Aetna Health Insurance Reviews

For example, their most recent question is why I needed to stay overnight in the hospital after having a complete hysterectomy. What are they thinking? They do not return calls and each person I speak with tells me something different. No one seems to be researching anything. They simply parrot whatever the file says. Unbelievably poor customer service, which seems to be geared toward not paying claims. Any help would be appreciated.

I also had short term disability with them and they turned me down to receive short term disability pay even though I had paid for this coverage and fully entitled to short term payment while out of work being treated for what turned out to be a herniated disc in my neck. These people are crooks. Buyer beware. I have no prior medical conditions and no pre-existing conditions and they have denied basically every test and claim that has come their way. And this was group insurance that my company paid over $1,000 per month toward my premium. As far as I am concerned, they should be closed down and their executives prosecuted. Putting honest hardworking people through this kind of hell is unethical, illegal and bad, bad business!

I finally got a hold of the guy I talked to in collections department. He told me, "I sent an email over there. I never got a response." (What about the call you said you were making?) Then he had the nerve to say, "I'm doing all I can on my end ma’am." (Are you kidding me?) Then had even more nerve to tell me, "Its five o'clock out here. I really doubt I'll be able to get a hold of anyone over there." (I'm competitive, bet me!) He hung up.

I called over to the mail order pharmacy company. "Yeah, I called collections like you told me to, and they can't figure out where the $125 charges are coming from. He said he sent an email over six hours ago and doubted he could get a hold of you this time of day. But yet you're still here. Maybe you can help me?" Associate laughs, mumbles something about collections then looks up my account and tells me there were three separate prescriptions that were sent but never charged for.

"How can that be? You charge my account right when you send the order. You know, like that $90 you charged me for my husband's insulin and prescriptions but won't send out because there are past prescriptions from a year to almost two years ago that you claim I didn't pay for? Why wasn't I told this earlier?" Check out the associate's answer, its classic! "Well, in the past we've just sent out orders without payment. With the recession we have a lot of people that owe us money and we're just doing what we can to collect money owed to us."

So Ms. Associate, what you're telling me is, some of these unpaid prescriptions are from over close to two years ago, way past the time I'll be able to track those on my personal account, and you charge me for my current prescription but fail to send it out because I owe you money from a year to two years ago that you tell me about now? How many prescriptions have I placed since October of 2008? Why didn't an associate ever say, "Hey, you owe us $55. We didn't charge for it, but it's due.” I would've happily paid it. But no one ever did. You've sent out 3 different prescriptions that you never charged me for but charge for all of the rest of them. And then you send me to collections so it's on my husband's credit on something we didn't know about!

This is yet another classic example of great customer service. Now, you're withholding vital medication that my husband has to have and that we've paid for because you forgot to tell me about past charges I've had for over a year?! You've continued to send out orders to me for the past year and never notified me I've had charges that weren't taken care of when I've called and placed orders? I'm sorry you're suffering, but I'm suffering too.

I've just paid you almost $100 to not get my medications. Now you tell me I have to pay you before I'll get my medications. You give me no time at all to pay you, but yet you take all the time you want sending me out medications my husband has to have in order to survive? We leave in a week. I don't have time. The least you could do is help me out a little so we can get these prescriptions to us before we leave." "Let me see what I can do. Well, I could take a partial payment of $100 before we send them out."

Post note: Today, I tried again to see if we could work out an arrangement to pay at a later date. I told the associate that the charges for my order that was never sent were still on my account. The associate said it was a "temporary charge" until the order was completed than it would be processed. What does that mean? The managers I've talked to are unwilling to agree to allow me to pay the $125 next Friday and send the order because it was over a year old.

I talked to the manager about why I've been allowed to place so many orders without them ever telling me I owed money and the associate said, "Because we updated our system." I asked the associate if it was done Monday night, and she said, "a while ago." So shouldn't I be allowed to make an arrangement and still have the order I've paid for and is pending sent?

After reading many stories on the internet about Aetna, I am finding that many other people have had the same experience, whereas Aetna has come up with excuse after excuse for not paying the injured party. This should not be allowed to go on like this. People are entitled to insurance they take out in such an emergency. Aetna is collecting people’s money but not giving the insurance that was paid for. I have supplied everything they asked for in a very timely manner, yet they have come up with excuse after excuse. Below is a time line of events.

On 02/12/09, the injury happened. I waited 6 months to file claim like you’re supposed to. On 7/24/09, the claim was filed. On 8/17/09, I spoke to Robert. He was sending an email to Jennifer my case worker. On 8/19/09, I left a message for Jennifer. I never got a return call. On 8/21/09, I faxed Janice the paperwork she requested. On 8/27/09, I spoke to Robin. She left a message for Jennifer to call me. She never did. On 8/29/09, I spoke to Todd. He was going to call back. He never did. On 9/01/09, I left a message for Jennifer. She never called back. On 9/03/09, I spoke to Jennifer’s supervisor. He had her call me back for phone interview. On 9/8/09, I sent a letter with information to Jennifer for the second time. I faxed it the first time. On 9/10/09, I spoke to Tim **. He said he’d verify the info they needed at once. On 9/17/09, I spoke to Tom **, Jennifer’s supervisor. He said they can delay it as much as they need and/or deny it. He said to complain to whomever I feel like complaining to. That won’t do me any good.

I am planning on writing letters to every committee person I can, every internet portal, news agency, chat site, and newspaper to let them know how Aetna treats its customers. I am entitled to being paid and Aetna refuses to do such, but collected my money for the last few years. I am now seeking legal assistance to file a complaint against Aetna.

Around June 21st, I received a statement from Aetna stating that I was being refunded $508.00. Surprise! I called Aetna and was told it was for my June 2009 and May 2009 premiums, since I had canceled in early May 2009. I thought this was odd, but was assured that it was because they had already withdrawn funds for May 2009 and June 2009 from my checking account (prior to my cancellation). I accepted their explanation and my refund.

On July 23rd, I received another statement of account from Aetna. The statement lists a bill for $150 for services performed by my Dr. Elena ** on 2/28/09. Please note that the services were done while I was an Aetna member in February 2009. The bill was denied by Aetna because they claimed I was not a member with benefits at the time. This is ridiculous! After further review, I discovered that this same bill was initially denied by Aetna for the same reason in March 2009. Again, I was a member (premium already paid and on record) when this service/visit occurred in February 2009.

To add further insult, instead of canceling my policy as I requested by phone and email (see below), it appears that some incompetent employee voided me and all record of my insurance out of their system. According to Aetna, this means that the bill they should have covered (for February 2009) to my doctor for $150.00 is being rejected. This fraudulent and negligent act initiated the $508.00 refund (that I did not expect) and the refusal of the claims for services performed in February 2009. This is fraud and it is illegal. You cannot pretend that I was never a member and you cannot deny coverage when I had paid the premiums for the month and the month that followed. Isn't that fraud? Suppose I had had surgery during that time, the bills would be more than $30,000.00. I would lose everything.

After two days and no less than 6 phone calls, I finally spoke with someone that understood the problem. Cheryl handled my call very professionally. She took my information and worked very quickly to assess the situation, no small feat considering I was one step away from contacting someone at the Chicago Tribune. She then connected me to Kristine. Kristine also handled the situation very well. Let me be clear, I do not blame either of these ladies for the ridiculous and incompetent way this fiasco has been handled. Having said that, when Kristine suggested the Aetna way to fix this problem that Aetna had created, I laughed out loud. She was told to suggest the following. In order to get this $150.00 claim paid, I would need to: 1.) give the $508.00 back to Aetna (they believe it's a refund for February 2009 and March 2009 premiums); 2.) pay $254.00 for April 2009 premium and $254.00 for May 2009 premiums.

To recap, Aetna wants me to pay $508.00 (that they refunded me in error) plus $508.00 for the two months that they were supposed to withdraw from my account in April 2009 and May 2009. All of this to cover $150.00, that was supposed to be paid nearly 5 months ago. Seriously?! I think Aetna owes my Dr. Elena ** $150.00 for her claim in February 2009 plus any interest that she is owed for carrying this delinquent bill on her records for nearly 5 months. Furthermore, Aetna owes me for the stress, mental anguish and the 4 hours of time spent on the phone on 2/23/09 and 2/24/09. This is the sort of thing that President Obama is talking about. This is how our healthcare dollars are being squandered. I am a healthy person. If I wasn't, I could have accumulated thousands of dollars in debt during this time that I was covered by Aetna and lost my home as a result of this negligence and fraud.

I feel there should be checks and balances in place to catch obvious mistakes such as these. I was told it was up to me to make sure the prescription is correct prior to mailing it. Considering I am mainly concerned with getting it in the mail so that my son doesn't miss a dose of medication, I don't feel it's fair to place 100% of the burden on me to make sure my doctor wrote the prescription correctly.

The sad thing is, there is an easy fix to this obvious mistake. I simply have my doctor fax a correction to the pharmacy and I get my missing 60 days of medication. However, the pharmacy refuses to give me any retribution whatsoever. They know a mistake was made, but are thumbing their noses at me. Their explanation is pathetic. After all, I am the customer everywhere you look in this situation - to the doctor and to the pharmacy. I feel as though I was just robbed in broad daylight. Would it be acceptable for me to walk up to someone who was looking the other way and snatch her purse with the explanation, "it's your fault - you should have watched it more closely." This would be an obvious wrong, and I would be expected to return her belongings.

There are very few companies that I know of that completely reject any idea of a return/refund/exchange/guarantee, etc. This company is one of the pathetic ones that couldn't care less whether the customer is satisfied or not and is willing to do absolutely nothing to fix a problem. And I have no choice but to use them for certain medications - I'm stuck between a rock and a hard place.

I started the program that next week and was there for 32 days. To my surprise, after the program ended, I received a bill from the hospital for $640. I promptly called Aetna to ascertain the problem. The rep told me that I was charged the standard co-pay for everyday I attended the program. I informed her that I was told that I would not have a co-pay. She rudely told me that it wasn't her problem. I then asked to speak to a supervisor. The rep informed that there was no reason to speak to a supervisor because they would tell me the same thing that she just told me. I told her that I didn't care what she thought the supervisor would say and that I would still like to speak to the supervisor. She asked me to hold and then hung up on me.

I called a second time and asked to speak to a supervisor. I was told that she was busy and that if I left a voice mail, my call would be returned. I left a voice mail, and of course, I never received a call. I tried again a couple of weeks later and was told that the manager was in a meeting but that she would return my call shortly if I left a message. I left a message, and still, there was no return call yet.

This is very frustrating. No one has the time to constantly call and try to rectify someone else's mistakes. What is the point of them having a job if I have to do it for them? This is not the first issue I have had with Aetna. They are the worst insurance ever. A word to the wise: If it has to do with Aetna, run the other way.

Rather than making an appointment to come back, when I was already there, I got the physical and he submitted the paperwork, showing himself as my primary care physician. I have since received a new insurance card listing him as my "PCP". However, since he was not shown on Aetna's records as my "PCP" at the time of the physical, they won't pay for it. I will pay the doctor for the physical, but I will argue with Aetna until I run out of breath! This is typical behavior of a greedy for-profit company. Aetna is relying on a technicality to deny coverage for a normally covered routine physical conducted by an approved doctor in the Aetna system simply to save money. I can afford to pay the doctor. But how many other small claims are denied by this company for no good reason other than to make more money? My claim is small and is under $200.00. But when they deny a few thousand small claims because of technicalities, they make a lot of money and many who submit those claims suffer because they cannot afford to pay for the services themselves.

Diverticulitis develops from a condition called diverticulosis. If you're older than age 40, it's common for you to have diverticulosis - small, bulging pouches (diverticula) in your digestive tract. In the United States, more than 50 percent of people older than 60 have diverticula. Although diverticula can form anywhere, including in your esophagus, stomach and small intestine, most occur in your large intestine. Because these pouches seldom cause any problems, you may never know you have them. Consequences: my out of pocket expenses up to now are $1,021.98, that is just to the hospital. The added stress of making phone calls and trying to understand why insurance wouldn't pay. Distraught breaks and lunches spent on the phone. Getting nowhere.

They covered it at first. They covered the bill, and then a few months later, took it all back and stuck me with the bill. I can't get any answers from Aetna on why they did this or what to do about it other than what they told me, which is to just pay the $1,371 because that would be the easiest thing for me to do. They can’t tell me why. I was never told about the bill not being covered and why they never sent me an end of coverage summary. Pretty much if you get Aetna, you’re paying for nothing. I have no clue on what to do about this. They won’t even talk to me. They say they can’t talk to me for some reason. When asked why, they can’t even answer that one thing for me. If anybody can help me, please let me know. Thank you for your time.

On September 11, 2008 my PCP gave me a referral to seek surgical care outside of the Aetna HMO system. At this point, let it be noted that Aetna is my secondary insurance. I had already established care with my surgeon before the referral request was made. My surgeon participates with my primary insurance, but not with Aetna. Aetna denied the out of network referral based on the fact that there were qualified physicians who participated with Aetna HMO. I researched these physicians and found that none of them specialized in adult spinal deformities. One of the doctors was a general orthopedic surgeon who also runs a spa. The next recommendation was a group over sixty miles away. Again, I did my research and none of the doctors did any spine surgery. The other option was going to the Duke University System. Duke is about an hour away and was a very difficult system to navigate. I know this because I have a child with special needs who was a patient there for many years. I did more research and found that the doctors who did spinal deformity surgery mainly did pediatric cases.

I had previously consulted other physicians about my condition. One surgeon advised I would undergo an eight hour surgery that would involve an anterior/posterior approach with a thoracotomy. I would be hospitalized for about one week and would be unable to return to work for about three months. Another physician suggested that I live with the curve, even though it was progressing. I also had many, many appointments with a physical therapist.

Once my primary insurance gave the authorization for my surgery, it was scheduled for October 30, 2008. I had surgery that lasted 4 hours, and I was in the hospital for 4 nights. I was up on post-op day one and off narcotics by the end of post-op day two. I was discharged with no narcotics and returned to work full time about 4 to 5 weeks later! My surgeon was, and is, a million times more qualified than any of Aetna's preferred providers. I am now 6 months post-op. My spine is straight and I grew one and a half inches taller! How is that for outstanding results?

I have filed two Grievance Letters with Aetna. The first appeal was denied because Aetna felt that I should have seen a lesser-qualified doctor within their system. The second appeal was denied again, for the same reason. I did provide supporting documentation to show that Dr. ** is the best surgeon around. I requested to know the name of the physicians who reviewed my case and in which state he or she is licensed in. No matter who I spoke with at Aetna, no one could give me the name of any physicians who have reviewed my case.

After both denials, I contacted the US DOL EBSA. I did not, and still do not, feel that Aetna really looked at any of my appeals or at the supporting documents thoroughly. I requested the name of the physicians reviewing my case, for the third time. Yesterday, I received a phone call from my contact at the US DOL who advised me that she had spoken to Mr. ** in Aetna's Legal Department. He stated that my case was not reviewed by any medical doctors, but I have a letter stating that my case was reviewed by a general surgeon. It looks like Aetna provided me with false information and did it in writing.

I, once again, have sent another letter to Aetna's Customer Resolution Team and requested my case be reopened and to have a doctor who has knowledge of spinal deformities and correction review my case. I do expect my referral request to be honored and made retroactive. I only want Aetna to pay their small portion of the medical bills related to my surgery. My primary insurance paid a huge amount and I was left with about $5,500. My primary insurance has already paid a huge amount and Aetna would have only picked up, in comparison, a very small amount. For me, it's the principle of Aetna not choosing to do the right thing for the patient. Instead, Aetna decided to do the right thing for itself.

In 2008, I spoke with the Celanese Americas Human Resource Director, a member of the Celanese Americas Retirement Board. I was told that their cost for medical insurance has gone up and they now pass it on to the retiree. I was also told that Celanese Americas may no longer provide retiree medical insurance in the future. I stated that I had a contract with Hoechst Celanese upon my retirement that provided a medical insurance benefit. It is my understanding that the Retirement Plan can be amended but retroactively for retired employees.

Each year, I receive a Celanese Americas Retirement Pension Plan Summary Annual Report. In 2007, the Pension Plan increased $41,129,283 in net assets. Over the years the plan has increased net assets yearly. It doesn't appear the Retirement Pension Plan is in any danger of becoming illiquid or justifying the substantial annual increases for retiree medical benefits.

I would appreciate your input regarding my experience with this problem.

Finally, one day, my mother could not move at all. We rushed her to the hospital. Finally, after 6 times, Aetna approved the MRI. My mother had a herniated disc so swollen it cut her spinal cord. She is now in a nursing home because she is paralyzed from the waist down due to the delay in finding the problem. All doctors asked said that if she had gotten the MRI sooner, she could have had a procedure and she would have been OKAY. Aetna destroyed her life.

Her doctor called them personally and they are allowing an MRI of the bottom of her spine ONLY, due to the discovery of the spina bifida. The doctor has already filed appeals. What about the rest of her spine and neck? If there is damage to ANY part of her spine it could affect the rest of her life!!! Do they not even care about children? Why do we even pay for insurance? Does everyone on this board know what the top Aetna execs got paid last year while their customers were struggling to get adequate healthcare and pay the denied bills? Try about 18.2 billion dollars! We will be changing insurance companies in January and if there is permanent damage to my daughter's spine...Aetna will be in court. I don't know what has happened, as I used to think that they were a good company. I warn everyone I know now to STAY AWAY FROM AETNA!!!

When I demanded a supervisor, threatened to report Aetna to my employer, Insurance commissioner, Florida State elderly rights and my local TV station, I finally got a person who gave me the simple following answer: "The drug store had no way to bill Aetna online for my flu shot under my medical coverage & it wasn't covered by my Rx because it wasn't a prescription." I went somewhere else for my shot. No biggie except for Aetna's customer service ineptness.

To date, I have been trying patiently with customer service reps and supervisors from Aetna for help, explaining every detail - from the severity cause for the ER's visit to the doctor mistake of putting the wrong code but they all refused. They have stated that - we choose to go to the ER for a headache and that will not be covered! Sure, I totally understand that concept - but this was not done with intent as they are stating, and it is very obvious that they prefer their patients assume and put their lives in danger, by staying home even when the symptoms seemed so dangerous, instead of being sure and safe.

my son cant get the help he needs and its interfearing with school and his daily life

I am the primary card member and had coverage on this date. My ER visit should have been $75. Instead I have a bill for almost $1500 because according to Aetna I did not meet the criteria for an emergency visit I've appealed their decision and have not heard back. It angers me that my throat was closing and I was having great difficulty getting air... yet they do not see this as an emergency. I wish I had agreed to being admitted... this is absolutly ridiculous!

One more thing... I had several throat cultures for myself and family in relation to this illness. We went directly to the lab where we had throat swabs taken. WE DID NOT SEE ANY DOCTORS, yet Aetna charged each of us office visit copays since the building that houses the lab also contains medical offices, so they use a code saying it's an office visit though it obviously isn't. Aetna is the worst company for covering any type of claim. I feel terrible for all those people that are not capable (old, impaired, unable to speak english, etc.)of jumping through all hoops that Aetna uses to avoid paying legitimate claims.

Considering the amount of money I pay for comprehensive insurance for my family, this is unacceptable. I paid, on time, and stopped receiving benefits because they are too busy to process my information in a timely manner! I was told that since I called, they would attempt to expedite the processing of my information, and would let me know within 48 hours if it was successful. I wonder how long it would have had no benefits that I paid for had I not called.

After calling Aetna on August 19th and asking what the problem was they said I had been terminated and not covered since June 30th. I asked and demanded to know why I was not told and why a termination letter was not mailed out. I also inquired as to where my check was since it was the middle of August and I had not yet received a refund. They said that an invoice was created on August 14th. On August 20th I received the termination letter and refund check, almost a month after the 30 day grace period.

I have no health insurance coverage and I am stuck paying a bill of almost $400 for an office visit that was not urgent or necessary this month.

America's life expectancy rate is lower than most other developed nations...our pitiful lack of adequate health insurance coverage. Health care is a human right.

My credit cards are maxed out . i am a diabetic, prone to siezures etc.no meds = hospital=lawyers

i am a brittle diabetic i test my glucose 10+a day,inject insulin 5-7 times aday, i suffer from hypoglycemic unawareness,high blood pressure,etc....i am prone to seizures and loss of consciousness, not to mention the economic impact of over charges, billing mistakes etc,

Despite the fact that the diagnosis was performed on-site and I have no medical history of polyps or fibroids, I was informed for months that it was a pre-existing condition and so not eligible for coverage. I had my doctor forward his tesimony to assert origin of diagnosis twice (and still was told by Aetna that it wasn't received). I had to argue with them on a weekly basis for months. It is worth noting that every time I called them, I got a different story about how they came to the determination that it was a preexisting condition. Finally, after threatening to write an article for the newspaper and testify at my University review of them, they paid. It took them 6 months to cover this surgery.

But then they didn't pay my anesthesis, also claiming it was due to a pre-existing condition! How can you cover the surgery, but not the anesthesia? Again, many weeks of arguing. It's exhausting.

Since then I have had notable other problems with them. I have a medical issue that makes my daily life difficult. My doctor wants me to get a durable medical advice that is expensive but would offer me relief. It would allow me to work on atrophied muscles every night to make them competent again. They put the prescription through for a predetermination. Months later, I still didn't have an answer either way from my insurance. I called multiple times and each time was told they were processing/reviewing the claim. Then, finally I was told a letter rejecting my claim came out weeks ago and was mailed to me. I never received it. They said they were going to mail it out again, and again, it was not received.

Each time I inquired over the phone as to the reason of my rejection, I got a different answer. Currently, they are refusing to pay my acupuncture bills, even though their coverage very clearly states that they will pay 80% of an acupuncture visit for a confirmed medical disorder with a doctor's referral up to $300 PER MEDICAL ISSUE (granted the acupuncturist is in network). Now, I did max out treatment for one medical issue, but then started receiving treatment for another. When I called to clarify this, they said the billing codes suggested the two disorders were similar (note: my two disorders were endometriosis-a gynecological disorder-and tendonitis). However, I gave them the benefit of the doubt and my acupuncturist resubmitted these bills after making sure the billing code matched my diagnosis (I think a number was off). That was over two month's ago and they still have not paid.

Every time I call to follow-up, they at first say they never received those resubmitted bills. After arguing they always, miraculously, find them. Then they tell me they will reprocess them and will get back to me in a few days or a week. They have told me that 4-5 times in the past two months. They never get back to me and when I call, it is always like I never even put that request in in the first place. And, as usual, I keep getting different explanations for why this is. One insinuation I received from representatives is that they want to make sure these health issues exist. My referrals are in the database by the doctors of these two very different conditions! It is astounding!

I have to put off acupuncture treatments until the situation is resolved (until they cover me). Acupuncture offered me serious relief from health issues that at times severely impair my day-to-day function. Furthermore, the medical device was denied to me, and I have to again live with a health issue that affects my daily life and makes it hard to perform my duties as a graduate student and research assistant. I got a B+ on a class I should have gotten an A on but was suffering these disorders due to lack of the proper treatment my doctors deemed necessary for my health. Finally, I have spent massive amounts of time on the phone in an attempt to resolve these matters and get the coverage I am clearly due.

Dr. then on my first visit after surgery, he told me that I was his first mistake that he cut the nerve to my tongue and, that I WOULD NEVER TALK THE SAME AGAIN and I would have to go to a speech pharmacist to learn to talk all over again, I was devastated , and I trusted cause he said that he had done over houndred of these surgical procedures, how dare him do this to me.

If you look on their website to find copay amounts, it says a 30 day retail supply is $35 and a aetna mail order supply for 90 days is $105. But if you only get the 30 day supply from them you are still charged $105. Well, apparently you get fried for using Aenta prescription home delivery for anything. It's totally not worth it. Just go to your local favorite pharmacy and have your prescription filled. Aetna home prescription does not save you money, in fact it might cost you considerably to use them. My advice: STAY AWAY! from Aetna Home Prescription Delivery.

I've lost over $250 due to the inflexiblity of Aetna Home Prescription Delivery.

When I had called aetna initially when I found out that I was pregnant, they told me that ultrasounds were covered at 90% for my plan and that there were no limits on the ultrasound as long as it was medically necessary. I did not perform these ultrasound for any other reason other than medical reasons. I'm being given the run around by aetna and my doctors office, both of them are blaming each other and i'm left in the middle.

I had to pay my doctor $500 for the ultrasound she did, and I'm sure a bill is being sent to me by the specialist for $572.

Patients portion of the bill is considerably higher.

I telephoned both the Aetna aproved PCP and the Aetna representative at Starbucks, Mr. Franada. Mr. Franada agreed that Aetna was wrong in not paying the bill for the Main Line Endoscopy Centre as the patient had been referred by an Aetna aproved PCP. (The doctors name appeared on the pathology report as the referring physician!)Mr. Franada also agreed that the patient would be covered for treatmant in the UK, (less his co-pay). Needless to say Aetna have not paid the Main Line Endoscopy Center invoice as promised and are only paying $164.10 of a $1201.94 invoice for the treatment the patient received in the UK.

Aetna's treatment of the patient is a complete abrogation of their duty of care. The patient suffered for two years because Aetna refused to settle a bill at the endoscopy center. Indeed, had they settled this bill in the first instance they would have saved themselves the cost of multiple ER admisions, doctors' office visits and would have saved the patient two years needles suffering and risk to his health. Furthermore, the patient's visit to the UK and my involvement would not have been necassary.

The patient suffered from a chronic infection of the gastric mucosa with an organism called Heliobacter Pylori. This is a simpe condition to treat but, because the patient was unable to undergo further endoscopy, (because the invoice for the first visit was unpaid), the patient suffered for a further two years and, eventually, had to visit the UK to access proper health care. The bill for the Endoscopy Center remains unpaid and, should the patient suffer a relapse or reinfection, he will again be left without access to proper medical care. H. pylori infection is a major risk factor for peptic ulcer disease.

Research has indicated that infection with H. pylori increases the risk of gastric cancer, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and possibly pancreatic cancer. These risks were increased by Aetna's unacceptable treatment of this young man. Of far less importance, my invoice for $1201.94 remains unpaid! I can stand the loss, the patient is a young man of limited means and with inadequate health cover.

Now, I am being billed over $700.00 for the procedure. AETNA denies having ever spoken with me. Plus, each time I call I get different answers. The physician denies any knowledge and says that there must have been some sort of a misunderstanding.

Bad feelings. I am in the process of filing an appeal.

Theft from my payroll deduction money's for longer than 6 months and also I was told I have no choice but to purchase the insurance or not work for KBR.

I have now been notified that by 6/24 they will be sending the matter over to a collection agency . At this point I dont know what else to do or where else to go. I cant get anyone to just pay the bills they were responsible for.

The stress of this ilone is enough but now I am beong threatened with collection agencies and I have already recieved one letter from a collection company. Why can anyone resolve this problem?

The request for an MRI was denied for the first time. The knee swelling was drained a third time and a second request for an MRI was rejected. The doctor requested a third time an MRI which was approved but for the wrong part of my leg and the nuclear medicine person could not do an MRI on my knee. My knee became infected and required weeks of antibiotics.

A second orthopedist was also of the opinion that an MRI was needed and submitted the proper request. Guess what! a 4th rejection from AETNA. I suspect the AETNA pays people in an office somewhere in the Carolinas to follow some rejection script that they don't understand and to reject requests based not on need, but on financial issues.

Don't know the damage since MRI would be needed to determine what is wrong. Emotionaly is wears away, and the pain continues. THANKS AETNA FOR YOUR COMFORT AND CONCERN

Dr's will not want to treat me with all of these bills going unpaid.

The complaint is my surgeries fell under Aetna's guidelines the entire time which was stated in the pre-certification and models sent to Aetna back in January. Aetna looked for every reason possible to deny the surgeries instead of looking at the facts that my case did fall in their guidelines. They have now put my health at risk with having to undergo another surgery along with financial hardship having to fund for another trip back to Texas for the surgery and more hospital fees that could have been avoided.

Meantime I have to suffer in pain while the joint surgery heals to undergo the jaw surgeries. I also have the risk that my joint surgery may fail due to the jaws not being corrected not to mention my restricted airway at 4mm is life threatening. This negligience on Aetna's part has put my health at risk and will cost further hardship both financially and for my family.

I presently have a 5mm ROM and no lateral movement and a 4mm restricted airway which 11mm is considered normal. I have lost all jaw function and also suffer from non-union of jawbone that Dr. was going to correct with grafting. My upper palate is so narrow that it affects my speech because my tongue does not fit in my upper palate. My doctors feel my misaligned jaw is causing my joint problems and function problems and if not corrected my condition will not get any better. I am unable to eat because of my 5mm ROM.

At this time Aetna has just denied my second appeal using cosmetic reasons as the reason for denial and feels braces can correct my problem. I am in my third set of braces and each time have had a major relapse when the braces are removed. I had a Lefort surgery and Arthroscopic surgery which both have failed.

Dr. W is well known for taking on complicated cases as mine and has high hopes that he can correct my medical problems and improve my quality of life. He stated to Aetna that my 4mm airway is life threatening. I have also provided Aetna letters from five other doctors stating my surgeries are medically necessary. I contacted over 20 doctors in the DC area last year and all informed me that my case was too complex for them to handle and referred me to Dr. Larry W. Last week my local doctors updated Aetna that my 5mm ROM and no lateral movement has not shown any improvement. Despite all of this Aetna continues to deny my surgeries. I spoke to Virginia Insurance Commission and he informed me that under Virginia State Laws my surgery is required to be covered, but my insurance plan is self insured so he stated he could not help out.

This has put a finanacial strain and hardship on my family because I have endured over eight complication surgeries and now denied part of a surgery that is medically necessary to put these complication surgeries to an end. I have spent hundreds of hours on the phone with Aetna trying to get approval and now since they didn't approve my entire surgery when I get approval I will have to pay again a plane ticket back to Dallas, Texas, hotel accomodations for up to two weeks. I also will have to endure five more months of suffering in pain that could have been avoided if Aetna would have approved all procedures. I have been on continuous painkillers since December of last year and will have to continue on this medication since my jaws are not lined up properly causing major muscle spasms. At this point I feel Aetna should be prosecuted to the fullest for not approving me surgery despite the 50 or more pages of documentation that was sent in warranting why this surgery is medically necessary.

I did not receive any contact from Aetna for several weeks, and when I did call in to check the status of my claim, my case manager, Judy Vasquez, was very unhelpful and rude. Several weeks later, I received a letter stating my claim had been denied due to lack of medical evidence that I should be off work. My doctor was outraged by this and said there was no reason for them to deny my claim. While I was still off work, I was injured by an accidental gunshot while removing a rifle from the gunrack of my pickup, and hospitalized for 6 days, from April 1st to April 7, 2008.

I was lifewatched by helicopter from Pretty Prairie, KS to St. Francis Trauma Center in Wichita, KS and spent the next 2 days in the trauma intensive care unit. I spent the next 4 days in the hospital with a chest tube in my lung, broken ribs, and slight liver damage. The gunshot had torn through my lung, torn my diaphram, grazed my liver, and shattered 3 of my ribs. We contacted Aetna to see what we needed to do to file another claim for this injury. It took MANY phone calls and almost 3 weeks before we got a straight answer from them regarding the status of my claims. They then informed us that all the time off would be filed under one claim, and that we would need to submit all new information for this injury and time off under the appeal for the first claim. We submitted over 50 pages of information. They requested all of the records from the hospital, including complete records, discharge summary, history and physical diagnostic testing results, progress reports, admission records, office notes, and restrictions.

After gathering all of this information from the hospital and trauma doctor, we submitted it to Aetna Insurance Company. I am still waiting to hear the status of my appeal. It has been almost 4 months since my origional claim, and over 7 weeks since my second injury and claim. They have not responded to phone calls and messages my wife has left repeatedly. When her or I do speak to my claim manager, she is extremely rude and unfriendly and seems to be bothered by our questions. When I saw my doctor again recently, he could not believe we hadn't received any benifits from Aetna Insurance Company yet. My doctor asked if we had involved an attorney yet and we are currnently unable financially to do so. Due to the lack of benifits and information, we have come under extreme finincial distress and are relying on donations and the goodwill of our church congregation and others to get by.

This has been an extremely stressful situation, physically, emotionally, and financially. We are doing everything we can to jump through the hoops that Aetna Insurance Company has asked us to do. I feel as though we are not receiving the attention we deserve to this matter. I also feel like Aetna is not taking our situation seriously. My doctor stated that Aetna is stalling, and that if they take long enough, we will just quit trying. That is not the case. We need every penny that is due to us from this time. Aetna is not providing the services that they should. They do not realize the gravity of the situation.

I get the feeling from Judy Vasquez, and others that I have talked to at Aetna that they don't feel like they should help us. They don't seem to act like this is a serious case that should be approved? I pay for this insurance to be covered for incidents like this, but they are NOT providing the services I have been paying for. I would like to see some sort of investigation to look into this case and see what the outcome is supposed to be. I am still off work at this time, due to the damage to my lung and to my ribs. It is unknown at this time when I will be well enough to return to full duty and work my normal 12 hour shifts. I am pleading for help from wherever we can get it. I need to know how to plan for the future and our continuing crisis.

Due to the circumstances caused by the inactivity of our insurance company, Aetna, we are in utter and complete financial distress. Since we have not received any payment since the beginning of February, we have fallen behind in everything. We have scraped by, buying only the necessary groceries, paying the minimum on our bills, and letting our credit cards and other debts fall delinquent. This could have all been avoided with prompt and accurate attention to our situation by Aetna. The emotional distress caused to myself and my wife has been extreme, and it is taking a toll on us mentally and emotionally. We can barely afford fuel money for my wife to go to work, providing the only income we have. I do not want their lack of attention to affect our economic future, but I'm afraid it has already.

On 5/6/08 i sent in the missing month of Dec for reimbursement,by fax with a note attached that it was the missing month and please process. I was told Iwould be reimbursed 7-10 business. after those days passed I called member services and was told my claim denied. I asked why and once again they realized that the service was approved and I should get reimbursed. Aetna does not contact clients when claims have not been approved.

On 5/16 I resubmitted the claim by fax and cheked in 10 business days (5/27 and 5/28) and online the claim said in progress . on 5/29 today the claim was once again denied for no apparent reason. I spoke to Nakia in member services and after being on hold for 32 minutes was told that they were resubmitting my claim and this time it would go through. once again she admitted they had made a error and see where this claim was previously approved.I was told once again that i would have to wait 7-10 business days for my claim to be processed and I quote Ms Nakia Sophia from claims put your claim through and it will not be denied this time I will watch your claim and check the status each day until the check is done I wanted to know why I had to wait 7-10 more days. I expreesed to Nakia that there should be no wait time and that they do have a way to process this without the 7-10 days wait.

Managers and Supervisors do not want to talk to members, but force you to deal with Aetna staff that has no authority. I requested an address where I could send a letter to in reference to my claim and was told I could only have a P.O Box and that was all they are authorized to give members.

Currently my husband (he has Care first insurance) is getting 6 months of chemo for sarcoma( a rare cancer) We are not able to make ends meet as it is.I expected to get reimbursed, for my claim so I could pay bills that are piliing up. Aetna doesn't seem to want to reimburse members for claims , even if they have been submitted correctly. They seem to want to hold onto your money longer and hope you give up trying to collect on out of pocket expenses from claims that are constantly denied. Some people do not have it in them to keep on resubmitting and fighiting for what is right when they have sick loved ones to care for.

I have had to pay thousands of dollars in out-of-pocket medical expenses for a variety of routine doctor visits, vaccinations and perscriptions. I have had to use public resources usually only available to the uninsured because Aetna will not cover simple vaccinations. I have spent untold frustrating hours on the phone trying to sort through matters with Aetna. I have been without essential medications for long periods of time because Aetna abruptly discontinues covering these medications.

i cannot have a child w/o infertility treatment. i am not pregnant.

Without Rx for several months, and out of Medication

On the 18 September 2007 I contact Aetna to inquire about purchasing insurance both medical and life for myself and my daughter. The package was sent to me and after reviewing the information sent, I was unable to pay for due to no longer working. (package received 26 September)

I contact Aetna 29 September 2007 and spoke with a gentlemen name Steven and explain to him at this time I am unable to purchase the insurance I had while working at Delta. I ask him if there was other options. While looking online I found the refund policy. Now I am sending this via email due to the lack of response from the department in which refunds are handle. I worked in the refund department for Delta, I know that there is sometimes a 90 day turn time.

Each time I call I get a representative that either doesn't know what they are talking about or they purposely say things to get me off the phone and when it doesn't happen I get frustrated. Either way, I eventually got through to a supervisor, her name is Tasha Hill and here is where my final and most legitimate complaint comes in to play. On april 14th, I faxed the exact form she requested to her direct fax number, got confirmation of the fax being sent, and then called and left a message stating that I had faxed the form and if there were any issues to please call me. I got no call, so I assumed my problems were over.

It's now April 30th and no check has been received. The reason i say that is in the intial welcome paperwork I received from SRC, an Aetna Company it was stated that your payment will be mailed to you approximately 7-10 days after receipt by SRC. On top of not receiving the check after 16 days, 2 representatives this morning told me they don't even see the claim being processed.

I have bills that are waiting to be paid with the money I was counting on from this benefit.

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.