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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.
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.
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.
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!!!
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.
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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.
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.
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.
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.
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!
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.
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.
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.
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.
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...
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.
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.
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!
I had some tests done that my Primary Care Doctor has wanted done to determine the cause of my wheezing while exercising. Aetna paid the claim the first time, but then about 7 months later they charged it back to the provider, who then charged me for the services. For SIX MONTHS I went back and forth between the 2 companies trying to get the COVERED SERVICES PAID, after 6 months the provider threatened to send me to collections, so I had to pay it. What other choice did I have? I can't afford it, I can't have it on my credit, and this is I think how AETNA is making SO MUCH MONEY! THEY CHEAT PEOPLE by charging back covered services and then screw the people caught in the middle between the providers and the customer service reps who are all POWERLESS TO DO ANYTHING. DO NOT USE THIS COMPANY!
I deal with many insurance companies for a living. Aetna is absolutely the worst of the worst. Their modus operandi is deny & then give you the runaround. I would rate them a minus 10. Believe all the negative reviews, stay far away!!
My daughter was in a car accident in Feb, 2018. After going back and forth between the car insurance and Aetna (our health insurance), we were able to settle the 'policy covered' amount with the car insurance. We gave the 'exhaustion letter' to Aetna in the beginning of May. It's been almost 3 months and Aetna has yet to send all the EOB's (explanation of benefit) to the medical providers. The bills are piling up with the additional threat of being sent to collections. Spoke with Aetna multiple times, but keep on giving the runaround.
The agents are rude and not helpful; their answers are inconsistent with one exception. They always have 2 weeks to send the EOBs to the service providers. And this is the case when we received the EOBs around July 1. The trauma of child in a car accident and the surgery after that is something I would not wish on anyone. Even more than that, I would not wish anyone experience this super efficient, well-oiled machine. Not sure if it is just Aetna or is this a common response amongst the payer community in health care. But I get a sense that they think the way for them to avoid paying is to stall and outlast the average patient.
I have called 10 times today and the system recognizes me and I ask to speak with representative. I hold for about 5 minutes and it goes directly to my comments about the representative who just helped me. I never was connected to a rep. What's up???
I chose this supplement when I turned 65 as a supplement to Medicare. Beware of their PRESCRIPTION stipulations! At 65, they are tinkering with what medications are okay for me to take. Seriously? If I have a written prescription from my physician of 8 years, the insurance company should not require ME or MY PHYSICIAN to jump through hoops to follow their guidelines. I have a prescription that they will only fill for people age 18 and younger. Oh my GOD! If my physician is intelligent enough to know of a use for this medication at my age of 65, why in the world am I paying them $40 for something that was free on my insurance. BEFORE I thought I was so lucky to be on Medicare? I am paying more out of pocket per month than I pay for the Medicare deduction out of my social security check. This is absolutely outrageous and UNHEALTHY for the patient! I'm leaving them ASAP!!!
Don't even bother thinking you are covered by the short-term disability insurance. My doctor took me out of work for a month and Aetna is the worse. They requested the same documents 3 times! My doctor faxed documentation 3 times with fax confirmation proof. I've uploaded the same documents 3 times. When I called in, the customer service reps were so nice...as they did NOTHING to assist me. The last time I spoke to someone for 10 minutes, I finally asked if they were going to actually do anything and they told me I'd have to talk to my case manager.
I've left Audrian ** messages and have never once gotten a call back. I've submitted complaints via their website 3 times with no reply. After a month of getting the run around and lots of duplicate requests for documents, they flat out denied my claim and closed my case. They are such a huge company that does not care about any of their paying customers at all because we obviously don't have many choices. I will NEVER take this insurance in the future. I pay around $550/month for absolutely nothing. I was better off when I didn't pay for any insurance. America is screwed with healthcare and this is another reason why. I hated Kaiser, but would rather go with them next time.
I have had an extremely negative experience with Aetna. They do not care about the health of their customers at all. I filed claims with them 17 months ago that I still have not received reimbursement for, despite repeated phone calls. Because of this, I have to keep looking up my claims on two different websites, since they recently switched to a new system, which is extremely inconvenient. I have spent dozens of hours on the phone with them with few results. Every time I submit a claim, they tell me they need more and more information from me to process the claim, and then when I do provide that information, they tell me that they didn't receive it. They process my claims out of order and tell me that I haven't submitted claims that I definitely have.
Many claims I have submitted three or four times, at their request. Sometimes when they give me cheques, they don't tell me what the reimbursement is for, so I have to try to look it up on their website for my records, which is often difficult. They have trouble processing many of the prescriptions my doctor gives me. My pharmacy will call them to ask about the delay in processing the prescription, and Aetna tells them they will call me the next day, but they do not. Several times, I have had to give up on said prescriptions and simply ask my doctor to prescribe me a different medicine.
Their coverage is extremely limited, deductibles are ridiculously high, and their call wait times are very long. I have had to stay late at work multiple times because I had to wait so long on the phone trying to talk to them during my lunch break, and they inconveniently do not offer customer support before 9:00 a.m., after 5 p.m., or on the weekends. I cannot recommend steering clear of this company strongly enough.
Released my social security number to third party. Aetna contracts with Mirixia a company who profits from Medicare Part D patients. That company then contacts my pharmacy to have this 3rd party monitor my medications. Our social security numbers were stolen in 2014. Now CVS Pharmacy is buying Aetna & both have had massive data breaches. Customer service is a joke.
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.
As of today, June 18, Aetna has not been able to locate this form. The address to which it was sent was correct; it is a P.O. Box, and evidently there is no person to answer a telephone at that location. After sending this form a second time, it has still not been located, and in ten days time, mother's health insurance will again lapse. I have been told by 4 different Aetna customer service representatives that no other form of transmission is acceptable for this form - neither fax nor as an email attachment.
Today, after threatening to involve either my attorney or my congressman, I was finally transferred to a kind supervisor at Aetna. He readily suggested that I fax the form. This has been done. I had asked to be allowed to fax that form multiple times. Why did it take threatening action to agree to a fax transmission? Aetna is irresponsible in the way it trains and manages its customer service staff. Its callous disregard for its good customers, allowing their healthcare policies to lapse through their own inept document handling must change.
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.
They were sent directly to the pharmacy during my office visit. Before I could get out of the parking lot, the pharmacy called to let me know Aetna would not approve my inhaler or my new medicine. I called Aetna and was told that my inhaler was a Tier 4 and would cost me $100 or I could change to a lower Tier medicine. I got the names of those and went back into the doctor's office to ask to change to one of those. For my new medication, Aetna did not have an alternate. Aetna does pay for any medicine for this condition I have. I am changing as soon as I can. This insurance does not appear to care about their clients.
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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