Aetna Health Insurance
About Aetna Health Insurance
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Aetna Health Insurance Reviews
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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.
An AETNA sales person called my elderly father and convinced him to change insurance companies from one he had for 40 years. Then AETNA would not pay what his other insurance company paid - even though they claimed they would be less expensive. We are now looking at a bill from them for thousands of dollars that say he owes as a co-pay. There should be something done about this company preying on the elderly. I filed a claim with them and they dismissed my claim. If anyone knows of any kind of action I can take - I would appreciate the information.
As I have read on this site from others, I have had similar experiences with Aetna denying claims from their In-Network Providers. In 2020, I went to see my heart Dr which was in-network, Aetna denied the claim as in-network and tried to bill me for out of network coverage, this was after while on the phone with Aetna their representative stated that the provider was in-network. I had to file 4 appeals and get my HR department involved as well as our Insurance advocate to finally get them to cover this claim as in-network.
Now in 2021, I seen the same doctor for the same check-up and I am being billed an additional amount. After 8 phone calls with Aetna claims and being told that this was being corrected in phone call 7, I am now receiving past due notices from the provider. I am back on the phone with Aetna and them telling me the same things that I have been told in phone calls 1-7. I have elevated this to a Supervisor to get this resolved hopefully. I have also contacted my HR department in hopes that we might CANCEL this insurance and find a company that actually covers their claims and has customer service. If you are considering Aetna or have options other than Aetna, do anything other than Aetna.
Health insurance is about peace of mind. Aetna was nothing but frustrating experience. They will go above and beyond to decline your claims later. In my case, they were declining my Minute Clinic shots (shots, then clinic visit) after I switched health insurance (two years later). They will mail you a letter in writing with disconnected response telephone number and bad URL webpage. Complaining to California Department of Managed Health Care is a waste of time. You may eventually pay for whatever services you used out of your pocket. To sum up, you could use Aetna to avoid health insurance penalty, but don't expect more than that.
If you are searching for a health care plan for your employees stay far away from Aetna and Altius plans. This company is fraudulent and doesn't care about their plan members, especially in their time of greatest need such as emergencies. The back of the insurance card says go to any emergency room in the event of an emergency. However, this is fraudulent and a lie. If you go out of network they will refuse your claims and turn their back on you after all you and your employer have paid them. They will leave their participating members with huge medical bills and offer no support.
Your employees will be suffering life changing challenges and Aetna/Altius will add to their life stress by refusing to help with their medical bills. What can be more critical for a health insurance to do than help in the time of an emergency? Your employees will go bankrupt while still being asked to pay their premiums. Avoid this company. If you care about your employees, do not use these health plans.
One would think calling the appointment number, one would be able to cancel an upcoming appointment. NOPE! I chose the option for them to call me back instead of waiting 10min. WOW! what a clown show! Received a call back and of course you need to go over all the ridiculous questions to verify who you are. After that was established they couldn't find anything. On the ridiculous phone for 25min. Then I chose to speak to a supervisor, there was another 8min and still no answer. Too many fools who should not be working in the customer service capacity. EMBARRASSING! Horrible Customer Service.
I've had Aetna for several years through my employer. I barely use my health insurance at all. But the two times I had to use it (one for a cavity) and recently for the ER (for a gallbladder attack) I was sent surprise bills in the mail, which upon reviewing, looks like they didn't cover much at all. Thousands of dollars in bills. The time I had a cavity, I had to pay for this procedure and that procedure and this is not covered and that is not covered. And this recent ER visit, I'm paying out of pocket for radiology.
This plan is OKAY when it's something like getting your teeth cleaned once a year but other than that, these people are GREEDY and don't communicate what they cover and don't cover. Instead they send you stupid little cartoon calendars that say "track your health daily!" and 14-page documents of general garbage information regarding in-network out of network. Send me that when I'm feeling okay, not when I'm out of the hospital and you decide now to have some semblance of customer service. Instead, out of the hospital, send me an itemization of the breakdown of my entire bill and show me what you even covered. Call me and ask me what the specialists even did, because swinging through in a white lab coat with a stethoscope and talking to me for 2 minutes shouldn't equal 400 dollar bill that Aetna pays then hits me with this or that charge.
My insurance provider is listed as Aetna through my employer. Cool. So, when I needed to see a therapist for PTSD I searched the website, read my plan benefits and looks like it is covered. I go to a therapist, give them my insurance information (which they accept, and are in Network), and have several sessions. Yesterday I get a notification that my claims for therapy have been denied and I owe 1300.00. It is super great for my mental health to receive such news. I panic, and call Aetna. They tell me oh no! Those services are covered by Optum. What is Optum? Who knows! I googled, I tried to find info on Aetna's website, I did everything I could. There is no helpful information about this online.
Unless you have mind reading capabilities, as far as I can see, there is no way for a new user to know that Optum is a separate entity from Aetna and who you go through for mental health care. I'm not trying to get in touch with Optum to see if my care is covered. Whomever came up with this system is insane. I shouldn't have to dig and dig just to figure out who to contact, what company covers what, etc etc. Absolute **. Run! Elsewhere.
I have to use Aetna since my company partner's with them. I pay into the top one available Aetna Choice POS. I needed a surgery because I have chronic sinus infection which cause me to have headaches, facial pressure and throwing up due to mucus. I also have one of the worst deviated septum so I cannot breathe at all out of the right side of my nose. This makes it hard for me to sleep etc.
I was going to have surgery to have this corrected and Aetna said it was not a necessity! It is not a necessity to breathe? It isn't a necessity to work? Because the sinus issues keep me from being able to work a full work day sometimes and most weekends I am stuck in bed in a dark room in a fetal position in pain or nauseous. My doctor appealed, I gave my side of things and they still said they would not approve! All this 5 days before my scheduled surgery! Why do I pay the most for "premium" insurance if it does nothing for me? I am glad me not breathing isn't a priority.
My daughter paid out of pocket over $2,000 for medical work and the company kept promising to send her a check. They lied. The worst customer service with reps who like to argue with you. As a retiree I wish that my former employer never switched from Blue Cross/Blue Shield. Stay far away from this company. They need to be investigated.
STAY AWAY FROM THIS COMPANY. The plan coverage details listed are confusing. Their representatives and my doctor's assistants weren't able to decipher the information provided which resulted in the denial of an MRI that I desperately need. I'm experiencing severe spine pain with neurological symptoms and they expect me to wait up to 30 days for an appeal process. Wish I would have read these reviews before I became a member.
Husband had to have surgery. Did our best to get referrals for specialists leading up to it. Claims folks kept nitpicking but eventually paid. He was cleared by Aetna for surgery. He has the surgery and then the hospital submits the bill. Suddenly they start to second guess and we had to send his medical records. Now their nincompoops are claiming the surgery, which had been pre-approved, is now not medically necessary and we have to pay $45k ourselves. So now we have to go through a lengthy appeal process and contact doctors and meet with their appeals department. And all this to happen during the work day when I am supposed to be, you know, working.
Aetna deserted me in my hour of need. I am 75 years old and was very active till I started having back pain shooting down my right leg. I could not drive, bike, etc. About all I could do to relieve the pain was to lay on the floor. I could not even attend church on Sundays. My orthopedic Doctor requested an MRI to determine treatment and it was denied by Aetna. Aetna suggested physical therapy and I went. The first thing I heard at PT was "do you have an MRI." So it has been about 8 months of pain. Over the last 10 years I have paid into Medicare over $40,000.00 in monthly payments and Aetna denies a Doctor requested MRI.
Every bad thing you hear about insurance companies is represented by Aetna. I received an approval letter for a treatment. The medicine they approved was not carried by their required pharmacy. After many hours of contact trying to get an explanation of why they would approve a medicine and require me to use the pharmacy that doesn’t carry it I was told that there was a specialty pharmacy that did carry it but that they couldn’t find the approval. I offered to email them the approval I was sent. I was told that they would override whatever was out there and approve the medication.
When the pharmacy called to schedule the appointment with the doctor all had been approved. When setting the actual appointment a denial was received by the pharmacy for the same thing I already had an approval for. The next day in the mail I got a denial. I have been sent to more extensions people departments everything you can imagine that I don’t need. The only thing I can’t do is actually get someone to speak to me about the issue. I’m sure what they’re hoping is that I will throw my hands up and give up. I won’t, I will just have to continue to deal with his poor poor company. Great at taking people's money but not great at providing a service.
I had 3 different doctors recommend an MRI, it was declined by AETNA EVERY SINGLE TIME. I had it done anyway, because I care about a Dr.'s recommendation. They clearly don't. BASED ON MRI FINDINGS, a CT Scan was recommended, which obviously was declined. I had to file an appeal in order to get it approved by AETNA. Total waste of time over and over again. I have been requested approval for the MRI since April 2022, we are in July, 3 months later, Stella L. is not working today... Or any other unacceptable excuse.
I have a record of all my calls and the time I wasted miserably with AETNA and Evicor (the company they use to determine if an specialist's recommendation is worthy or not). Today, for instance, I called Evicore two times and AETNA 3 times, started at 14:33 and finished with a call to AETNA at 17:03 that lasted 45'. That's what they do: you are a ping-pong ball, they don't give you names or emails to document anything; they make you spit your liver repeating apologies they don't feel. During my short experience with AETNA I am convinced that the company's only concern is saving as much money as possible to the expense of their customers health.
This is the worst plan for providers to become credentialed. I have credentialed 6 providers over the last year and only 2 have just been approved. Credentialing is easy but waiting on Aetna is the worst. They credential fast. You see the patients then they won't pay the provider stating they are waiting on the contracting specialist to add them to the roster. So if you plan on being a provider expect a waiting period to get paid way over 1 year then they stale date your claims.
I have called everyday for 1 year and always get the same response, "Oh I will escalate this to the contracting department." Don't expect an answer because they never get to the escalation. You call back the next week and they say, "Oh I will escalate this." They have no representatives for you to speak with, only people who answer the calls in the Philippines. They can only tell you they will escalate. It's not their fault because this is what they are told to do and then they hold the brunt of the upset providers because the contracting department does not get back with you. I will never recommend Aetna to any of my patients or people I know. It's a nightmare.
Tried and failed 3 times to get a simple cardiac stress test authorized. I had to cancel THREE appointments. They will blame their vendor Evercore, but I contracted with Aetna, not Evercore! The worst! Would not recommend to my worst enemy!
I switched to Aetna CVS Health Insurance in Jan 2022 and the benefits summary appeared to be pretty good. What I didn't realize is that they want to decide what medications I take even at the objections of my doctors. We have spent 2 months requesting prior authorizations, appealing, appealing again and all they say is NO, try an alternative that we (insurance company) likes better. How can an insurance company be allowed to decide what medicines are right for me? This is completely backwards.
When I called to ask that question of the Insurance company, they hung up the phone. As of now, I have stopped taking the medication because I can't afford to pay the retail prices. My pharmacist told me that he sees this often, especially older Americans stop taking their medicines because they simply cannot afford them and they are at the mercy of insurance companies. Is that really how it is supposed to work?
I had Aetna 2 years in a row. I was promised my monthly free med when I signed up, it turned out I had to pay $100/month copay, I appealed but it was useless, the powers that be insisted I keep paying the $100/month copay. I had to pay $250 copay for an ER visit, $5/ month copay for a monthly test, $140/month copay for a sleeping pill, $600.00 copay for a Cardiovascular drug performed during a stress test, that's a lot of money when you're on SS.
I'm still paying it off, all this adds up monthly to an Insurance advertising they are by and large "FREE." They are not. I have Blue Cross advantage Medicare now, medication is drastically cheaper. I still have to pay the standard $45.00 to see a Specialist, my $100 monthly med copay I paid at Aetna is reduced to $10.00 copay with Blue Cross. When I started getting Medical bills in the mail for the years I had Insurance with Aetna, I thought this Insurance was guaranteed to drastically reduce medical bills, not increase them. I've had Blue Cross for most of my life, these other Insurances can't hold a candle to them!!
Aetna denied me getting a crown on a broken front tooth even though I have 50% coverage in and out of network! I pay them $140 a week! Why?! Just a bunch of thieves! Run as far away from this company as you can!
P.O.A for my mother who has dementia. They can't seem to find the P.O.A document that I have sent over several times and which came with the application. Now they've hired people offshore, a no-no in my book when it comes to sensitive information. Bye-bye Aetna.
Aetna Health "Insurance" reps chat up your HR department with promises of lower group insurance costs with no loss of benefits to the employees but instead employees are required to not only pay sizeable shares of premiums, but high deductibles, and co-pays which effectively add up to no one earning under $68,000 per year can afford even an annual physical with tests. A real life example of this nightmare is when the employer offered a "complimentary" on sight dermatology screening.
After a quick examination in a triage set up in the parking lot by a "dermatologist" and a couple of freeze treatments of nonmalignant freckles, a bill for over $400 arrived with Aetna sending two letters and 4 pages of papers to declare they were only paying $28 as a co-pay. This company should be investigated for unfair and deceptive business trade practices, but since they are probably in bed with many a politician who pulls the strings of the insurance regulatory agencies - don't hold your breath. I am definitely in agreement with many reviewers who recommend changing your job to get out of this bad deal, and self fund your own medical care at this point!
On 11/11/2021, my neurologist conducted EMG, MRI and wanted a Myelogram done. I have a severe condition that affects bladder retention, my ability to walk and my balance. I had difficulty getting a specialist referral PCP, Memorial Hermann Southwest told me the Radiologist had to approve it that not true. Due to having to escalate simple issue, I decided to switch plans for 2022. I feel the issues are directly dictated by Aetna because they do want to pay for service when member changed their plan. Aetna gave the appearance of assisting and basically is dragging out the process until 2022 plan begins. It is scary to think that Aetna would place a member’s health in jeopardy to save money. Also, penalizing the member for changing plan.
I proceeded to go to an out of network dentist Aetna told me to pay the hundred dollars and I will get reimbursed. Three months later they finally approve $100 and they send it to the provider instead of sending it to the customer. No agent has any idea what you’re talking about. They tell you they taking care of it and they just hang up. I got disconnected four times because they did not know how to solve my problem so they just hung up on me. This is the worst insurance company I’ve ever dealt with. Good Luck If your place of employment offers this insurance.
After my first year of service with Aetna I would never register with them again. Their copays and deductibles are terrible. They are a reflection of how broken the US insurance system is. It's pretty much not worth having insurance through them at all, you may as well just bankroll savings or switch providers instead of giving funds to these frauds.
After turning 65 a few years ago, I had to find supplemental insurance. I started with Humana. Being a low income person, most of the services were low costs and low co-pay. My 2 medicines were also free. I talked to someone who said my rates would stay the same for a year. In one word...LIE. After 3 months, my rates went up nearly $100 more a month, and I was STUCK until Nov, due to Obamacare. Then, at the same time, my cholesterol med changed from zero to $8. I called and was told that medicine was reclassified to a higher level. I protested and said it was not nice that I have to pay $8, while their CEO was making $220 million, and asked them to remove that med. I found a website that charged me $10 for the same med, but was glad to change. BOTTOM LINE: In Nov, I dropped inHumana, and tried Aetna. This will be my 4th year (they now added vision coverage), and I am satisfied. My 2 meds (now 3) are still free. Thank you Aetna.
They take forever to process claims/reimbursements. They will deny your claim for the smallest of details. Deductibles are extremely high. HSA spending is not worth it. Customer service is friendly but often times not helpful. It’s so bad that I’m actually considering changing jobs because the health insurance is so bad.
I am a current customer and I am beyond frustrated with this insurance company. I always have to call customer service to get my medicine approved even though my doctor said it is medically necessary for me to have the medicine. Aetna also took 10 days to preauthorize my MRI & now they are denying my surgery stating it's not necessary. Currently I can't sit for more than 10 mins, I can't walk far and I have a Limp, and I can't sleep through the night because my back and knee is hurting that bad. I guess this insurance company would rather I become crippled and have to pay for insurance claims the rest of my life instead of approving my back surgery. What ever happened to Quality of Life?
Aetna Insurance has been a great help to me. I have never had any kind of problem with the insurance or anyone that I have had to speak with. They have been extremely helpful in answering all my questions, even the dumb ones. They helped me understand how everything will be going for me after being diagnosed with lung cancer. Caring, understanding and helpful. Can't get any better than that.
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