my prescriptions. I called. They told me that Aetna had suddenly decided to stop paying for prescriptions at any pharmacy in the entire country - except for CVS. (I did not know when I picked Aetna that they were owned by CVS). I was spitting mad. It was a mild inconvenience for me - but the principle of the thing is outrageous. They are unfairly, illegitimately restricting healthcare access. They are doing it in a self-serving, monopolistic way, driving people to use their own pharmacy in order to increase profits at patients' expense. That has me spitting mad.
But wait, there's more. So I tried to move my prescriptions over to CVS. I called my Doctor's office and asked them to send in the prescriptions to have CVS mail order them to me. Days passed and nothing happened. I tried to use the CVS website to transfer the prescriptions from my previous pharmacy. I received some vague failure message. I can't even access the part of the website where I manage my prescriptions - the first or second time I tried to access that, it told me I had tried "too many times" and would be locked out for 24 hours. I've tried a few other days since then and immediately get that result. **
The third time I had my doctor's office send in the prescription I received an automated call telling me they were working on filling it. Hours later, I went in to pick it up. Then the pharmacy clerk told me that they could not fill my daily prescription. The one I had been taking for years. Aetna decided that my daily, long-term prescription was now "90/365" - you can get a three-month supply of this daily medication... ONCE PER YEAR. This is a pretty common daily medication, mind you, and my previous health insurance company had no problem with it. I called Aetna again and they said special paperwork needs to be send to the doctor's office to get them to approve the prescription they already sent in, in order to allow it to be filled more than once a year. This is madness. If you have a choice, avoid Aetna at all costs!
I’ve had Aetna Better Health of LA for over a year and have never actually got to speak with a human being. I have called every number I can find. They have an absolutely useless recording at the number they give out. The recording will tell you that you DONT need a referral -which is a lie because all health care practitioners tell me Aetna Better health absolutely requires a referral. There’s NO LIST of approved doctors either. You just have to call every doctor In a hundred mile radius and ask if they will take ABH. ABH will not email. They have an obnoxious portal that takes days for a generic useless response from an answering service that will definitely be inaccurate.
As soon as my profession recovers from the pandemic I will find insurance that is NOT AETNA. EVEN IF I HAVE TO PAY MORE it would be worth it to have access to information, communication, and a decent website. The website is a nightmare. There’s no LOG IN button. You have to click a tiny “register online” link to get to the login. Even if you have been registered for years. Why mislabel that? It’s like they are being deliberately obnoxious or cumbersome to thwart users. But really logging in won’t help because there’s information there. Good luck finding an approved RX list. They demand you use that list but bury it ten links deep in teeny font in a sentence about something unrelated.
So the phone number is useless, the website is useless, the only communication you will get with these people is paper mail letters telling you that your medicine/ procedure / doctor is not approved. Which could be avoided If they would provide an accessible list of anything they do approve or allow human telephone communication. I’m assuming there isn’t a list because every single thing, even old common drugs, have needed “prior authorization” which is just a way to undermine doctors and make you suffer while you wait for a drug that’s literally ten dollars at any pharmacy if you don’t use Insurance.
Honestly I pay out of pocket for most healthcare because this covers nothing I need and I can’t find what they cover. I needed bloodwork and was on the phone and website for two hours- found nothing useful. No idea what labs ABH covers. I talked to Aetna (not Better Health) but they kept transferring me to ABH’s useless recording. I finally just went to the nearest Quest and figured I’d pay for it myself. The funny thing is that awful useless dystopian recording at (855) 242-0802 is always preceded by the line “we are here to help.” No. No one is there.
In January 2020 I switched from Aetna to another carrier. Aetna didn't cancel my coverage as requested and continued deducting over $300 a month for premium. I thought this was my wife's insurance premium so it was paid. This year we both went to a zero premium Medicare supplement. When we were still billed the $300+ premium in January 2021 Aetna was contacted. They owed us over $4000.00 for premiums we paid in 2020. For 3 months we have had to constantly fight with Aetna to get our money even though they admit it is owed to us. Aetna keeps promising payments were mailed but they never come. They are either unbelievably incompetent or unethical. Either way, we will never choose Aetna insurance again!
We have threatened legal action against them but all we received was another promised payment that hasn't arrived as of today. Anyone who has an Aetna Medicare supplement better be absolutely sure when you change coverage plans that Aetna actually cancels you or you will go through the same 3 month long nightmare we are experiencing.
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.
Aetna Health Insurance Company Information
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