Aetna Health Insurance
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Aetna Health Insurance Reviews
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Aetna decided to part ways with UCLA in February 2023. I can't help but think they were being malicious & deceptive in their choice of timing to break the news to their patients, as they were told only a month after the window of time patients were allowed to choose another health insurance provider. I've been having sleep problems since October of last year and need to get a sleep study done. My old PCP decided to leave UCLA around the same time, and Aetna wants me to get approval from the new PCP, who won't be in office until May 2023, IF AETNA DECIDES TO STAY WITH UCLA. Aetna is a joke of a company that only cares about profit and not the health & well-being of human beings. What a bunch of liars and cheats!
We are new to Aetna and we have specialists that care for a chronic condition. Appointments are made 1 year in advance. Now, Aetna is saying that I cannot see that specialist without a referral from a primary care physician even though these are continuation of care issues. We have not been able to get an appointment with a PCP and so my daughter is going to lose her appointments with her specialists because of red tape. Had the specialists been out of network, I would have just filled out a form and the appointments would be covered. Because these doctors are covered by Aetna, the process requires a visit to a PCP (we don't have time to go to a PCP to get a referral... and why would we need to do this if it's literally just to check a box??? A PCP cannot help... these are appointments for continuation of care that took us years to get to this level of care to begin with!) This is insane.
I have spent over 12 hours on the phone with Aetna over the last 3 weeks trying to resolve this issue. It took me 3 weeks to get to speak to a supervisor at customer service... even though I had waited during week 1 for a supervisor and was told they would call me by end of business day... 2.5 weeks later, I had to make 5 calls and wait on the line for over 3 hours again to speak with a supervisor. I have dealt with poor customer service before, but this one takes the cake.
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First of all, Aetna will do ANYTHING to avoid properly covering you. I saw a PCP for a routine medication visit (literally a 15 min visit to discuss if my meds are still working). Suddenly Aetna decided that my Nurse Practitioner, whom I had submitted claims for just 8 wks prior, was not only a DOCTOR but a SPECIALIST. So my copay went from $20 to $50 for a 15 min visit with a NP. I submitted a complaint and the representative that I was messaging with, just kept repeating that "Our records show ** is a specialist". I have asked to see proof, I have asked them to look at previous claims, I have screen shot the clinic's website where it says that the provider is a NP, I have screenshot previous claims, and they simply WILL NOT discuss this with me.
It's similar to when I got my yearly women's exam, and Aetna refused to cover any part of it because "it wasn't coded as preventative". My clinic, which is through Cox Health, said that the visit and the exam and the pap smear were all coded as preventative and other patients have no issue getting insurance to cover this. Aetna is unfortunately the only insurance I can get through my work so I am stuck feeling like not only do I have a REGULAR full time job, but now I get to spend hours every week begging Aetna to cover the most basic things. I work harder at getting the coverage I PAY FOR than the actual insurance company.
I already know, when I am sick and needing medical care, that if I want to get help I will spend weeks arguing with Aetna about BASIC FACTS. My pap smear came back concerning, but I can't even afford to go see a OBGYN for it because I'm still paying off my $600 bill for my YEARLY WOMEN'S HEALTH VISIT. I could die of cancer while arguing with Aetna about codes and coverage.
The website for Aetna is one of the worst I’ve ever dealt with. There are no options to contact anyone by email; the option to telephone tells you to go get the number off the back of your card. When you call and opt for the “concierge” option, the person answering is there merely to answer the call and write notes in your account. I ask to speak to someone in billing, and I am told the billing department is in a “back office” and does not accept calls and does not have an email address. Aetna endorses the e-checks sent by my bank but does not post the payment to my account. The entire experience makes me feel as if I am dealing with gangsters.
Their transportation promise is bogus. They never show up to pick you up to take you to or from your doctor's office. Their PCP listing is full of con artists. One says he'll see patients but is booked till 2025 and wants you to see his nurse. (Hans **). One Medical, one of their providers charges $199 to sell an Amazon gadget called Doximity under the pretense of membership. You can't be assigned to a doctor unless you purchase this membership. Their network dentist does a sloppy cleaning and tells the patient "to go to Turkey to get her teeth fixed" and charges $990.00 for not providing any treatment. PCP THEY ASSIGN GETS DENIED 4 REFERals TO SPECIALISTS.
Their mail-order pharmacy charges 42$ for an inhaler that is broken. They send a blood measurement kit without testing strips and refuse to send any. Their customer service consists of agents from Philippines who can hardly speak English. Senior citizens stay away from Aetna Medicare. They will literally abuse you and ignore your medical needs.
Banner Health, with which our family has had very positive experiences, and Aetna appear to have cobbled together an inept insurance program with almost impossible to discern co-pays and out of pocket expenses, actual covered services or real in-network facilities and physicians. My carefully chosen PCP's first appointment was over a year out; the first available PCP over five months. The website is hideous to navigate and offers almost no concise answers. The "member number" for help is not but when you do get to their "concierge" services these poor folks appear to be trying to navigate a system as murky as the patients do. Could not get a definitive answer on a colonoscopy despite one inept and one very well intended and smart seeming person doing their best.
Have ended up with hundreds in non covered services for a facility that said they were in network but were not and for a service (cataract surgery) not even covered although this would be hard to determine based on their member website or directory. I have postponed important medical procedures until I get new insurance. Just a mess.
We were just trying to get some proof of premiums for my elderly mother-in-law. Has been impossible to get it. This company has been extremely difficult to deal with. Talk about a run around. Too bad I cannot give them zero stars. The sixth person we talked to, after four phone calls, did a nice job. She seemed to want to help us. Not sure if the others really cared. So maybe the one star is deserved.
Checked Aetna's website prior to utilizing a practice and physician on their website. Listed as in-network. Called to speak with a representative and their response was "in-network." My husband and I have had the same plan since 2021 through his company. Chose identical plans both years. 7/26/2022 provider reaches out to Aetna for insurance verification prior to starting services. Mails copy to me and I begin. I'm 2 weeks away from surgery, more than $5000 out of pocket towards health care, and I received a call from Aetna and facility, saying it's NOT covered. I'm still in the same plan-year. Nothing has changed, except Aetna just said "nope."
I spoke with not less than 3 customer service representatives that saw unethical practices themselves. Including one that said, "the hospital is covered in-network for this claim, yet the physician that utilizes the same tax id is not covered. That has to be incorrect." I spoke with another rep after informing her my plan has not changed at all in 2 years, and her response was "behind the scenes Aetna has changed & their limited their coverage for your plan."
I informed her that was not communicated to employees prior to enrollment, and she says "I suggest you call HR." She stayed on the line with me. I'm taking the legal route now! I work in healthcare at the management level, and I can't believe it's "ok" for insurance companies to scam working Americans. Don't choose them. Do whatever you can to find a better healthcare provider, unless you don't need anything more than an annual physical. Hope this helps someone. This is not all, just all I can include right now. I'm drained and they know the average person doesn't know the ins and outs of their scams, so RUN!
Wow! Aetna has been a nightmare. I pay extra for the PPO plan so that I can see specialists without a referral, as well as visit out of network providers. The out of network feature is very important to me, considering a lot of doctors in the DC area do not accept Aetna (probably because it's so horrible), and instead, they operate on an out-of-network basis. As a result, I frequently have to submit my own claims. Unfortunately, every single time. the claim is processed incorrectly. I then have to spend hours on the phone each week fighting with representatives for a simple reimbursement. It's to the point where expect it to take around 2 months and 10 phone calls to finally get my claim processed correctly. After that, it takes a few weeks to finally receive a check in the mail.
To make matters worse, a majority of their customer service associates do not understand English very well. As a result, I have to re-explain the issue around 3-4 times before they finally understand correctly. Then I get transferred to someone else, and the whole clown show starts over again. All in all, Aetna is a joke. If they are going to try to operate in the United States and use an electronic claim form to make things easier, maybe they should invest in a software that actually works, as well as customer service associates who speak English.
This company’s practices should be illegal. They are in the insurance business not in the business of determining prescriptions. They are rejecting a medicine I have had for 20 years. Just try to wear you out.
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.
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