Aetna Health Insurance Reviews

When I call the insurance company they told me that the y do not cover 25 m check up just 24m and i try to tell them that this is his 24m check up and that i could not get him in any sooner. Are insurance companies really allowed to do this.. Cause now i am stuck paying the 200 dollar bill that should have been covered fully by the insurance company.

200 dollars might not seen like a lot to some people but in a middle class family that is a lot.. Now i will have to struggle to pay this bill so i am not turned over to the credit bureau. I just wish i knew how to make this aware to more people so the same thing doesn't happen to them.

Now it's on to the pharmacy. They couldn't manage to ship my meds in time, which are time sensitive, of course. My doctor was fortunate enough to have other patients who no longer needed treatment and they donated their meds until the ones that were due to me finally arrived. That lead to another problem. The next month they said I couldn't have them yet because I just got some; didn't I have any left? Well, because they mailed it late, now they were denying the next round of treatment. Hence, more tears, anguish and stress. Really not something who is trying to have a baby needs, which I did tell them.

I finally get pregnant-yeah- but unfortunately I had a miscarriage. Here is where it gets crazy. I had to treat again, obviously, and they told me that I should have medication left over from before the miscarriage. Well, I did, but only until I found out I was pregnant. It was then that I threw them away since I no longer needed it. I was denied any new meds and was told to pay out of pocket, thousands of dollars, and maybe I would be reimbursed on appeal. Thank God I didn't do it. My appeal was denied. They told me it was considered lost or stolen meds. Of course, it was neither. Next round of meds they accidentally took $130 out of my checking account for co-pays they said. I have been on these meds for months with no co-pays. They said my plan must have changed. It didn't. They finally figured out that I was due a full refund. That was 2/19/08. I still have no money. They claimed they gave me a refund on 3/4/08. Apparently they had a system glitch, yes, that's what the supervisor called it. They were going to overnight it 9 days ago. still no check. I called today and was told they are still working on it. Of course they always say sorry, but is that paying my bills?

I'm out $130 and countless hours of time. I would like a copy of my notes on file by Aetna. Of course they won't give them. Do I have any way to resolve this? It's completely horrible that this is how people with problems/injuries get treated. I don't need to be reminded all the time there's something wrong with me.

This is the first time I've used this policy, which I got through my job. I'm not impressed at all so far with the customer service. No surprise to me that they'll take my premium money, but won't be there for me when I need the coverage. I'll be paying out of pocket for at least one visit to the ortho doctor. I can afford it now, but if Aetna continues to deny coverage, it could be an issue. I'm a single mother and earn a decent wage, but it only goes so far.

This was for a billing of $725.00 from my rheumatologist which was okay'd last year after I had a referral from my primary doctor. This time, as requested, I had a script from my doctor and faxed it to Aetna to show them. They then informed me that they couldn't okay the coverage since it was out of network. Now they are refusing to pay this bill from 08/24/2007. This was turned into CB Accounts Inc., Nat'l Communication in Peoria, Ill. Ph. Number is 866-867-0179. I have always had good credit, and this will affect it greatly. I am in dire need of assistance and hope and pray you can assist me. This stress has caused my rheumatitis to flare up more than once and have been put on two medications since being diagnosed last year. Please help me or direct me to someone who can help me. Thank you.

This has caused me to incur bills of $725.00 for this last rheumatology visit in 08/24/2007, and a current bill from Carle Clinic in Bloomington of $1,818.62.

Please don't make the same mistake we did. Aetna does not have a Maternity coverage program that is any different than the regular coverage they offer. Mom's to Babies is a joke; it has nothing to do with financial coverage. Just some nurse calling you to ask how you are. I have a doctor and friends to do that.

All of the diagnostic testing and ultrasounds will result in over $1000 more in copays then if we had stayed with Keystone and enrolled in their maternity program.

I called Aetna back was first told that the doctors billed it as a doctor visit. Called the doctors and they told me no, it was just billed as shots. No doctor. Called Aetna back and was then told that they charge a copay no matter what. So I ask for a supervisor. Got her voice mail and left a message that said she would call back in 24-48 hours. Two weeks later I still had not heard from her. So I emailed the Customer Service. I was sent this email:

Thank you for using the Aetna Navigator website to contact Aetna Member Services. This is in response to your claim question on Cheyenne for October 23, 2007. Your plan requires a copayment be taken for any office encounter even if no office visit charge is billed. It appears that your doctor's office policy is not to take a copayment when there is no office charge billed. However, this is not your plan of benefits. You were told 2 times that the shots would be covered at 100% after the $20.00 copayment was applied. I have forwarded your request to the supervisor of the account. However, you did not provide a phone number that she can return your call and we do not have your phone number on file. If you have questions, you can reach Member Services by logging on to www.aetnanavigator.com and select Contact Us. You may also call the toll-free number on your member ID card. Sincerely, Internet Response Team Aetna 12159058.

I told them that the first 2 had said no copay charges for shots only, and asked for a supervisor to call me. They emailed me back:

Thank you for using the Aetna Navigator website to contact Aetna Member Services. I am sorry you were dissatisfied with Aetna's service. We strive to give our customers the best service possible. I have sent your return telephone call request to the supervisor of this account. Please allow 24 hours for a return call. If you have questions, you can reach Member Services by logging on to www.aetnanavigator.com and select Contact Us. You may also call the toll-free number on your member ID card. Sincerely Internet Response Team Aetna 12188095

It has now been another couple weeks with no calls from Aetna. The first time I called before going in for shots in October I asked about a copay so that I wouldn't have to go through this. So I have had 3 different stories about what and why I am being charged. I didn't write down the exact dates I called, but for any future things I will write down everything and have them send me a email to confirm what was said. The fist call after I was billed was about December 21 2007. Then I emailed Jan. 4 2008 and Jan 7 2008. I just emailed the BBB and complained so I am now waiting to see what happens. I also want now to drop Aetna and find a different insurance not through work, but have been told I have to wait to drop it until next December.

We live on a very limited budget. If I have to pay the $60 in copays it has to come out of my food budget. I stress out now about having to go to the doctor at all. Because Aetna ends up making us pay for everything.

I've lost money that I could have used because they don't want to refund my payments, bad credit because of medical bills I cannot pay out of pocket, and constant pain because of dental problems that are getting worse.

Undue stress and money we put out which we should not have had to!

Early November I had another ultrasound done, my 20 week ultrasound. The day before I had it done I called Aetna to make sure all paper work was in order and that the provider was in network. They told me I would be fine. Well, the ultrasound was denied for being an experimental procedure. I called told them it was not, it was a normal ultrasound. The gal that works for Aetna said give us 10 days to get it reprocessed. It looks like it was a mistake on our part. Then today I called them to see why it is being denied again; now they claim that they cover only one ultrasound per pregnancy; and now I have to go back and make the place that did my first ultrasound re-bill them under different codes, then get the 2nd ultrasound re-billed as well. Then they claim they will pay for both. Now I'm afraid that they will put up a fight to pay either one. I am saddened to say that I am not the only they give so much trouble too; many of my co-workers are going through similar situations.

I am physically ill over all this. I have prenatal care pending. I need to get all my bills up until now covered before I get more things done.

I have to pay these medical bills out of pocket.

The PCP called and try to get it approved but they were asking for surgical codes which they didn't have because they were not the doctor that was performing the procedure so she thought that she started the claim but what I later learned is that according to Aetna she didn't. I then called the doctor that was going to do the procedure to let them know that they needed the codes and to call them with that info which she did. Then they called me back to tell me that the claim wasn't started so I called the PCP back and she called again this cycle went on for three days.

Finally I called Aetna back and said that this system isn't working and they needed to figure it out because everyone was calling them and they had no record of it. They also told my PCP I had been terminated for my health care which was not true. They are laughing all the way to the bank cashing my premiums so I should not be terminated.

I called again and was told the same thing that this women saw where there was a note saying i was told there was no copay and sent a message to please process the claims and she also said it was unclearly stated in my coverage and not to stop getting my shots that i needed them and it should be ok. I called today and was told no they are not covered and it was an error and they were not going to pay for them and the lady laughed at me as i was telling her that i dont have all this money to pay to catch this up, but would find a way.

I went into the doctors office and told them what had happened and they looked at the notes from billing and said the billing person had also called aetna and was told yes she was told there was no copay but that was and error and we will not cover the injections fully.

Now I have one bill and will be getting more to pay for the days that I did go and have to stop getting my allergy injections. I was tested for over 60 things and had reactions to all of them. I am taking medicine for my allergies and alburterol and advair for the asthma that i suffer from that the allergies contribute to. I now wasted all this money for treatment that I can not continue to afford to pay for so can no longer get.

Ongoing severe pain and emotional stress related to lack of responsiveness of Aetna. Inability to access services needed for physical therapy. Inability to access medications prescribed for treatment of condition and pain management. Need to spend countless hours of time in trying to resolve these issues, and still finding no resolution to the issues.

When he attempted to settle the issue, he learned that his policy was indeed expedited but that of his two sons was not. At that time, the policy information did not indicate the two sons were covered. This was 5 mos. after enrollment, 2 1/2 mos. after the policy was effective. My son has an appointment with the specialist he was referred to during the previous visit. This appointment requires a precert which I am unable to get as the insurance company still does not indicate my son is covered.

After talking at length with United Airlines, I was advised to have the doctor's office contact the insurance company as research would show that both boys were indeed covered. Not feeling confident this would work, I attempted to verify coverage myself beforehand.Sure enough, when I spoke to the rep at Aetna, I was told my child was not covered. After spending more than 45 min. (something a doctor's office will not do) on the phone, I was finally told that it did show my son was covered but that he was listed as pending. I was told by Aetna, to have the doc's office call for verification despite that yet another attempt revealed that this information is not readily available without a prolonged conversation, hold time and in depth investigation into the matter. I was then told that if this did not work, I could pay out of pocket and Aetna would reimburse me although she would not fax me a promise of this.

To follow this advice is to set myself up for the insurance company to deny this claim. Ultimately, I am unable to take my son to the specialist unless I am willing to pay as an unisured pt. or wait until they have sorted through this and issued a card. It has already been 5 mos. since enrollment and 3 mos. since coverage was effective. This is inexcusable for a company so large as Aetna to provide such incompetent customer service.

I am paying my son's bills as an uninsured patient because I am unable to provide proof of coverage and although Aetna does confirm this by phone, the amount of time necessary greatly exceeds the reasonable amount any doctor's office will spend.

I am also upset with the walk-in clinic which misled us and I will never visit one of those again. I think Aetna should have paid the claim as a standard doctor visit, which is what it was. They have way too much red tape, so no normal person could ever figure out all of their loopholes, and I suspect most other Aetna members have gotten stuck with such an unexpected bill at one time or another; I wish someone had warned us (which is why I'm filing this complaint - I hope it helps someone out there avoid this mistake). At $1000/month for insurance, I think the least Aetna could do is pay a lousy $90 doctor bill for a sick child.

She resubmitted office notes and highlighted salient portions of the record. She asked them to reconsider. They sent a letter denying the appeal. They gave no reason for this and a phone number, above mentioned, and I called, a operator answered and could not tell me why. This is a legimate claim and I just want them to pay. Included in this claim is the medication, shot on left side, shot on right side, and an EMG. They say they won't pay for services or supplies determined by aetna to be experimental or investigational, however they paid for the shot on one side but not the other, nor the medication botox.When I asked why the operator could not tell me why. They have given me no further answers.

An attorney stated something about the plan being self-insured so I could only sue for the unpaid amount not any other damages. He said the other damages is how you can pay attorney fees.The current bill is $1846.00. The attorney said it would cost me more than that for the attorney alone. He stated Aetna knew that and knew it would cost more than the claim to get the claim paid if we took them to court.If I had that money I could pay the claim. I can't pay the claim nor an attorney.Not counting the principle of the matter.Please help.If they have done it to me they have done it to someone else.I am now covered by my husbands insurance which does cover this, the same company I had before my employer switched to Aetna.But I can't get treatment until this claim is paid.

I am lining your pockets while you are giving me horrific care! I hope you all suffer at some time in the future!

Received another bill from Riverview on 15 July saying that we were now 120 days overdue. Contacted Aetna on 26 July 2004 and was told that they still didn't have the BCBS Explanation of Benefits from Riverview. Talked to Riverview Hospital that same day and was told that they faxed everything over again. An Aetna rep (familiar with what has been going on) confirmed that they received everything. Received a notice on 5 Aug 2004, that Riverview is sending the payment to collections.

I contacted Riverview on 9 Aug 2004 to find out what information they had on file about this bill, how many times they have faxed things to Aetna and how many times Aetna has claimed to be processing this bill. In the meantime, I have found that BCBS has also sent over the EOB to Aetna. I contacted Aetna on 10 Aug 2004 and was told that they were still awaiting the Explanation of Benefits from Riverview. Aetna's rep claimed they were going to contact Riverview again. I explained to her that Riverview has faxed the bill along with the EOB several times over the past 6 months.

I also pointed out that how can an insurance company keep losing all the paperwork. It seems that everytime this bill went to Aetna - it magicaly disappeared. I also explained to Aetna that now all of this was going on my husband's credit report. Aetna's rep told me that there was nothing they could do until they received the EOB and bill. The rep also told me that they have no records of ever receiving all the paperwork from Riverview Hospital. And that if Riverview had to report us to the credit collection agency then that is what they have to do. It was not their fault.

I have had the worse headache that has been going on for the past 3 months trying to get this resolved. Now because of AETNA, this bill is going to go on my husband's credit report. This is hurting our chances of getting a house because of this. How can they get away with this? No one in Aetna seems to care....

In late December my company laid me off. I immediately called Aetna to find out what I needed to do . They company representative told me that I had already paid my co pay and that part of my severents package they would keep my insurance for six months this would be until June 2001. I was contacted by Cobra in April of 2001 and again called Aetna to make sure I did not need to purchase anything that I was covered for my pregnancy. My husband had full coverage at the time with another health company however Aetna told me that I did not need to do anything. I did call my husbands insurance and they told me that my pregnancy was preexisting and so not covered by them. So anyway I figured that was ok because Aetna had told me not to worry everything was ok.

This is my first child and I was young and believed what they said. I was so worried about not having insurance in June that we induced my son so if there were any complications I would still have health coverage. Now they won't pay. Orange Park Medical is calling me everyday to get the balance which is something like 10,000. I can't buy a house or a car because they have put this on my credit. Aetna refuses to pay them. When I call Aetna they tell me that OPM did not file with them in a timely matter that why they won't pay. OPM has a different story.

I am a middle school teacher and thus do not make a lot of money. My family cannot get a home loan because of this and we are in dire need of help.

My son's prescription costs are $380 a month. The medical bills that they are supposed to cover, but have on hold for months now, total several thousand. The doctors have started demanding payment from me.