Aetna Health Insurance Reviews

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About Aetna Health Insurance

Pros
  • Helpful customer service
  • Wide range of coverage options
  • Quick claims processing
  • Affordable premiums
Cons
  • Frequent claim denials
  • High out-of-pocket costs
  • Limited provider network

Aetna Health Insurance Reviews

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    Page 6 Reviews 640 - 840
    TechPriceRefunds & PayoutsStaff

    Reviewed June 2, 2020

    I just join this year with Aetna, did my research to make sure my PCP was in the network an all. Now they sending me a letter in May about the provider not being in the network as of Aug/2019. I joined Aetna in Oct/Nov. 2019. talking about I can still see the provider... by paying more money out of my pocket! I am on a fix income. Dont have money to throw around. I would not recommend them to anyone! their info is not correct, unprofessional to me! Wish I could give them a FAT 0.

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    Customer ServiceCoverageTechPunctuality & SpeedStaffBillingHonesty & Transparency

    Reviewed May 31, 2020

    I am having horrible experience with Aetna. I went to multiple service providers for my family members and given my Aetna Card to them, they check it in their system and say that yes they are in-network with Aetna and had to just pay the copayment. Later I receive hundreds of dollars of bills, when I checked the same with Aetna they say that the provider is not in network. I believe that multiple service provide can't lie and tell the same thing, what it means is there is something incorrect or Aetna provide misleading details to service providers which is passed on to the patients.

    I disputed this through internal review of Aetna and they simply denied. One of the Service Provider is Baylor and Scott. Both Aetna and Baylor and Scott doing handball to each other and I have been going through so much of stress due to that. Even I have highest level of coverage and doing all right things (checking with service provider before availing service multiple times, over the phone and during the service) and still in the receiving end. If you are with Aetna be ready for the sleepless nights. I am sure that there are thousands of such patients who are having stress full life due to Aetna Insurance.

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    Customer ServiceRefunds & PayoutsStaffBilling

    Reviewed May 13, 2020

    Aetna Medicare got to the point 2020 they refused to pay for almost every medical procedure. Denied all medicine. Pay for some that make no sense and you're making medical calls whether or not I can see a doctor. They actually told me that, "We are a HMO. We have the right to decide whether or not you can see a specialist. If we don't want you to see a specialist we have all rights to stop you from seeing any doctor we don't want you to see." I had to contact Medicare so I didn't have to be their patient anymore. They don't actually like paying for medical services at all. I was with him for 5 months. Started receiving all bills and they were supposed to pay for them. They always find a way to wiggle out of paying for your medical even though you're paying them money.

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    Customer ServiceCoverageBilling

    Reviewed May 11, 2020

    I have two special needs children, and they both receive multiple therapies a week. We transitioned to tele therapy because of COVID, and were told by Aetna copays were waived for all tele therapy sessions during this time. Now they say they aren't and I am being stuck with a giant bill retrospectively. I have learned over the years that Aetna never gives the same answer twice when you call to discuss coverage. I should have known better than to believe them.

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    Customer ServiceCoveragePunctuality & SpeedStaff

    Reviewed April 29, 2020

    My dad had to have triple bypass surgery 3 years ago and my parents had Aetna. My dad was in the hospital about 4 days then sent to another rehab/recovery facility. Aetna decided he needed to go home after 2-3 days because who needs ample supervision and care after major surgery like that? All his doctors and my mom had to fight with these "people", I use that term very loosely, to keep him there as long as he needed.

    My own experience is that the company I work for went with Aetna for a few years. Thankfully, last year they switched back to a real insurance company and my basic Dr. appointments are being covered again. Even calling Aetna an insurance company is inaccurate. They're more like a "Give us your money but don't you dare need anything from us" company.

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    CoverageSales & MarketingPriceHonesty & Transparency

    Reviewed April 27, 2020

    I’ve never written a review of a health insurance company before. However, having Aetna has compelled me to do it. It’s horrible, but unfortunately we are stuck with these guys via my husband’s job. Getting an approval for a medication seems to be just about impossible. The drugs my husband has to take for his condition require a prior authorization from his doctor. This is where you have to brace yourself. The faxes get lost, and I end up being transferred to five different departments etc. And guess what? In the end they still deny you for no reason.

    Two medications in a row were now denied (both on preferred list). They make excuses, and tell me to ask the doctor to file an appeal. This is what we are currently working on. The amount of rigmarole we’ve had to deal with over the last three months is unbelievable. It’s being my part time job to get this approval, and so far I have nothing to show for it. What are we paying the premiums for? This company has no regard for consumers. It honestly feels like a scam.

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    Customer ServiceCoveragePricePunctuality & SpeedRefunds & PayoutsStaffRates

    Reviewed April 24, 2020

    I have had Aetna for 4 mths. In this time, most of my medications have required preauthorization, or I have a crazy high deductible to get name brand medication. Once the RX deductible is met (meaning the customer pays out of pocket for everything before insurance pays toward cost), they then have the right to deny me the medication once they have to participate in paying towards the medication. I was transferred for 48 mins to different departments to try and file an appeal...I never reached the right department and then I was finally put back into the main system w/ no direct transfer. I hung up at that point. When you call for basic benefit help, you get routed to outsourced workers in countries like India, making it hard here and have to wait on that annoying delay.

    I pay too much out of my check every month to get crappy services and nothing's covered until I meet a 4k out of pocket deductible 6k max outta pocket deductible, which does not include co-pays and your monthly deductions from your check. If met, this is a plan that can cost upwards of 8k plus. And all expenses are on you except a basic doctor's appointment, where you get a negotiated rate for simple service until the deductible is met. Aetna should be ashamed of their policy structures and lack of support when you call. My company changed last yr from Cigna and it was much better in terms of basic support from its employees when you call in and there were many other benefits within plan that did not come at an additional cost to policy holder. Aetna offers you nothing!!!!

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    Customer ServiceCoverageSales & MarketingPricePunctuality & SpeedOnline & AppRefunds & PayoutsBillingFollow-Through

    Reviewed April 21, 2020

    I have been a customer with Aetna for over seven years and have yet to have ONE satisfactory experience with them!

    1) Their customer service department routinely gives out incorrect information and then they won't even honor what they have said - even when presented with THEIR own call reference number.

    2) Their plans don't really cover anything and there's always some silly excuse as to why the money I'm paying (OUT OF POCKET!) for my appointments, prescriptions, etc. DOESN'T even count towards my deductible! Therefore we NEVER meet our deductible before it starts back over at zero every January, and we just end up paying for every darn thing out of pocket (including our monthly premium!).

    3) Their website and customer navigator page hardly ever works as advertised which always forces me to have to make calls to them - which almost always results in me getting incorrect information...or being told that I will receive a callback that I NEVER receive.

    In conclusion the only service that they provide for our monthly premium is 'low-balling' my doctor "for me" and then calling it a "contractual adjustment"...Meanwhile I'm doing all the paying of bills and they haven't paid out a dime! Avoid Aetna!

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    CoveragePrice

    Reviewed April 13, 2020

    I Have their Gold plan and have a $6k deductible. I paid them almost $20k last year and went to a doctor twice, and only for routine physical and the second time to review lab results. Recently broke my leg and these guys don't even cover the boot for my leg. So far, they have covered almost nothing in my couple years with them. Not sure if this is just Aetna or just the American Healthcare system, but someone is failing. If it weren't required by the feds, I would drop these guys immediately.

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    Customer ServiceCoverageTech

    Reviewed March 28, 2020

    I use an asthma inhaler. I called in a refill only to learn, on a Saturday morning that Aetna would no longer cover it. Aetna is closed on weekends, so left without critical meds. Why did Aetna not provide me with advance warning? I never experienced an issue like this with my prior provider.

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    Reviewed March 25, 2020

    My father was admitted to the hospital and then the doctor ordered rehab at skilled nursing facility. Aetna denied the claim. The hospital sent an expedited appeal. Aetna claimed they never got the most recent report. My father's deteriorating in the hospital, while the hospital fights with Aetna to get approval. The case manager said Aetna is notorious for denying referrals. Avoid Aetna like the plague!

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    Customer ServiceContract & TermsCoveragePriceStaffFollow-ThroughHonesty & Transparency

    Reviewed March 22, 2020

    No matter what the answer is NO, not in this lifetime or any other. They did not follow through, did not keep their word, did not provide what was fair and reasonable and DENIED EVERYTHING that cost me a fortune because they ALWAYS SAY NO. TOOK THE PROBLEM HIGHER... RESPONSE... NO. Was supposed to have a patient advocate... did they help, NO. The most dishonest, conniving, irresponsible, lying, useless health insurance company on the planet. DO NOT GO HERE. You will lose. Time, money, patience and anything else you want to achieve will never happen. They are horrible, horrible, horrible.

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    TechStaff

    Reviewed March 12, 2020

    This company is so terrible my provider just dropped them, after 2 years I need to now shop around in network and rebuild the medical understanding of the last couple years. Let's reflect on that Aetna, you're equally atrocious to patients and doctors and every time I drive by your ridiculous castle off I84 in CT I'm reminded of how much money you're making and how goddamn poor of a job you do for the citizens of this country. You suck.

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    Customer ServiceStaff

    Reviewed March 5, 2020

    Called customer service in order to make doctor change. Javier located in Fla was not able to understand English, repeated a few times still, going off in another direction. This was the English line, not the Spanish, when I mentioned he is not following what I am saying, he said "Jesus!" and added some expletive, then " I will transfer you to someone else."

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    Refunds & PayoutsStaff

    Reviewed Feb. 21, 2020

    We took my husband to an Urgent Care for cellulites only to find out the co-pay for urgent care is $175. If we would have utilized a "Walk-In" clinic, our co-pay would have been $35. When we spoke to an Aetna agent, the only Walk-In clinics in our area are Minute Clinics inside a CVS. There are numerous Urgent Care centers in the area. So I have an option to visit a CVS for $35 and visit a non-doctor or pay $140 more for a doctor. This seems absurd to me. Why make it difficult to visit a doctor.

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    Customer ServiceCoverageTechPunctuality & SpeedStaffBilling

    Reviewed Feb. 20, 2020

    Saw a dermatologist (who I've seen for many years) in Sept. In Nov. I received a letter from Aetna saying they had made a mistake in processing the claim - which wasn't processed until Dec. At that time they claimed the doctor was out of network. I spent an hour with an Aetna rep who determined he was in network and the claim was reprocessed correctly. In late Feb. I received a bill from the dermatologist for 350.00. Apparently, Aetna asked the doctor to return the previously issued payment. I called Aetna. Spoke to an inexperience representative who repeatedly told me the doctor was out of network. I pulled up the Aetna website where it clearly showed the doctor in network. I was told I would need to file an appeal but that she didn't think it would be approved.

    After being put on hold 3 times for a total of 50 minutes, she changed her response to the doctor wasn't approved at that location. OMG. I ask to speak to a supervisor, she confirms that the doctor was not approved at the location. I asked if it was standard and acceptable behavior to pay claims and then reprocess? I asked why I didn't receive a letter informing me that he was no longer in network? I asked if all previous claims from this doctor would be recalled? Her answers were that they were acting within their rights. I will be contacting my employer to let them know of this inexperienced, unpleasant and fraudulent insurance provider. Beware apparently they can decide to review/reverse claims at will.

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    Customer ServiceCoverageRefunds & PayoutsBilling

    Reviewed Feb. 18, 2020

    I've been trying now to get a couple of completely valid routine wellness check up medical claims paid for two of my dependent kids. Date of service was last Jun 2019. It's now Feb 2020 and these bills are about to go to collections. After MANY times of calling in and holding for a good hour, I was given the same run around each time. I provided the additional information they needed to process the claim, which was ridiculous in itself. To make a long story short....they will do anything to avoid paying a claim in hopes you will just give up. I can't say enough bad things about my experience with Aetna. At this point my recourse is to consult an attorney. If you can get insurance elsewhere run!

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    Customer ServiceTransparency

    Reviewed Feb. 18, 2020

    I signed up with Aetna Medicare in November 2019 to start Jan 1 2020. Was in need of three doctors. Primary, Gastroenterology and Pulmonology. Went to Aetna website and picked out a list of six doctors. I called all six and none of them participated in Aetna Medicare. I called Aetna multiple times and their end answer was the system needed to be updated with the most resent doctors participating. Needless to say how unacceptable this is! This is February, the system should have been updated in January. So disappointed that I am stuck with Aetna for a year.

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    Customer ServiceCoveragePricePunctuality & SpeedMaintenanceStaff

    Reviewed Feb. 13, 2020

    My main reason for trying out this plan was to have a battery replacement for my spinal cord stimulator. For about 20 years I’ve been on plain Medicare, but it was/is going to cost over $4,000, and the plan I thought had a $280 ambulatory service copay. Turns out, it’s $375 ish or close to it. It became active on January 1st of this year (2020).

    The first issue wasn’t really unexpected, but one of pain medications is in dispute as they don’t want to cover it. So, I am appealing it, but expect it not to happen. Not that surprising, nor my main issue. Fast forward to January 29th, my pain doctor did a ‘test’ procedure to see if I would be a good candidate for a nerve block. THIS too was denied. He even tried to appeal it himself and was told he couldn’t do anything else about it from a peer to peer conversation. Now I am appealing it and hopefully he gets paid like he deserves to be. So here we are, February 13, 2020 and am switching to another plan next month. If I could give them 0stars, I would.

    I needed this to help make a surgery possible. What I didn’t ask for was a company that I would have to appeal every single thing that my Doctor’s want to try to elevate my pain. Not sure what else to say other avoid Aetna like the plague. Out of 4 phone calls to fix an issue only one lady was helpful. The rest were so useless, after explaining my issues 5 times, just hung up in frustration. No idea how this is a major insurance in Texas, because it’s atrocious. Hopefully the insurance from companies is better than Aetna Medicare is all I can say.

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    Customer ServiceCoverageStaffBilling

    Reviewed Feb. 13, 2020

    Called to confirm surgery. Told by first 3 of 4 service reps I no longer was covered. 2 hours on phone to get correct response. Also, told I needed to see primary physician for PT coverage even tho I had letter of order from surgeon dr. Wasted time and $ on appt with primary dr even tho not required under managed care policy. Told last yrs PT covered when inquired but refused partial pay when bill submitted. Terrible service with usual incorrect info when requested.

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    Customer ServiceTechPunctuality & SpeedStaffRatesCommunication

    Reviewed Feb. 7, 2020

    This company is a Awful and horrible company to deal with. They have no communication skills and Credentialing dept. and provider services are off-shore reps that don't know how to spell out the next word they are saying. Whatever question I have the answer is 30 Business days. I am waiting over a year for some requests and the wall is a better thing to talk to. Don't deal with these slow people!!! Contradicting info provided by the reps looks like they are all working under their pillows!!!! Pity zero stars is not an option to rate this company. They don't even deserve the first star!!!

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    CoveragePriceRefunds & PayoutsRates

    Reviewed Feb. 4, 2020

    Rates went up 100% for me in 2020. My insurance premiums were $156 per paycheck in 2019. Now in 2020, my premiums are $300 per paycheck. Also, the plan doesn't cover much. My wife just had a baby and I still have to pay about $6,000 out of pocket.

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    Refunds & Payouts

    Reviewed Jan. 31, 2020

    Dr. said, "You need an MRI," but said, "They (Aetna) wouldn't pay for an MRI unless you get an xray first." Then aetna wouldn't authorize the MRI because, the xray didn't show the problem. The problem the Dr. said she wouldn't be able to see in an xray, thus the need for a MRI???

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    Customer ServiceCoveragePricePunctuality & SpeedRefunds & PayoutsBilling

    Reviewed Jan. 31, 2020

    One of the worst insurance companies. First the hospital sends me a bill when Aetna was supposed to cover me. Then when I call aetna they agree with me and call the hospital to get rid of the extra charges. Few weeks later another person from aetna calls and claims there were some fine prints which we did not read and you have to pay the whole amount. Does not matter if you buy their platinum, gold or silver plan. You will end up paying for everything.

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    CoverageStaff

    Reviewed Jan. 30, 2020

    I switched insurance thinking that Aetna was a better choice for me. I was totally wrong. I am an individual with chronic pain, stenosis, degenerative bone disease, rheumatoid arthritis, fibromyalgia, spondylosis, and post-laminectomy pain syndrome. I TAKE ** and will be taking in addition ** to alleviate the unbearable pain that I live with. Well, this company has chosen to brand me and NOT cover the OPIOIDS that I so much need and that I have been taking without any shame, for nine years, they think that people that take those medications are junkies.

    I am a responsible 68-year-old person, and never had an episode of overdose or wanting more than my doctor prescribes. For their poor judgment, and lack of consideration, I am changing insurance as of 2/1/20, I do not need to be judged by faceless and heartless individuals because I take a medication that certain individuals have branded as a sin and shame. No, I am not ashame to look for relief in OPIOIDS and will continue to do so, as it is my right as a human being to live a better life until the end. Signed: Evangelina **, Miami, Florida.

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    Customer ServiceCoverageTech

    Reviewed Jan. 30, 2020

    Worst insurance in USA: So confuse, all refers are denied. Very difficult to call offices. You get from CVS the over the county stuff that neither the CVS workers want to buy, terrible everything. If you get Aetna with Chen Clinic as as your health provider you are going to be in hell (el infierno) both are an evil combination, Chen doctors are fine, they do their best but the administrative process from Chen Clinic headquarter are going to make you sick back again. I will comply with the Social Security, Insurance Commission, Better Business Bureau, and the Attorney General. In fact I maybe will record all the terrible bureaucracy about this mediocre insurance and Chen Clinic Headquarter. Muy malos los servicios telefónicos en español.

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    Customer ServiceCoverageTechPunctuality & SpeedRefunds & PayoutsStaff

    Reviewed Jan. 30, 2020

    I was a lifelong member of Aetna Better Health. My primary care physician left the network. I spent days going through mind-numbing voicemail screening only to repeatedly be provided with a list of physicians that was obsolete. When I phoned an office I was either told that the physician “is no longer in the network” or else that the facility as a whole “no longer accepts Aetna”.

    While covered with Aetna Better Health I scheduled an appointment at the Whitehall Dental Group and was told by Aetna that I would be receiving a $50 gift card. The dental group knew nothing of this and a few weeks later I called Aetna who said I would receive the gift card in a couple of weeks. That was last year and when I called, after 2 weeks of misdirection, I was told that the card would not be issued due to the fact that I was compelled to seek alternative coverage due to a dearth of providers. Interestingly enough my niece attended the same appointment and presently has Aetna but she too has received nought. It is appalling how needlessly difficult Aetna makes any and every service or concern inquiry.

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    Customer ServiceCoveragePricePunctuality & SpeedStaff

    Reviewed Jan. 30, 2020

    My husband and I both selected Aetna for our Medicare advantage plan for 2019. One of our primary considerations was dental care that we both needed. This plan allowed for $525 in reimbursement for any dental services. We had no problems or concerns for general medical services with our PCP, referrals and prescriptions. For that I would give them a 5. But I needed dentures at a cost of $1500. I knew that Aetna only paid $525, but that was a significant help towards this expense. I sent my receipt and documented services to them in October. I followed up a few weeks later with them.

    They verified that they had received the claim and I should receive this check in 6 weeks. I was a little disappointed that it would take this long but calculated that I should receive this a little before Christmas. It is January 30th, 2020 and I still haven't received this check despite numerous calls in which I was told to wait a little longer. My last call was on January 9, and I was told that the check would be reissued. This has caused me considerable problems. For this reason, I have concerns about the reliability of this insurance and I have not been been able to talk to anyone who would be able to resolve this.

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    Customer ServiceCoverageSales & MarketingStaff

    Reviewed Jan. 29, 2020

    I signed up with Aetna Insurance this year because of the hearing aid benefit, $1250 per ear, advertised on Aetna's Website members benefits for hearing aid. They're purchased from a Hearing Aid Supplier-Hearing Care Solutions that is being represented by Aetna for the hearing aids benefit to purchase them. It's a bait and switch scam and fraudulently aids & false advertising. Turns out the $1250 per ear is not true of what Aetna advertised benefits are. Hearing Care Solutions states it's only $950 per ear, that Aetna's clients ordering hearing aids from Hearing Care Solutions. Nowhere on Aetna's or Hearing Care Solutions listing benefits page for hearing aids- does it show which hearing aids consumers do or do not qualify for- Hearing Care Solutions Management says that Aetna Clients do not qualify for a $1250 per ear, only @ $950 per ear.

    Aetna Website benefit page clearly states $1250 Per ear, all of Aetna's agents inform new Aetna clients it's $1250 per ear. Leaving a published Aetna pamphlet with the advertised hearing benefit of $1250 per ear. Falsely advertising you into believing your hearing aid benefit is. $1250 per once you signed up- I called both companies, And get told there nothing that can be done-Hearing Care Solutions In Colorado CEO was rude to me and hung on me after reading the complaints on BBB, in my opinion, it is a bait and switch, falsely advertising the hearing aid benefit to sell you their insurance.

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    Customer ServiceCoveragePunctuality & SpeedStaff

    Reviewed Jan. 22, 2020

    My doctors at UNC hospital recommended TMS treatment for my severe, treatment-resistant depression. Aetna denied coverage of this treatment because I am 20, not 21. I turn 21 later this year, and the FDA approved age for TMS treatment is 18 years old. I am within the medically recommended age limit provided by the FDA and doctors at my hospital and in the field. My doctors attempted to file an appeal, and were denied a peer-to-peer review for my case.

    After learning this, I attempted to contact Aetna twice about my case, and speak to whoever made the choice to deny coverage and a peer-to-peer review for this treatment, so that I could self-advocate. Both times, I was met with resistance, and was not put on the phone with anyone who had made decisions about my case. I had an extremely hard time understanding and hearing the people I spoke with on the phone, and they gave me no new information whatsoever. I spent a total of over 30 minutes talking to various customer service representatives who refused to transfer me to someone with medical knowledge or who was involved in the process of denying my coverage, despite my doctor's approval. I spent a lot of time on hold.

    I have never filed a formal complaint before, but seeing as this was the worst decision-making and customer service I have received in my life, I found it necessary to do so. I would like to make sure that this does not happen to any other Aetna customers in the future. This review is also going online, so that potential customers have an idea of what they are getting into. I would not ever voluntarily receive Aetna care after this experience.

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    Customer Service

    Reviewed Jan. 21, 2020

    Can't get straight answers. I have Humana and never had these problems. No one recognizes my member ID when filing claims including flu shots as well as blood work. I have tried calling customer service and cant get a straight answer.

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    Customer ServiceCoverageTechStaff

    Reviewed Jan. 21, 2020

    I was calling from a provider's office regarding a claim that was denied because of 'gender-mismatch.' This patient's claim has been accepted and fully covered for 6 times in a row and this 7th claim is suddenly denied because of the patient's gender is mismatched? This is a terrible excuse for not getting jobs done properly. The patient's coverage has not expired, still eligible, and the representative kept repeating the information I gave him in arrogant manner. Clearly did not know what he was doing and didn't even have willpower to look up what went wrong. Name of the Representative: Richard. Ref#: **.

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    Customer ServiceContract & TermsCoveragePriceStaffRates

    Reviewed Jan. 21, 2020

    I have been using a generic version of my asthma medication for months now and paying a reasonable $15 copay since I switched jobs this past summer. I received notification in December that this generic medication would no longer be covered and that I would have to use a brand name versions that are now going to cost me $200 a month. I called and spoke with a representative who couldn't provide any valuable information about what my other afordable options were. The call with their rep was a complete waste of time. Two of the three drugs on their "preferred" list are for COPD only and cannot be used for Asthma, so these are NOT even alternative options for my condition. So, even though there are generic, reasonably priced options available in the market that I used to be able to purchase (with the same plan), I now have to use the most expensive options on the market, so they can all make their money by taking mine. Beyond frustrating.

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    Customer ServiceCoveragePunctuality & SpeedMaintenanceStaff

    Reviewed Jan. 16, 2020

    Floridians DO NOT CHOOSE AETNA insurance especially if you already have AV-Med Insurance in South Dade County. We have been fighting since Jan 1 to get to our Cardiologist, as both my husband and self also have loop recorders. No Doctor is monitoring us since Dec 2019. Doctors have cancelled appointments due to lack of PCP showing on our records. Our Primary DR. Cindy Mitch ** is in their plan, but technical difficulties stop her referrals. Our agent after over a month can not help us. The customer service no. refers us to that special Florida customer service no, because of all the problems with this new Florida Plan. No help there either as we are unable to register and no one in the meantime is watching, listening to us.

    My husband has had triple bypass heart surgery and I am not allowed to drive for 6 months because of last hospital visit and loop recorder which specialist in both our cases are not monitoring. We are beyond desperate at this point. Additionally my husband, a recovering Cancer survivor must have a procedure every 3 months to ensure no new cancer cells have developed and requires a referral. Has no way of obtaining the referral required. Our new cards and Not. DO NOT WORK.

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    Customer ServiceTechPricePunctuality & SpeedRefunds & PayoutsStaffBilling

    Reviewed Jan. 14, 2020

    On December 13, 2018, I was in a no-fault scooter accident in Quintana Roo, Mexico. I was transported by ambulance to a local island hospital and then moved to to a hospital in Cancun where I received Emergency Care due to the extent and severity of my injuries. In Emergency Care, I was diagnosed with a concussion without loss of consciousness and it was noted that I suffered multiple contusions to my body including an injured right leg and knee. This required a two day stay (December 13-15, 2018) that included immediate hospitalization, blood work, diagnostics tests, CT scans, stabilization, observation (had blood on the brain in proximity of my neuro cortex!) and general care.

    FULL reports and invoices were provided to Aetna via the member portal on www.aetna.com. This included comprehensive details on all providers, services rendered including CPT codes and the related costs – and my diagnosis and test results. Needless to say, I was not stable enough for a transfer solo to the United States or other to an “in network provider.”

    As is the case in the USA, such services were provided by the 'host' hospital as well as its affiliates, which are all clearly noted despite Aetna’s responses to the contrary and were part of my timely, original submission. Providers clearly shared and “sent” on December 27, 2018. Contact information for a liaison also was “sent” on December 27, 2018 and noted (in the upload to the member portal and via multiple phone calls to Aetna). This provision was part of due diligence and to ensure any questions could be addressed and any clarification needed could be made possible, including, but not limited to, translation from Spanish to English.

    Despite providing comprehensive information and calling multiple times to try to resolve, Aetna failed to provide any clear, fair or reasonable resolution to my overarching claim(s) and/or related elements. The calls to Aetna have resulted in posting and re-posting of rudimentary information without any regard to the comprehensive details that I initially provided – and with Aetna continuing to note that I had not provide adequate information ranging from “missing member name” to “no associated provider”. There’s no question, this information was never missing as was provided at the onset of the claim “sent” on December 27, 2018.

    While this was a SINGLE claim that spanned December 13-15, 2018, the Aetna system has splintered it into pieces making it unnecessarily complex and disconnected from reality. I was forced to complete a total of 11 unique submissions for this single claim. Due to a the 5MG limitation Aetna has set in its member portal the 11 submissions were made and included 18 corresponding attachments. The corresponding attachments expressly called out the names of all associated providers to lend clarity.

    Multiple times I asked that my submissions be thoroughly, astutely, accurately, fairly and ethically reviewed based on the comprehensive information I promptly -- and continued to provide. Keeping in mind that I am not a medical professional and/or a healthcare claims administrator, this includes clarification around any/all items including, but not limited to:

    • DX codes
    • CPT codes
    • Revenue codes
    • Billed type
    • Provider TIN
    • Provider PIN

    • Translation from Spanish to English

    I also respectively asked that Aetna proceed with reimbursing me for expenses I incurred once my 2018 deductible is exhausted. I, in good faith, did my part. Aetna and its minions did everything they could to NOT uphold their end of the deal. Really, truly a disgrace.

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    CoveragePriceRefunds & PayoutsStaffBillingHonesty & Transparency

    Reviewed Jan. 12, 2020

    I have Aetna Insurance through my spouse's employer and pay more in 2020 than 2019 with sub par coverage. I had a procedure of an EEG from 4/23 to 4/25 in my home for Syncope passing out and severe migraines. I received a bill from my doctors office in Jan 2020, statement date of Oct 2019 and the Service was performed in April 2019.

    I spoke to the physicians office 3 times prior to the procedure to make sure this was covered by Aetna and was told all three times that it was with no charge to me. Aetna should have not told my doctors office was covered and now denying to reimburse for the procedure. Aetna chooses to charge more for the insurance but deny claims to make the patients responsible for procedure expenses. There needs to be more clarification on what is covered and what is not. It is not very professional and lack of integrity & honesty with this company.

    Renee, Ft Worth TX

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    Customer ServiceStaff

    Reviewed Jan. 8, 2020

    I mailed in my prescriptions in December 2019 and only got an email on January 7th saying they could not fill the dosage written. My doctor wrote me a prescription for 90mg per day of generic ** and Aetna is saying they can't go higher than 60 mg per day. Who are they to change my dosage? Why are they questioning my doctor? Why did it take so long for them to get back to me? I now have 3 days of medicine left and am having to take 1/2 doses while trying to get more. I have spent over 3 hrs collectively on the phone with very rude customer service agents who have given inaccurate information.

    I am now trying to have the prescription transferred to a local pharmacy so I can pay CASH for it because I am desperate for my medication (which treats PTSD in my case). Not having this medication is not a functional option for me and no one is helping me. I just heard from my local pharmacy and Aetna has hung up on them twice when they called to request the prescription transfer. I am absolutely appalled at this behavior. I never should have left Kaiser. Kaiser was amazing. WORST DECISION EVER TO CHOOSE AETNA!!!!

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    Staff

    Reviewed Jan. 8, 2020

    We got the policy through employer, Aetna has wrong info. about gender. My employer contacted aetna to change my wife gender as female but they keep on reversing as husband. Because of that all the claims got denied. Worst service ever. Aetna representative told us to contact employer to change the info from their system. We contacted our employer (HR) they did change our info. and sent it to aetna but aetna keep on reversing my wife gender as husband. Worst service ever.

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    Customer ServiceCoverageTechRefunds & PayoutsStaffRates

    Reviewed Jan. 7, 2020

    I have called multiple times to get a new insurance card for my newborn baby. Every time I call they are rude and inconsiderate. They aren't helpful and obviously don't know what they are doing. If my employer didn't have this insurance company as their provider, I would have kicked Aetna to the curb a long time ago. The rates are outrageous and the out of pocket amount is much more than my husband and I can afford. I would never use this insurance company on my own.

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    Customer ServicePunctuality & SpeedStaff

    Reviewed Jan. 6, 2020

    I am an Aetna Medicare Advantra Premier Plus (PPO) H5522-001 member as of 1/1/2020. Problem 1. The "technical support" group claims they do not have me in the system. Why not? I have an Aetna card with all of my membership information included on it. Problem 2. I went through the website communication process last week but they have not yet responded. Problem 3. When I call Aetna, the phone keeps hanging up. It took me six (6) calls to get through - and I've been on hold waiting for someone to answer for 30 minutes. Problem 4. I am losing faith in Aetna - and I've only been a customer for 6 days! IN SUMMARY: I AM HOPEFUL I DIDN'T MAKE A BAD DECISION SWITCHING TO AETNA!!! How about a little help Team Aetna! Thank you in advance for responding to this correspondence!

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    Customer ServiceTechOnline & AppMaintenanceStaffBilling

    Reviewed Jan. 4, 2020

    Aetna website is beyond useless and unusable. After I paid 2 claims online to the provider, I did the same thing again and this time, it kept complaining card info was invalid. Card info was correct. I triple checked. I tried Discover instead of Visa and same thing happened. Then I started from scratch and entered Visa card again. This time it said payment was declined by credit card company. I called my CC company and they said, "We did not decline anything, nothing came through." I tried again while online with the agent and now back to card invalid error. SIMPLY AWFUL. Also, the site does not work well with Chrome and I had to use Safari. They do not make links open in new tabs. Everything needs too many clicks. The online experience is awful. I hope they make some investments in technology. It is after all 2020!

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    Customer ServiceContract & TermsCoverageTechRefunds & PayoutsStaffRates

    Reviewed Jan. 3, 2020

    Our company provides mental health to many patients with insurance. Aetna pays below Medicaid for the state of Virginia. Several attempts have been made to increase our rates. No one at Aetna has bothered to respond, except to send out ridiculous questionnaires, stating they need more information, which they were sent. Calling Provider Relations is a waste of time, as they are clueless. Their English is poor. They know nothing about the network department, and they do not have a phone number for the network department.

    Today, we are making the decision to drop Aetna, and not have a contractual agreement with them. We are informing our patients why we are dropping Aetna, and helping them to navigate to another insurance company that will be more responsive and pay providers at a fair rate. We started this process during open enrollment and many patients were able to make the switch. Other patients are choosing to stay with us and pay out of network rates. Too much time is wasted with Aetna. Time to move on.

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    Customer ServiceCoveragePriceStaff

    Reviewed Jan. 1, 2020

    We’ve had Aetna health insurance through my husband’s company for the past 18 years. They’ve become progressively worse. For the past 2 days, they played games with us re: filling a Rx that I’ve taken for the past 12 years. Putting us on hold forever several times, transferring us to agents who give us the runaround and do nothing- only to hang up on us, and tell us different stories about what paperwork they have received from my Dr. when we repeatedly send it to them. I take the brand, and have tried the generic in the past, which has sent me into tachycardia due to a heart condition.

    Now it’s New Year’s Eve, and they’ve done everything in their power to ensure that I don’t get my medicine, that suddenly it’s no longer approved, and I can’t afford it in the New Year as I have to come up with my 4K deductible all over again. Shame on them. Migraines and tachycardia, please stay away. My insurance company doesn’t care. And they claim to care to reduce costs. At what risk??

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    Coverage

    Reviewed Dec. 31, 2019

    The new 2019-2020 Aetna Plans are pure robbery. You must meet the deductible with in-network providers before your coverage kicks in. 3000.00 deductible + 8400.00 premium = 11,400.00 per year before you get insurance. All cost with specialist, behavior, etc goes toward your deductible (at a reduced network rate.) This is like bad dental insurance - which they offer as well. How can they get away with this?

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    Staff

    Reviewed Dec. 24, 2019

    Had to take my husband home from hospital after having his toe remove because of diabetes. Was in hospital for 11 days, doctor wanted him to go to rehab and Aetna refused. We are both 73 yrs old and now I take of him which I am not equipped to do. We pay all this money to Aetna and this what they do. They only care about the money, not the patient. Aetna would not tell why he was denied. Some company they are. Would not advise anyone to use them.

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    Customer ServiceCoverageStaff

    Reviewed Dec. 17, 2019

    Aetna is the absolute worst company I've EVER had to deal with. Unfortunately my employer chose to move our health insurance from Blue Cross (fantastic company) to Aetna (garbage company). Since switching to Aetna, I've had the most out of pocket expense that I've ever had in the 10 years that I've carried my own insurance. This year for example, I've only met $80 towards my deductible & have spent over $1,100 in out of pocket expenses. This is the last month of the policy period.

    Their customer service is also the worst I've ever dealt with. They will annoy you to no end to refill a specialty rx but when a new rx is submitted they don't bother calling you to tell you that you need to set up a delivery. They also read from script, which is very irritating. They like to tell you what dosage of medicine you should take... they think they're doctors. I honestly can't even believe they're still a profitable company or that any reputable employer would want to subject their employees to this type of treatment. It's clearly all about the money. If your employer cares more about the employees than profit then you'll have better coverage than Aetna.

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    Customer ServiceCoverageStaff

    Reviewed Dec. 14, 2019

    Aetna Healthcare provider many companies with ill suited treatment or no treatment at all. Beware, to save money and cut costs, your health is in jeopardy if you are beholden to them for your health benefits. They have a wide practice of denying legitimate health claims in order to secure their future revenue. Do not ever assume that they will do the right thing where your health is involved. The customer is very low on the totem pole and usually ends up being nothing more than one of their casualties. They truly are an evil enormous company promoting clients to suffer needlessly in order to further their own greedy financial gain.

    For four months I have been suffering. I have horrid pain, pressure and discomfort and need to relieve myself by urinating every five minutes whether awake or while sleeping. I have what’s called an extreme case of overactive bladder. I originally went to my primary care physician for diagnosis and treatment. She sent me to an OBGYN for evaluation. He did some testing and wrote me a prescription to calm my bladder. He also referred me to a Urologist.

    The prominent and well respected Urologist did extensive testing, evaluation and came up with a treatment plan. He told me to immediately stop taking the medication that the OBGYN gave me. He said it ages your brain 10-20 years. I am already at high risk for dementia, as my dad had Alzheimer’s as my dad had it, my mom has it and I carry the marker. In addition over the years I’ve been on other medications that put me at high risk for dementia or Alzheimer’s. He told me I had two other choices. I could be treated with **. Bad with that there was a high likelihood that I would be catheterized up and past 6 months. My best and greatest option was to do a procedure called C-Interstem developed and facilitated by Medtronics.

    I tried the test of C-Interstem for 5 days and it was life altering and life changing. I was suddenly able to function like the extremely active and energetic 56 year I had been before this crippling condition took over my Life. Now this procedure mind you is covered by ALL of their health care providers and is widely used and performed. However, Aetna does not cover it and chooses to call it “experimental” though all doctors will tell you this has been going on for quite some time and is anything but experimental. Most would call it revolutionary and positively effective, though perhaps cutting edge.

    While I have been trying to get Aetna to understand the severity of my situation and cover it, the doctor’s office and myself over the past month had jumped through so many hoops to get this done while they continue to throw one roadblock after another in front of us. A health Aetna advocate called, named Chanda **, and spoke to my husband Rather than myself which is odd and unhelpful. But she assured she was there to assist me and help me get this covered. She was SO awful.

    I tried calling her back for three days with the bogus number she gave my husband. Finally after being on hold for nearly three hours I was able to get through to her on an Aetna line. Like all the other customer service people, she was there to only hinder my process and continue to throw roadblocks. One by one we checked off the guidelines until she got to the last one which she said it coldly, callously and inhumanely I might add, that it was necessary that I have these horrendous side for at least a year before Aetna would even consider covering my procedure. Chanda ** proudly told me on her recorded line that she would be sure to email me the guidelines that I didn’t meet!

    Beware People of the fast and sharp decline of this Evil and greedy self seeking health Insurance Company called Aetna. Beware of so-called customer advocates like Chanda **. Know that they are only out to screw you and financially advance their company at all costs. Regardless of how wrong and unethical it is, these advocates and representatives are only out to screw you cruelly disguised as someone sympathetic out to help advance your cause. I have to wonder what they pay such soulless supposed professionals to be false and do such insidious and dubious work. Talk to your employer before taking a job whereby you might get stuck with Aetna putting your life and health in jeopardy. Your health is everything. I hope everyone can stay on top of it and move forward now with a little more knowledge about Aetna Health insurance.

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    Coverage

    Reviewed Dec. 11, 2019

    Aetna is the worst insurance company I have ever had the displeasure of dealing with. Unfortunately, through my job I have no choice but to use their insurance. They don't cover medically necessary charges, leaving their customers with high out of pocket bills to pay. I wouldn't recommend them to my worst enemy. If you have the choice, do not use Aetna unless you like throwing away your hard earned money.

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    Coverage

    Reviewed Dec. 1, 2019

    Aetna refuses to pay one dime for my hospital bed. It covered everything else at 90 percent. After visiting the ER, I was hospitalized on a floor dedicated to my medical crisis. This hospital unit was designed with private rooms, only. I am being charged $7,200 for this hospital room because Aetna has told me they only cover a semi-private room. That was not an option for me, a semi-private room so, I appealed because none of this was my fault. My appeal was denied. I am absolutely furious that Aetna will pay nothing for my hospital room. I was forced to have a private room and am now getting screwed over for it. I am being told that the hospital has semi-private rooms. So what??!! That has NOTHING to do with my situation which, Aetna REFUSES to consider.

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    Price

    Reviewed Nov. 20, 2019

    Aetna requires you to have an annual exam and blood work to keep from paying 30 percent more for insurance. Even when you do these 2 items they still charge full rates. Total rip off. I wish we could change plans.

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    Customer ServiceCoverageStaff

    Reviewed Nov. 13, 2019

    We’ve had Aetna Health Insurance through our employer for many years. Our company switched from another provider which was excellent so we had a good reference. I have spent countless hours on the phone trying to get basic coverage and claims info from their poorly trained reps and they also show little respect or kindness in how they talk to customers. The other day I was told their system crashed and that I’d get a call back. Of course I never got a call and when I explained this to a new rep she did not offer an apology, explanation, was completely disinterested. I had to escalate a basic claims question to the manager which is like pulling teeth, all over her poor attitude and misinformation about my claim. It seems they have a hard time getting info readily - such as trying to find a clinical policy bulletin - which speaks to the inefficiencies and leadership inside Aetna as well.

    I could in with pages of examples and because we have a lot of conditions, we have to deal with them a lot. It’s non stop problems and it is very common for practitioners to sigh in disgust when we mention Aetna as they typically “don’t have as good of coverage and more red tape” compared to better insurance companies. We continue to complain to our employer hoping they will re-evaluate and dump Aetna to keep their workforce happy and healthy. Worst insurance company we’ve encountered.

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    Customer Service

    Reviewed Nov. 7, 2019

    My husband has a DVT in his left leg and has now been diagnosed with Prostate cancer. As part of his cancer treatment the Doctor has to have a MRI in order to map out where the radiation rods will be placed. This mapping helps to ensure he does not end up pooping and peeing on himself for the rest of his life. Aetna sits forever on the request then turns it over to some horrible lying company called Evicore. They kept delaying delaying and kept lying to me about when they would let us know. They delayed long enough that the MRI had to be canceled. The Doctor says he was on the phone being transferred around for 45 minutes and could not get an answer. Now his treatment is delayed while the cancer is eating away and still we are trying to get approval. They keep delaying and delaying.

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    Customer ServiceInstallation & SetupSales & Marketing

    Reviewed Nov. 4, 2019

    I received a bill from my doctor for the bloodwork I had done for my annual physical. When I called Aetna, they told me it was denied because I didn't have the bloodwork done in the required 7 day period. I went 10 days after my physical appointment because I already had a scheduled mammogram at the same place and didn't want to miss more work. I explained that I was never informed that the bloodwork had to be within 7 days of the appointment as I have never had Aetna before and asked for an appeal because they could see I did both on the same day. I then asked for them to send me where it is written in my policy that I had to have the bloodwork done within the 7 days. I was then informed that it is not written in my policy. The 7 day rule is an internal rule.

    I asked for an explanation of how they can penalize a customer when the customer has no idea of this policy. I even called my doctor's office and they have never heard of this before. I am currently in appeal about this but feel something should be done about an insurance company basically scamming its customers. If you are going to deny my claim because you say I didn't follow the rules, then you should be telling me the rules!

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    Customer ServiceStaff

    Reviewed Oct. 30, 2019

    I've had Aetna Medicare Advantage PPO since 2017. For the first year, it was great. Then they were bought by CVS and now it is a giant hassle to do anything. Fax in reimbursement forms and they go into a black hole. You have to call multiple times, file grievances, call corporate, etc. to get any information at all. Employees are not trained and can give you hardly any information at all. Nothing but frustrating. They don't seem to care about customers at all. Even the hold times on the phone have gotten lengthier. A good company has gone totally downhill. I cannot even find an Aetna agent to discuss 2020 plans. They appear to simply not want customers. It's too bad, as my doctor is in their network, but I don't think I can deal with this horrible customer service for another year.

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    Online & AppStaff

    Reviewed Oct. 25, 2019

    I've submitted claims via their website, which they claim to have not received and I've submitted claims via the postal service, which they've also claimed to have not received. That is issue #1. Issue #2 is that I have been submitting claims for 10 months of 2019, which have been going toward my deductible and now they say they've made a mistake on that! I have been in constant, monthly contact with the claims area, who call themselves "your customer advocate" and no one in the past ten months has ever said that these claims wouldn't apply. I even have emails from them discussing where the funds would be applied. I am a trained employer benefits person and I can now honestly say that I have never worked with a worse company with respect to employee health insurance.

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    Staff

    Reviewed Oct. 24, 2019

    Aetna Better Health of Ca is a company that leaves families feeling frustrated and hopeless. This company hires anyone to be case management and these people do not know how to coordinate care and above all provide care to their disabled population of clients. Families feel very unsupported by their providers and case management staff.

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    Customer Service

    Reviewed Oct. 23, 2019

    I was in a car accident that caused 2 herniated discs, multiple bulges, and other issues with my back and spine. Before I could even get an MRI I was told by Aetna that I needed to try physical therapy, which doesn't make any sense because this was before we knew what was wrong. I eventually finished PT and got an MRI that revealed my injuries.

    A year and a half later today, I get a call from my doctor 5 days before scheduled surgery, saying that Aetna is refusing to pay for my surgery because there is "Not enough radiologic interpretation" to warrant getting surgery. My MRI report clearly states what my injuries are and I've had 2 Orthopedic doctors suggest surgery since then. I've already made arrangements with the state and my employer for temp-disability. Aetna has been nothing but terrible to me over this past year and a half and I would not recommend their "services" to any human being that cares about their health.

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    Coverage

    Reviewed Oct. 23, 2019

    My mother recently suffered a left-brain stroke that immobilized her right side (arm, hand, and leg) as well as her speech. She transferred to a Skilled Nursing Facility where she is improving. Though she is unable to speak, she is walking with a walker and is starting to gain strength in her hand and arm. She requires assistance getting dressed and eating, and must wear diapers due to incontinence. When she arrived, she was on a feeding tube; they removed it 4 days ago. She has lost weight and has been on pureed food for just over a week. They were hoping to put her on solid foods this week.

    She has been in the facility for 20 days however; they notified me Friday afternoon (approximately 3:30; rush hour DC traffic) that her insurance would terminate Monday. I filed an appeal; it was denied Sunday. I do not understand why coverage would end for someone who is unable to care for herself and with continued therapy would improve. I understand she will never be 100% but I do not believe she has plateaued either. This is her second stroke. The first was about 7 years ago. They had to run a few tests to confirm it was a stroke. She did not lose as much mobility as this time yet she was in rehab for almost 6 weeks.

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    Process

    Reviewed Oct. 11, 2019

    How in the ** do I stop the mail adverts for a person that has died? My brother died five years ago. I really do not think that he needs the advantage program!! I have called, emailed and sent US postal mail. This has been going on for over a year. How do I stop this harassment? ?

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    Reviewed Oct. 10, 2019

    Aetna will only allow mail-order prescriptions and they take upwards of ten days to fill them. This is a massive problem if you actually require daily doses. They are willing for you to run out of required medications to preserve control and ineptitude. I strongly recommend choosing another insurance provider.

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    Customer ServiceCoverageSales & Marketing

    Reviewed Oct. 7, 2019

    I pay hundreds a dollars a month so I can pay hundreds more. I have Aetna through my employer and still have to pay hundreds of dollars a month in premiums. Last year, Aetna provided a "wizard" to see if I was getting the best coverage for my needs. I ran through it twice and switched based on its recommendations. What a mistake. My monthly medication costs went from $20 a month to $190. Not to mention the massive deductibles. But what really fried me was the need for a "preauthorization" for an MRI ordered by my doctor. Why on Earth does Aetna have the right to delay and even deny my medical needs?

    Other issues were calls that went unreturned and the inability for anyone at Aetna to give me straight and honest answers as the coverage I had. I.e. How much was covered for an MRI, etc. All of these added up to delay of care for an issue that has now gone well into the third month. The system is scam designed to take as much of the consumer's money while allowing for the absolute minimum amount of care. There is no wonder why even people with health "insurance" are considering Medicare for All.

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    Customer ServiceStaffProcess

    Reviewed Oct. 4, 2019

    If you need something simple and are on the phone directly with Pharmacy or setting up insurance they are fine. With any other task you will often get young, new reps that don't understand your question or when they do, they have to study the system to figure out what to say to you or how the process works. It's often like waiting for your 85 year old grandfather to fill out his email address on the Apple remote for Apple tv. Way too often the reps don't know what a insurance, vacation override is and you can tell them 5 times and they will have to ask someone else, where to send you, what it is you're asking about and if it's possible.

    For some reason they are all too proud to ask for help and would rather keep you on the line for 45 min while you teach them what it is you are asking. They probably have a call center in a low income area and largely hire reps with little experience. They have too many departments for everything so one person can't do what you need, they have to figure out who does that and where to send you. This company will probably go out of business someday if they don't revamp.

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    Coverage

    Reviewed Oct. 2, 2019

    I cannot judge Aetna performance since I had it for less than a year, but decreasing coverage for one of my medication starting September means I get full coverage for only seven months, that could be an indication that its coverage is not as good as claims indicated.

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    Coverage

    Reviewed Sept. 30, 2019

    When we moved to another state I was able to get a lower monthly premium with Aetna than my previous supplemental plan. The coverage is the same (plan g). The ease of switching plans was easy also. Both my husband and I have aetna and have been satisfied with this plan.

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    Price

    Reviewed Sept. 27, 2019

    I love this insurance plan n, Aetna senior products supplemental insurance for my medicare plan, because it helped me with cataract surgery cost (0), compared to previous insurance company, clover (500 per eye). It is high (98.00 per mo.) Is why not a perfect score.

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    Coverage

    Reviewed Sept. 26, 2019

    Sorry insurance, paying per week my half of the insurance is $52.00. My job pays $52.00 for their half of the payment. All in all this insurance is being paid $104.00 a week, my deductible is over $6,200.00. My out of pocket is pretty much the same. In order for this insurance company to pay for anything I have to pay this first. I have to pay my deductible first before they pay anything. Only thing I get is a discount on in network doctors. They say after your deductible is paid they pay 100%, not true. I still have to also pay out of pocket money of over $6.200 and then it's 100%, not sure if this is the case because I've never finished paying the out of pocket amount. Most doctors I've been to don't have much faith in this insurance company.

    I went to my family doctor. My copay was $25.00. I went back to the same doctor's office and my doctor was out of the office, so they had me see my doctor's assistant. I paid a $25.00 copay and was billed $40.00 for the remainder of the copay because Aetna considered my doctor's assistant a specialist. There are so many problems with Aetna. They have been paid over $5,400.00 in premiums. I have paid my deductible of over $6,200.00 and most of my out of pocket of over $6,200.00, why do you need insurance if you're in good health or some what good health, you would be able to save yourself money by staying away from Aetna insurance, good luck to those who still have this insurance company.

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    Reviewed Sept. 26, 2019

    I have always had a positive experience with Aetna. I had one overnight hospital stay a couple of years ago for monitoring. All I had to pay was my $60 copy for emergency room. I visit my PCP two or three times a year with a small copy. I do have to pay a deductible for blood tests, but that is it. Overall I am very satisfied with their service.

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    Coverage

    Reviewed Sept. 24, 2019

    I recently enrolled in Aetna Coventry Freedom Plus plan as my wife had previously done so. It has proved to be perfect for our needs, as a PPO it practically covers every medical care provider we would require including dental and vision. Although getting questions answered online via messaging can be a bit difficult for those atypical requests they do a fine job. I don't know why anyone would ever want or need to enroll in Part D.

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    Reviewed Sept. 22, 2019

    They consistently do not pay for my prescribed medicine. YTD they have paid $13.67 while I have paid $565.75 plus my premiums to them. They tell me I will have to spend $3820.00 before they pay more. The next stage does not do much either until I have paid out of pocket $5100.00 per year. Therefore, they only help if you have a catastrophic problem. Given I'm 9 months into the year there's no way I will reach the $3820.00 level so at the end of the year they start it all over again. So in their eyes I'm privileged to pay them premiums all year so they can pay me less than $20. I will most certainly not be renewing coverage with them and if the California lawsuit becomes a class action suit I will be joining it.

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    Coverage

    Reviewed Sept. 21, 2019

    Having issues getting eob's but otherwise seems to take care of business pretty well for an insurance company. My husband's had this plan for 4 years and covered one major cardiology event with no out of pocket to speak of, that's impressive!

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    Customer ServiceCoverage

    Reviewed Sept. 20, 2019

    Aetna has been a great health insurer... until I actually started making claims. In the past two years my family has had some unfortunate illness and accidents — the very thing you have insurance for— only to discover that at every step they deny claims and put the burden of proof that it should be covered on the person making the claim. Think about it — just after a major trauma with a big bill, we get an official rejection notice. This timing is bad on so many levels. If this were a single instance, I would call it a fluke and move on. But it has happened repeatedly, whenever the bill is bigger than a doctor’s office visit.

    There is no advocacy, no help, the insured is caught in the middle between clinic billing, and Aetna saying no. And to be clear — each time, after the three-ring-circus of denials — they have always paid. It was their obligation. But their rejection almost had the desired effect... the hassle was so big I asked myself, “would it be easier to pay myself and skip insurance?” Then I realized why they did it. After I connected with an attorney, she let me know that that is a standard practice for Aetna. Wow.

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    Customer ServiceCoverage

    Reviewed Sept. 20, 2019

    Overall coverage is good (recently had to have minor surgery); co-pays are very reasonable; good coverage of medications; customer service helpful when I have had to call with questions; have not had any issues with payments.

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    Staff

    Reviewed Sept. 19, 2019

    Since my employer switched from the fantastic Horizon Blue Cross & Blue Shield we have been tormented by AETNA. Every single transaction with AETNA is a problem. Providers not paid, or NOT PAID ON TIME FOR ROUTINE ITEMS and FOLLOWUP APPOINTMENTS. IT IS ALWAYS A PROBLEM!!! NEVER ONCE HAS IT NOT BEEN A PROBLEM!!!! I will DROP AETNA after 1 year when the open enrollment period comes. I have an HMO provided by the military that I will use alone and stop paying AETNA 23% of my pay for their ungodly awful service!!!!

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    CoveragePunctuality & Speed

    Reviewed Sept. 19, 2019

    I've been with Aetna for over six years and have full supplemental coverage. Claims from my providers have always been paid fully and promptly, even the humongous charges associated with a heart attack and medical, flight. As with all medical expenses, premiums have skyrocketed while most of us retirees have fixed incomes and that is starting to present a problem; but, that would be the same with any company. There have been absolutely no hassles and I'm happy.

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    Customer Service

    Reviewed Sept. 18, 2019

    Always easy to reach someone. Had all my questions answered anytime I called. Seem to genuinely want to help with whatever you need. I did not expect them to be this good, so it was a pleasant surprise.

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    Customer Service

    Reviewed Sept. 16, 2019

    The worst online pharmacy order system possible. Whenever you try to go online to refill a prescription the screen goes blank. When I call for tech support, I get disconnected repeatedly. When I finally got connected, they couldn't hear me even though I could hear them and I got disconnected again. After several hours over several days, I am still not able to order anything online and I'm yet to speak to someone in tech support. If you have a choice do not use Aetna pharmacy services.

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    Customer ServiceContract & TermsCoverageStaff

    Reviewed Sept. 9, 2019

    According to my plan I am 100% covered for in network maternity. However, I received a bill from my midwifery group saying that my insurance would only cover a small portion of a routine blood test. The first time I called Aetna they said that my midwife submitted the wrong billing codes and needed to change them and resubmit. So I called my midwife and then her digital billing center to get that straightened out. The billing center told me that I had a deductible and that’s why Aetna only covered a little. So I called Aetna again and asked why I had a deductible if I’m in network and I’m covered 100%. They said this time that they don’t have a contract with my midwife but they do have a contract with the birthing center she is associated with and where I have my office visits. So I call the birthing center and they tell me that my midwife is part of the birthing center and through that has a contract.

    While all this is going on the customer service representatives had a very difficult time understanding my questions. They also couldn’t seem to come up with the words to best answer me. It’s extremely important that these folks understand English and are able to speak English at a level that is necessary in order for them to do their job effectively and efficiently. Shame on Aetna for not training these people well enough.

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    Reviewed Sept. 4, 2019

    The worst insurance company I ever dealt with. Constantly denying claims. Losing paper work. They want to pay nothing even though we pay them. My wife had breast cancer and had a mastectomy and they denied her reconstruction under cosmetic surgery. These ** don't even know the ** law. They have to pay for it whether they agree with it or not. They just denied my wife's over night stay because they said it was not necessary never mind that her nipple was just sitting on top of her breast and need to be tended to every 2 hours so it would night di. I could go on but it will do no good.

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    Customer ServiceStaff

    Reviewed Sept. 4, 2019

    I was approved for Medicaid a couple of months ago. I'm a diabetic, who started my Medicaid service with 3 provider options. Aetna... And two others. The default was a company called Magellan. But you have X amount of time to switch to any of the other options, so I notice Aetna was the most geared for diabetes... out of the three companies. So I switched.

    Let me say, that I had no such issues with Magellan the first few weeks. They called me often. I got emails. They kept up with my diabetes case managers. And I received a little consideration from the start. I know this, because it didn't take much time at all to receive my new Dexcom G6 Blood Sugar Sensor Machine (which Medicaid now covers, btw).

    With Aetna, my case managers tried reaching out via email, to supply my Dexcom supplies... Aetna never responded. So they had to contact me, to contact Aetna... where they took a long time to tell me it's going to take 2wks, after telling me the request actually went in THAT day. So then, I have to contact the caseworkers, to contact Dexcom, and you see the frustration. I feel like I'm doing their jobs.

    So, someone from the two companies is lying about when this claim was even dealt with. Meanwhile, my blood sugars are back out of wack. 2wks went by, still haven't heard from anybody. Woke up today, rather pissed of about this taking almost a month. My health is having an adverse effect from it. Meanwhile, Dexcom is just waiting to send the next kit, just need someone to bill first. After I called Aetna (and being forwarded a couple of times). They tell me that this claim has been approved. Yet, nobody knew. Aetna didn't contact any of us, to let us know. Thanks Aetna. So far, You suck.

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    Customer Service

    Reviewed Sept. 4, 2019

    Bottom line: Aetna was denying all my claims, even in-network people. I would never have known, except one of my providers showed me their letter. Stating that I have insurance coverage elsewhere? Uh, no I don't. Aetna claims they've been trying to contact me. Uh, no they haven't. No phone calls, no letters. All of my contact information is correct. I called them up in early Aug 2019, spoke to 'Steve' who clearly was not a native English speaker. Told him I have NO other insurance. He said he'd take care of it, refile all the claims. NOPE.

    Had to call back weeks later, another non-native English speaker told me 'Steve' put down that I DO HAVE OTHER INSURANCE. I said, "Really, what provider did he note?" NOTHING. So she said she'd mark it down and refile all the claims. NOPE. 3 or 4 of them are still sitting in there denied, including $1600 out of pocket for lab work. If I got everything done this year that I should, I'd be out $5k to $6 out of pocket BESIDES what I've paid in premiums already. I'm an honorably discharged Marine; guess I'll have to drive 30 minutes to the tender mercies of the VA hospital?

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    Customer ServiceCoverage

    Reviewed Sept. 1, 2019

    This company has terrible coverage. Bad customer service, don’t empathize with patient at all. Had an insulin pump that broke, and had to resort to ** insulin. However, Aetna doesn’t cover this medicine because they are not a preferred partner so I had to pay $320 out of pocket. I called customer service which recommended ** as a replacement. What idiots - completely different type of insulin. Only reason I use this insurance is because it is offered through my school. Can’t wait to drop them.

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    Customer ServiceStaff

    Reviewed Aug. 30, 2019

    Now that Aetna is in bed with CVS, they force you to get your maintenance prescriptions from CVS or mail order. I can no longer walk up the street and get my medicines from my neighborhood pharmacy. Now I have to spend 40 minutes going to CVS and waiting in CVS's long lines so that Aetna can pad their pockets. I filed an appeal with Aetna when they wouldn't let my neighborhood pharmacy fill my prescription and after 60 days no response (told me it would take 30 days). I've had Aetna for years and in the past was happy with them but now they are all about money and don't care about their customers. They act like an HMO now (I have a PPO) but I feel like I'm in an HMO now. Customer service is not great (I did have one rep that was helpful/pleasant) but the rest did not care.

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    Customer Service

    Reviewed Aug. 29, 2019

    I went to a clinic where Aetna did not have direct billing, therefore, I had to claim the money back. Aetna accepted the request and officially informed me on the amount. But the bank charged me with the transaction fee, so I received less money that I was promised. I contacted the insurance company, their reply was:

    "Aetna has sent the full reimbursement to the client and if transaction fees occur within the account that would be the responsibility of the client’s." I answered that this kind of approach is not acceptable. I am highly disappointed in this company.

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    Customer ServiceCoveragePunctuality & SpeedStaff

    Reviewed Aug. 21, 2019

    I switched to Aetna PPO Jan 2019. Had Humana Medicare Gold Plus for 6 years. No major problems. Aetna offered lower premiums and more benefits. That is great if you can get them. I have paid out double the amount of premiums in co-pays and co-insurance. Not a thing is covered as purported. I was even charged for diabetic screening which is supposed to be no cost.

    I have been calling on my first 3 claims of 2019. One in Jan, one in Feb and one in April. All routine in-network primary care visits. All paid out of network. Now is is the real issue, customer service. Aetna reps strung me along for months stating they are working and reworking and would resolve the issue. After months of waiting and checking weekly, I file a complaint on 8/13/19 and was told I was too late. I don't know if it was purposeful or that the agents are so inept that they just didn't know how to resolve the problem. Anyway as soon as new enrollment opens, I will be crawling back to Humana with an empty wallet.

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    Customer ServiceCoverageSales & Marketing

    Reviewed Aug. 18, 2019

    Aetna began arbitrarily denying my doctor’s billings, telling him I wasn’t insured any longer. Over the last 6 months I have sought redress and had them tell me over the phone that I AM and always have been covered and it was a mistake, assuring me that they will re-submit the claims and they will be covered. 4 TIMES. Every time they deny it again, then play stupid about it over the phone. What’s worse is that my doctor says they have been denying claims by covered dependents systematically over the last 6 months or so. They are playing with peoples’ lives to scam a bit of extra profit. My only recourse is litigation. DO NOT GIVE AETNA YOUR MONEY!! They will screw you over.

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    Customer ServiceStaff

    Reviewed Aug. 16, 2019

    I have been almost a month trying to get approval for treatment on back and hip for chronic pain. I can tell you Aetna is professional at LYING. I was on phone for over 3 hours with them. They called next day saying a conference call was set up with my Dr on a Wednesday. I said that can't be as he has procedures all day. They said I was wrong. I called Dr. They said no call. So now still waiting. All I know is I'm in MAJOR pain and they won't help. How does our government let scams like them go on? Do we not have some protection? California is suing them. Maybe Texas should too!! Only good news I have heard is Aetna is moving out of our area. That is good as when I checked them out on Facebook it scared the hell out of me. They deny treatment for cancer victims!

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    Customer Service

    Reviewed Aug. 7, 2019

    As someone who had Blue Cross/Blue Shield for 42 years and never got one call from them and they were always there when needed, the company I retired from changed me to Aetna about 3 years ago. I get calls telling me I need this and to have that. I am old enough to make up my own damn mind and don't need anyone to tell me. Even when put on the don't call list I still get calls from them.

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    Customer ServiceCoveragePriceStaff

    Reviewed Aug. 2, 2019

    The customer service reps. are NOT knowledgeable. They do NOT know the correct answers. It happens when I call and it happens when the doctors office calls. You get a different answer every time and the answer is NEVER correct. I am retired from a bank. I purchase this insurance by paying the bank $397.00 per month, not counting what Social Security also deducts for coverage. I read the booklet that Aetna gave the bank and the bank gave the booklet to me. I even doubled checked with Human Resources at the bank I am retired from. I understand the book, however no one at Aetna knows what to do. Last year the bank offered Medicare as primary and Cigna as secondary. It did cost $100.00 more per month but it was well worth it. Aetna Medicare has a prescription GAP. I use Asthma Medication and in a few days my prescriptions will NOT be covered. This did NOT happen with Cigna Medicare retiree. NEVER USE AETNA!

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    Customer ServiceStaff

    Reviewed Aug. 1, 2019

    I have spent hours on the phone with Aetna over the past few months to get my IVF reimbursements paid to me and every time I talk to a representative, I am told to take a different approach to get my payment. At best, they are incompetent and can't train their employees to actually solve customer issues. At worst, they just don't want to pay you and hope that you will give up.

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    CoverageStaff

    Reviewed July 31, 2019

    I pay more than half my paycheck every two weeks for "premium insurance" with Aetna yet they hardly ever cover the cost for most of my appointments with their in-network specialists. It's absolute insanity to have to pay $500+ to every specialist I visit several times a week. If you have Aetna, don't get sick. American Express switched from Blue Cross Blue Shield to Aetna last year and it was the worst mistake ever.

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    Customer Service

    Reviewed July 27, 2019

    Aetna is one of the many reasons people in this country are starting to vote for universal healthcare. This company is a joke. They take your money and pay nothing. I have a high deductible plan, and they won't even accept a simple doctor visit for dizziness. I pay hundreds, my company pays hundreds more (thousands over the year), and I still have to pay for everything up to 7000 dollars a year and they won't accept a claim for 220 for once simple visit. If you do have Aetna, call them as much as you can. Fight with them if you have to. When you are able to change your plan, do it. Aetna is criminal.

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    CoveragePrice

    Reviewed July 23, 2019

    My wife made the mistake of signing up for DMO vs PPO. Worst insurance mistake ever. First none of our dental providers will accept it. Provider who will accept it is very very limited. Finally after finding a provider we had to get them assigned to our insurance. We were informed that we picked the provider on the 18th of the month. Guess what, the cutoff is the 15th. So we had to wait an additional month for the provider to accept us. So if you sign up on the 14th you can get an appointment two weeks later. If on the 16th you have to wait 6 weeks. This is 2019 where everything is done by computers. So this is a BS policy issue by Aetna nothing to do with technology.

    So in summary: almost no one accepts and when they do there are super extreme rules to follow or you're told no. Under PPO you have no problems getting appointments, finding a dentist or getting coverage. You have to pay more but low price and no place to use it is not a bargain. Also Aetna is no help. They just say, "It's all in the fine print that your wife should have read with lawyers before signing up for."

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    Customer ServiceOnline & App

    Reviewed July 21, 2019

    Go somewhere else for Medicare. I have been on the Aetna PPO since September 2018. I am unable to get a doctor or dentist that is part of their network for over 10 months now. Every time I try to find one, from their website or on the phone, the doctors are either no longer there or are not accepting new patients. All phone calls to Aetna have failed to provide an in-network doctor. On the phone they will tell you anything they think you want to hear. Go somewhere else if you need to actually get medical or dental care. Good luck trying to get anything from this company.

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    Punctuality & SpeedStaff

    Reviewed July 20, 2019

    I can't believe the government lets companies like this take advantage of human beings. I've had my cat scan every 9 months on schedule and all the sudden one day they deny me. The government pays them and they don't help their clients. Trust me this company is crooked. They're not out to help you. They're out to get what's yours. They don't want to help you. They're Crooks. This company is worth billions and they can't even help me get a CAT scan to prevent cancer. I've had cancer twice already and this cat scan will help me. This cat scan will dictate my life but now since I've been denied I know now for a fact this company is crooked. They're hypnotized by the dollar the government gives them. Us humans are nothing but numbers to them.

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    Reviewed July 19, 2019

    7 weeks and still no money. My husband went on short term disability on June 2nd. Aetna has said they mailed a check and he would have it by July 15th. Nothing. They said he would have a direct deposit today. Nothing. His neurologist wrote his leave until September 2nd; Aetna only approved through August 2nd. I am working 2 jobs, 64 hours per week to barely pay our bills and take care of our family. If you're able, avoid this company like the plague. I truly hope you never have to deal with them.

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    Staff

    Reviewed July 16, 2019

    Misrepresentation. When joining plan was informed dental coverage was included. This reason for joining among other benefits. Upon going to dentist I found no enrollment was done. I was informed that enrollment period was over and would have to wait for review. BEWARE OF AETNA REPRESENTATIVES - SHADY, AT CONSUMER COST.

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    CoverageStaff

    Reviewed July 15, 2019

    Crooks. Called prior to procedure to inquire if a provider and procedure are covered. Was advised that it was covered 100%. Later receive a bill for a procedure. Call the company and inquire - they review the recording, agree that they told me it would be covered. However, they state they were wrong and now tie this in multiple conversations with managers and appeals. No responsibility for their actions or mistakes. Incompetence and greed.

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    Customer ServicePriceStaff

    Reviewed July 9, 2019

    Had an RX transferred from Walgreens to CVS- Aetna’s preferred pharmacy for the purpose of getting the 90 day dosage at the pharmacy level- not having to wait for mail order. My RX is the brand-ordered by my Md- do not substitute. My monthly cost is approx-$17.00- thus 3 mo supply co-pay should be around $50 to $60. CVS notified me my 90 day cost-$101.00. When I called Aetna to find out why this increase- the pharm phone rep said “this medicine is hard to find & the price went up”. I was surprised at this statement. I reminded the phone rep- I was changing to get the preferred member rate- this rate was $0.0 from Aetna & I paying full cost. That didn’t make sense.

    I had the rep check my history to see what I’d previously been paying all year-verified I’d been paying the lower co-pay. His stated the same info again. My response: So Aetna is fine with their members being price gouged- as the CVS cost was 50% more than Walgreens price. Why was that ok by Aetna for members to treated this way- of course he had NO response. Basically, from this phone rep’s attitude- why was I questioning anything. I’m completely disappointed by Aetna’s member service- basically NONE.

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    Customer ServiceStaff

    Reviewed July 3, 2019

    Aetna forces you to use their mail order drug program or CVS only for maintenance drugs. Why? Because they are part owners of CVS. What they don’t tell you at the beginning is that they will force this upon you after 2 months of refills. Another thing they don’t worry about is how rude and impersonal CVS is when it comes to asking for information about medicines you are taking. The CVS that is about a mile from my home hardly ever have the medicines in stock resulting in multiple trips when you are in need of the drug.

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    PriceStaff

    Reviewed June 26, 2019

    I took my son to an ER that was out of network. I was informed by the office that I would pay a certain amount and wouldn't get a bill. A few months later, I get a bill for $90 extra dollars. The office said they bill a rate and then submitted it to the insurance company for whatever reason, who uses a set of codes to define the cost....which was more than the office stated to begin with. The Dr. office said Aetna did this and Aetna said it was the Dr. The best part is how the Aetna rep told me literally that maybe next time I just pay out of pocket. I guess I'll just pay out of pocket from here on out as it has been cheaper all around.

    They say they didn't hear that on the recording, but I have witnesses that say otherwise and it was obvious as to the reaction on their faces when they heard the rep say that. Aetna is very unprofessional and don't do what they're supposed to do. Push your company to move to another major medical insurance provider if they use this unethical company.

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    Reviewed June 24, 2019

    6 months of trying to get them to approve brand necessary epilepsy drugs. Sent letters from Neurologist, called, begged and I am still fighting them and have paid most of it out of pocket. Medication is not a choice people!

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    Customer Service

    Reviewed June 19, 2019

    This is the first time we have had medical insurance through Aetna where I work. I hope we never do that again. My MRI with our insurance last year had a negotiated rate three times lower than with Aetna this year. I appealed the claim a month ago thru the Aetna portal. The only response I've received so far is a postcard in the mail that tells me they received the appeal and will be in touch. After reading many other reviews of Aetna I doubt I'll hear anything. Don't bother calling their billing department. Their response sounded like they were reading cue cards to know what to say. The negotiated rates through Aetna should be renegotiated and get in alignment with other carriers. I feel Aetna only cares about Aetna and not their customers.

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    Coverage

    Reviewed June 15, 2019

    Do not I repeat do not trust these fraudsters. They will try to wiggle out from any and all obligations. Go without insurance before you trust these lowlifes. My daughter had to have an emergency C section and NICU follow up care and they denied it all.

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    Customer ServiceCoverageStaffProcess

    Reviewed June 12, 2019

    My wife broke her back and Aetna declined the surgery. They claimed it was experimental. (You’ll come to find out they have a bottomless pit of excuses.) Her doctors were shocked and explained it wasn't experimental and was the only surgery that would apply to her condition. They'll ask for a pre-authorization on just about every prescription you hand into the pharmacy. This means you'll be stuck in a run around between Aetna, the pharmacy and the doctors trying to get them to re-approve the prescription before it can be processed. This process will delay you getting the medication and keep you tied up on the phone trying to get another authorization before your meds are filled. This entire process took over half a year to complete for a cholesterol medication!

    During this period our doctor would provide free samples. Our doctor even ended up calling them multiple times and soon after he said he had worked his way up their bureaucratic ladder and finally gotten through to them – they said they never received any of his calls! This process becomes surreal and shocking – you almost feel like you’re in an episode of the twilight zone. The experience is something that still bothers everyone who was involved, from the nurses to our doctor and even us. After this long stint of not receiving the medication, they final acknowledge they received the pre-authorization, but six months later they cut the cholesterol medication off again for another round of their pre-authorization games.

    Recently my wife went into the ER due to an allergic reaction to a medication. The doctors said she was close to a coma and they kept her for 3 nights pumping her full of electrolytes she had lost due to the reaction. Aetna is saying this ER visit is being declined due to it not being on their list of authorized ER visits. The amount of money I provide them for my family should cover any of these expenses… but if the procedure or medication is the least bit expensive, you’ll learn the pain of trying to get any coverage through them. I don’t ever write reviews – but feel it’s almost my civil duty to warn others of this company.

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    Customer Service

    Reviewed June 5, 2019

    3 recent procedures have been denied. The hardest being for a CAT scan for a lung condition. Second it denied radiofrequency ablation for serious neck problems. One morning I spoke with 4 different people including one from the third party decision maker company. They all talk in circles and no one will take responsibility for an answer. After 90 minutes I just gave up. Initially a CAT scan was requested by my Dr because of a new large nodule appeared. He wanted a CAT after 3 months. Aetna said after 6 months. At 6 months they said a year. Have something growing in your lung and be told to wait. I later found out that they deny 40% of treatment requests.

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    Customer Service

    Reviewed June 1, 2019

    I tried to make a claim two months ago, but the process was really slow, until now, the problem didn't solve. I called and messaged them several times, I explained again and again, while the customer service only told me that we will review the claim and process it within 10 business days. However, nothing happens, problem still be the problem. I do not want to waste my time on such company.

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    Customer ServiceStaff

    Reviewed May 31, 2019

    I have a chronic illness and they constantly give my doctors the runaround with needing extra notes. I had a resting heart rate of 180 for weeks and they’re saying the heart monitor my doctor gave me was not essential. No insurance company should be able to make that call, ever. They are reckless and terrible. I try to use community health services as much as often when I have a problem to avoid stress but that’s not always possible. I hate hate hate Aetna. Please beg your employees not to use them!! The will only make your life more difficult in times when you don’t need more stress.

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    Reviewed May 30, 2019

    Aetna declines any request for MRI OR CT based on nothing. They are the worst insurance company I've ever had. How does your clinical decision when a doctor sees the need for the test. But you have problem getting paid every month.

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    Coverage

    Reviewed May 30, 2019

    Preventative maintenance items that are supposed to be covered (mammogram) not being covered. Went out of network so expected to pay the difference and Aetna won't pay a single dime. Went in-network the previous year and that was applied to deductible since the order had a medical diagnosis. I was owed my one screening for that year but no they won't cover anything. The doctors and facilities in-network is minimal compared to Anthem. My next note is to our HR department requesting they start looking for other providers.

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    Coverage

    Reviewed May 22, 2019

    I have a private Aetna HMO plan through my husband's employer that we have had for years!!! I have seen the same doctor for the past 8 yrs! Well all of a sudden they are telling me they cannot cover and prescriptions wrote by my physician because he is not a contacted provider with Medicaid! I’m not even a Medicaid recipient so what does that have to do with me or my doctor? They are saying if I want my meds covered I will have to find a new provider and have him listed on the excluded provider list! What crap! Aetna is the worst insurance company I have ever had and will be switching companies come the first of the year!

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    Customer ServiceCoverageStaff

    Reviewed May 19, 2019

    Aetna is an absolute nightmare. A glitch in their system has caused me hundreds of hours spent fighting a claim. Long story short, I updated my PCP on their website. I received EMAIL CONFIRMATION that my PCP was updated properly in the system. A month later, I had a procedure done with my new PCP (I had called beforehand to confirm it would be covered - Aetna said "yes").

    Then, a few months later I get a bill for the entire service - Aetna explained that they denied my claim because I was not covered by that provider. Um. excuse me? I updated my PCP online, I told them. Aetna had CONFIRMED this change. My insurance card had the name of the right PCP. This is ridiculous, I thought - how could they even fight this? I had documented evidence on their own website (through their Message Center) that my PCP change was received and approved. Yet, for MONTHS and MONTHS they fought, lied, denied, and harassed me. I have never in my life experienced something so absurd. Every single person in their call center was unhelpful, rude, and condescending. Every time I called, I had to re-explain my situation. They did not even keep notes on my case?!

    I am not exaggerating when I say this has been a nightmare. I will never in my life choose Aetna again as my health insurance provider. I beg you to stay away from them. They will do everything in their power to not pay your bill. However, I am relentless and have been fighting back - FINALLY after a year of calls, letters, formal appeals, and emails, they have finally reversed their denial because their review "concluded you had changed your primary care physician (PCP) prior to the services being rendered. There was a system issue and the change did not updated in all Aetna's systems." Yes. I know. I told you this hundreds of time. You could have just looked at the Message Center and we could have been done with this. But instead I spent a year receiving final notice bills and threats of being sent to collections while I fought with the incompetent and dishonest people at Aetna.

    Please - choose ANYONE but Aetna. I never thought I would experience an issue like this. It can happen to anyone. Aetna will pry on people who are week and will reject your claims unjustly. Don't just take my word for it. Read about the family that sued Aetna and WON for $25 million - the judge ruled that Aetna was reckless and didn't spend enough time reviewing a patient's case before denying her coverage for her cancer treatment (she later passed away from cancer). Bottomline: Aetna does not care about you. They care about money.

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    Customer Service

    Reviewed May 16, 2019

    After being told from 3 different people where to get the system from, all of which were wrong, the so called SUPERVISOR told me how sorry she was and gave me the right number and company to call. Called it to be told I had the wrong company and they gave me the correct number. Hope to finally get a meter within the next week 21 days after it was approved. I think they should all get a referral to a Proctologist to remove their heads from their **!!!

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    CoveragePrice

    Reviewed May 16, 2019

    My wife is a diabetic and was on an insulin pump. The pump was fantastic and helped her manage her insulin dosages with great results. Our previous health insurance providers always covered most of the cost for supplies but not Aetna. They cover a fraction of the cost of supplies, demanded that my wife use a different brand of glucose meter and then barely picked up any of the cost for the test strips. My wife is back to using a needle and manually calculating her insulin doses. My monthly premiums are higher than our previous providers, the deductible is much higher and the coverage is minimal at best. I am in the process of looking for a new job because the poor health care insurance. I recently went to the dentist; the bill was over $400.00 Aetna paid about $22.00.

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    PriceStaff

    Reviewed May 15, 2019

    Claim to provide services, they do not. Multiple accounts of Medicare fraud, 3 doctors who are under investigation for medical malpractice, Dr. Kendell **, Dr. Christine ** & Dr. James **. They refuse to provide home care even though I signed up for that specific plan, the doctors accept you as a patient & then refuse to provide any treatment, any prescriptions. Their medical negligence by the insurance company itself & the doctors nearly cost me my life in Feb. 2019 from major internal bleeding. Even after I got out of the hospital, the doctors refused post-op checkups & to provide the 4 meds the hospital doctors said were necessary to stop the bleeding. Colorado finally got the End of Life Options, thank God! At least now while we're being neglected & dying, we can choose to get the hell out of Aetna Hell.

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    CoverageStaff

    Reviewed May 10, 2019

    I have high deductible group coverage through Aetna. Family $3000/year in network. $4000 out of network. On top of that I pay $300/month in premiums in my group plan. This year we had a baby so easily met both in and out of network deductibles. I visited an in network urologist for a vasectomy consultation and was told I have copay since my deductibles hadn't been met. I was asked to pay $30 copays for consultation and $100 deductible for the procedure. Their staff had contacted AETNA and were told that they were out of network and that I hadn't met my deductibles. Neither of those are true.

    High deductible insurance plans are becoming very commonplace. It can be very confusing to understand all the variables that apply and a simple mistake by AETNA staff can lead to unnecessary charges passed on to the plan holder where AETNA should in fact cover a claim. This is a convenient "mistake" for AETNA to make that would be financially beneficial for AETNA. A very small percentage of plan holders are vigilant at tracking their own information and status and knowing where they stand. I'm 100% certain that after the mistake is made, it is up to the plan holder to catch it and rectify it, not AETNA. Like I said, it is a VERY convenient "mistake" that would lead to a financial windfall for AETNA. I will be digging into this much more thoroughly.

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    Reviewed May 6, 2019

    ** you Aetna. You overcharge me. Like to went into debt. Hundred dollars to talk to my doctor for five minutes. Humana is just a ten dollar copay. Aetna charge me 50 dollars for one of my meds. Humana just charged me 88 cents this morning.

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    Reviewed May 4, 2019

    I’ve been Diabetic since age 11. I’m 64. Started using ** insulin. Was great product. All of a sudden, "Sorry we don’t pay for ** anymore. We pay for ** insulin." Yes, but ** is TRASH! It doesn’t work. Oh, you can still get ** but you’ll pay $250 out of pocket. Gee, thanks for switching to a product that DOES NOT WORK! Terrible.

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    Reviewed May 1, 2019

    Aetna is my secondary insurance and with my recent claim, they have denied benefits saying there was no preauthorization for the service - they are a secondary. Do I have to contact everyone to see if it's ok? Just one more way to no be liable. Dumping Aetna first chance I get!

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    Punctuality & Speed

    Reviewed April 27, 2019

    Very slow to process referrals and not for people on fixed incomes as they have you going to urgent care or are with high copays as you. Need referrals to get treatment. This is the worst advantage plan I have been on and will not renew again.

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    Coverage

    Reviewed April 26, 2019

    I am in the gap coverage stage, I entered this stage on February 21st. I have realized the way they process my claims will keep me in the gap coverage a lot longer than it should. you would think that if a claim was reversed for any reason it would not affect you but it does. They list all the claims you pick up and what you pay and part of company's discount pays goes towards your out of pocket expense. They also list the prescriptions you don't get for whatever the reason is and that is subtracted from money that you did pay towards your out of pocket.

    Here is one reason a claim might be reversed: the pharmacy started to fill the script and realized that they did not have enough in stock so they canceled the prescription, so $229.84 was deducted from ytd out of pocket expense. Another reason a prescription might be canceled at the pharmacy is if the doctor calls in the wrong prescription. My paid out of pocket expense has to reach $5100.00 before I am out of that stage. At the end of February my out of pocket expense that was paid totaled $1803.+ change ytd. The following month after purchasing more prescriptions and paying more money towards my out of pocket expense, it went down to $1507.83. It went down because claims for medicines that I did not purchase were subtracted from claims that I did purchase.

    Some tips that might help with this that I am going to try are: 1. Take all your prescriptions off automatic refill and auto enrollment (you have to request them to be filled). 2. If you need a new prescription from the doctor, get a paper one. That way you know it is the right medicine for you and it is the right amount of pills. 3. Ask the pharmacy to make sure they have the medicine in stock before they try to fill it, otherwise it will be a reversal. 4. Ask the pharmacy to only put the claim through once and if it is denied work this issue through the insurance company making sure they take the claim off and don't reverse it. This one is going to be a little tricky but it is your hundreds of dollars going in their pockets for nothing to be gained by you. So don't get angry and DON'T GIVE UP. And I am pretty sure when they do away with gap coverage they will replace it with something either just as bad or worse.

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    Coverage

    Reviewed April 24, 2019

    From my experience as a member in N.J., if you have stock in the company good investment because they seem to be about profit first. But if you want needed coverage they will deny it if they can plausibly can.

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    Customer ServicePunctuality & Speed

    Reviewed April 20, 2019

    We requested therapy authorization for our kid. We got the plan with the highest premium hoping that we we get our services covered. It is stated in their plan that therapy services are covered if in-network. The problem is of so many therapy clinics nearby, none is in-network. We requested Aetna for authorization. Three weeks later, when I called to follow up the request, they said they haven't received the request. We went offer the details to make sure we got the right number where the documents were faxed, and all were right. We we started all over again. They said they were going to call me back at these certain days, of course, nothing happened!

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    Reviewed April 17, 2019

    Aetna has flirted with a plan for cost managed insulin that I really liked. It treated insulin like "tier 1", and then made tier 1 free through the donut-hole. I hate the donut hole! What happened to closing it?? Also, I like Highmark's national provider network.

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    Coverage

    Reviewed April 17, 2019

    I pay every month 120$ for Insurance coverage for single person for 5 years and when I had to go doctor in 2019 they say I have visited a specialist so it can't cover for me, the bill should be at least 1800 dollars out of my pocket to get covered. If Insurance isn't helping when I need why the heck do I need to pay first for Insurance and then for doctor visits. Aetna sucks for sure but I didn't try other insurances either so I feel there should be a comparison to tell how much Health insurance has a problem in US.

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    Reliability

    Reviewed April 17, 2019

    I had Aetna before I retired 12 years ago. Now that I have Medicare Aetna is my secondary health insurance. I never had any problems with Aetna before Medicare or after. The company I retired from pays 90% of my premium which was part of my retirement benefits after 30 years with the company which makes it financially easier for me. I find Aetna very reliable.

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    Coverage

    Reviewed April 16, 2019

    I have health insurance coverage with both Aetna (through my former employer) and Medicare. I am pleased with the coverage I have and find Aetna quite responsive when I have questions. I also appreciate that our coverage now includes prescription eyeglasses.

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    Reviewed April 16, 2019

    We are on Advantage Plan 0 premium but with co-pays. Should have stayed with paid premium Plan G. It is great but the out of pocket for services eats up what you pay in premiums. That about sums it up.

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    Customer Service

    Reviewed April 15, 2019

    I just received a bill from a doctor's visit where I had some blood work done. I went to doctor's office that is in network but that doctor mailed the blood specimen off to a hospital that is out of network. Aetna just sent me letter informing me that I will be receiving a bill for 9,000.00. I have been on the phone with them all day and am not getting any help. I don't have control over where blood work is sent.

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    Coverage

    Reviewed April 15, 2019

    I originally purchased the chair using a different health insurance provider. After the change to Aetna, I needed a new battery for the chair. In order for Aetna to cover a new battery, I had to turn in even more paperwork than the original purchase required of me.

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    Coverage

    Reviewed April 15, 2019

    My coverage is through a group and I feel deductibles are too high. They didn’t cover all of my blood work from my physical so I feel that’s not acceptable. I don’t care that they felt that what was ordered didn’t fall into their guidelines. It was part of my yearly exam.

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    Customer ServiceCoveragePrice

    Reviewed April 14, 2019

    Considering that AETNA is my secondary (to Medicare), the coverage is expensive (barely lower than when AETNA was my primary). The way they handle the deductible and co-pays mystifies me, though the coverage has been good. Dealing with them though (online or on the phone) is like crawling though an unlit funhouse designed to dump you out.

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    Customer Service

    Reviewed April 14, 2019

    Very poor customer service. They do everything they can to get out of paying claims. You are stonewalled to get the claim reviewed again when it is their mistake. English seems to be a second language for their CS folks so that creates problems. Ask for copies of the same documents over and over, just stalling hoping you get frustrated enough to stop contacting them.

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    Price

    Reviewed April 13, 2019

    I was diagnosed with osteoporosis 12 years ago. I’ve lost over 3 inches in height. Before I was on Medicare my Dr. prescribed ** and I took that medication for 7 years until new guidelines indicated that patients should not take this medication for longer than 5 years. I then suffered a severe fracture of my elbow, so then I was then prescribed twice annual ** injections which are very expensive. When I had SCAN Medicare Advantage Plan in Calif. my PCP would refer me to a rheumatologist who would order a bone scan, and lab work to justify the need for **. SCAN always approved the **. When I moved to Ariz., in December 2018 SCAN no longer was available, so I selected Aetna Medicare HMO Prime. Their provider directory is out of date, and there are very few providers who are accepting new patients. This is an awful Medicare Advantage Plan driven solely by financial gain.

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    Customer ServiceCoverage

    Reviewed April 13, 2019

    No diabetic supplies coverage. Customer service had to give me another supplier to furnish me with test strips and lancets from somebody else, they were free but, Aetna doesn't cover them. Everything else is ok.

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    Coverage

    Reviewed April 13, 2019

    I find it unbelievably frustrating that you do not know what dr’s or technicians at a medical center that accepts insurance are not actually covered by the policy until it is too late. For example, the technician performing a CT scan, and you do not have an alternative. Or even know to ask for one.

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    Reviewed April 13, 2019

    I can’t wait until President Sanders launches universal healthcare so we can put all of those double-dipping SOBs out of work. Is there any other industry where you pay up front, then pay again, and even after being paid twice, still don’t get what you paid for unless you pay a third time?

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    Customer ServiceCoverage

    Reviewed April 12, 2019

    I was recently scheduled to have cervical spine surgery since the disc in my spine are starting to press on my nerves. I've been on pain medicine for years and have been back and forth to the doctors for years. I have done everything that my doctor asked me to do and finally did physical therapy in which the next step would be surgery. I was scheduled for surgery and had made arrangements with my job and people to help me out during my recovery, I even did my pre op and paid my doctor for his portion of the surgery, however the day before my surgery the insurance denied my claim (the insurance knew about the surgery for three weeks).

    It's dangerous for me to drive because I have limited mobility in my neck and my right arm just tingles (it's quite annoying). The insurance has no problem taking my money to keep me covered, but they have a problem paying money to help you out. This is the worst insurance that I've ever had. TERRIBLE CUSTOMER SERVICE!!!

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    Customer ServiceStaff

    Reviewed April 12, 2019

    The customer service is excellent. I always interact with the best people who are knowledgeable. The one place I think they dropped the ball is in preventative care. I think having a benefit to help people afford a gym membership would be money well spent. An active person is going to be much healthier.

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    Customer ServiceStaff

    Reviewed April 12, 2019

    I am friendly reviewing new Health Insurance for myself, and including few people for arriving at my homestead that I would partially consider. An individual ** person initially arrived, while including a VERY PROFESSIONAL & very comfortable conversation together while clearly reviewing & responding with my overall questions being given.

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    Staff

    Reviewed April 12, 2019

    They are changing formularies to their own benefit and not the patients. So called equivalents and or generics do not work the same as the name brand the Dr. is initially prescribing. They need to let Dr. be Dr.

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    Reviewed April 11, 2019

    I passed out and fell on the garage cement floor that resulted in an emergency run and ultimately 4 days in the hospital and more doctors, tests and procedures in that short time than I could imagine! All in an effort to determine what had caused me to pass out and crack my skull. I was amazed at how little out of pocket $ we had to pay.

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    Customer ServiceStaff

    Reviewed April 11, 2019

    So far every test I have needed has been approved with no problem. I am also satisfied with my deductible especially for a couple of outpatient surgeries I had to have. I've called the consumer help line and they have been very friendly and have been able to answer my questions in a way that I am able to understand.

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    CoverageSales & Marketing

    Reviewed April 10, 2019

    After reviewing provider plan options offered by my employer selected Aetna as it covered all doctors used as well as all Rx. Now 3 months into coverage they indicate they will not be covering one of the name brand drugs. This appears to be bait and switch and am not happy with this. All in all Rx coverage much better than last year's Express Scripts which was terrible.

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    Customer ServiceStaff

    Reviewed April 10, 2019

    $0 premium, low co pays, great customer service. Great local rep. Have received several calls from reps that want to explain my benefits and other services provided. So far, I think Aetna is a good company and currently I have no issues with them.

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    CoveragePrice

    Reviewed April 9, 2019

    Aetna in my opinion offers a great coverage policy, however the cost of the policy is extremely high compared to other policies and the option the medical providers offer if you decide to pay cash. They provide many options, but for the average American in my opinion their pricing is out of reach and out of touch.

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    Coverage

    Reviewed April 9, 2019

    Paid $5000 in 2018 on insurance, went to the doctor once, my child twice. I paid almost $200 per visit. Why should I have insurance? Now my doctor won’t accept Aetna! WTH!!!

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    Coverage

    Reviewed April 8, 2019

    I have the Aetna Medicare Advantage plan, they actually cover more than when I had Medicare and Blue Cross & Blue Shield as my supplement. My only concern is that they offer different coverage options, but do not tell you how to access them.

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    Punctuality & SpeedStaff

    Reviewed April 8, 2019

    It's an HMO with the attendant disadvantages, but Aetna teams with a local HMO coordination organization and things happen pretty fast, and I can call my primary care provider for a referral to a specialist usually (I've been his patient for many years, so he knows my background pretty well). In an area that is "doctor-challenged," I can usually be satisfied with the specialists furnished (recently balked at one and another - the one I wanted - was provided).

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    Coverage

    Reviewed April 7, 2019

    Switched to Aetna Medicare Plan D. Multiple orders "effed up."

    #1 Sent wrong product and billed $141. After multiple contacts, they still haven't agreed to accept unopened package and meds. It appears I'll have to sue Aetna in Small Claims to get these ** to take back their mistake and reimburse me.

    #2 Later Aetna refused to fill another doctor's prescription for a generic alternative to a very costly med. So I asked about getting the brand name drug. They refuse to cover that. The medication is helping me avoid a high risk surgery--had 4 already over the last 50 years, several requiring lengthy hospital stays and recovery. But "What does Aetna Care?" That's Medicare's problem!

    GREAT REASON FOR SINGLE PAYER HEALTH INSURANCE...so insurance companies don't refuse to pay because "SOMEONE ELSE--the Government"--is responsible. No wonder US health costs are higher and health outcomes are poorer than other countries who expend less and their citizens enjoy better health.

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    CoveragePrice

    Reviewed April 7, 2019

    Does not cover needed meds for my diabetes or COPD. I can't afford them so have to do without. My inhalers are too expensive. Was prescribed ** for diabetes but can't pay for it. I've tried then applying for assistance but that's Still not helping.

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    Coverage

    Reviewed April 6, 2019

    I was picking up my prescription when the Pharmacist told me that she couldn't fill it due to Aetna's change in the way they cover prescriptions. She gave me a piece of paper from Aetna saying that I could get my prescription mailed, or go to CVS to get it filled. Since I was standing at Safeway, where I've filled the same prescription for the past 10+ years, I had to waste my time calling them to 'opt out' of their new way of wanting me to get my prescription filled. I had to waste at least 20 minutes of my time to ensure I could continue doing the same thing I've been doing. I'm paying premiums to this company to be inconvenienced?? Really?? Really, really not impressed!!!!

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    CoveragePrice

    Reviewed April 6, 2019

    Lack of covered medications, most all medications need to have prior authorization without it they refuse to cover especially on diabetic medication like insulin. Because they jacked up the price of the insulin that DID work.

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    Reviewed April 6, 2019

    Plan costs $200 per month for retired teachers. High deductibles with no co-pay. No drug plan. Pay full price for drugs until deductible is satisfied. After deductible is satisfied, then 80/20. Texas legislators did this to retired teachers. It’s killing retired teachers who can’t afford healthcare.

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    Staff

    Reviewed April 5, 2019

    They need to crack down on their doctors and health workers when they are abusive and discriminatory and when they lie about the patient's health just to get paid more money. They need to listen to clients more when they are telling about discrimination and abuse.

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    Coverage

    Reviewed April 5, 2019

    Aetna Disability Insurance has no problem accepting your monthly payments, until it comes to actually paying out on a claim. Aetna disability Insurance uses every tactic they can to not pay out on a disability claim. If this were not true, the common insured person would not have to seek a disability attorney to get an insurance claim paid by Aetna. It is notable to see that there are a lot of consistent complaints online about Aetna Disability claims not being paid to a lot of other Aetna insured.

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    Customer ServiceCoverage

    Reviewed April 4, 2019

    I have had Aetna since I have retired from my company. I turned 65 and am now in Aetna Medicare Advantage, and so far I am sorely disappointed the way Aetna has handled my claims. I have spent hours on the phone trying to get through to Aetna that I have no other insurance, that I only have Aetna Medicare Advantage, but they keep denying my claims saying that I have a primary insurer in Medicare and that Aetna Medicare Advantage is the secondary insurer all the while I have over $75,000 in medical bills not being paid. I was told in January that it was fixed and I have 3 additional phone calls to fix this problem, every time, I am told it is fixed; and as of last night, it still has been fixed.

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    CoverageSales & Marketing

    Reviewed April 3, 2019

    Daughter goes to emergency room. Bill is $1200.00. Aetna denies $1100.00 and only pays $100. If I didn't have a child in college, I'd drop Aetna and put the $400 per month they are robbing me in the bank, and drop the coverage entirely. Totally worthless and a total scam. Even Highmark is better!

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    Customer Service

    Reviewed April 3, 2019

    They dropped most of my Drs from plan. It’s horrible what has happened. Drs in network won’t see me, they say they were dropped too but online says they are not. No help when I call Aetna... Despicable insurance company!!!

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    Staff

    Reviewed April 3, 2019

    I had severe vascular issues requiring many surgeries and Aetna refused to pay leaving me on extended long term disability and in financial hardship. My surgeon filled out all the required paperwork showing a medical necessity for these procedures and they were still denied... Horrible that in today's age people who are sick have to endure additional hardships.

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    Customer ServicePriceStaff

    Reviewed April 2, 2019

    Where do I start? Last year, my first year of medicare, I received my 4 medications a N/C on my Humana medicare plan. This year Humana dropped the same plan in my area so I had to find a comparable plan. I was quoted by Aetna for pretty much the same plan as I had with Humana. Well my doctor ordered my first prescriptions form Aetna mail order and they want to charge me $25 each for 2 separate prescriptions that I had been getting for free.

    Called Aetna, oh by the way when you call Aetna you better plan on spending the day with there phone reps. It takes about 15 minutes for the phone rep just to get your member ID right. Aetna uses mostly letters in there member ID. Tell me does a b sound like c,d,e,g,p,t,v,z. That's why you have to repeat yourself so many times just to give them you member ID number. USE NUMBERS IDIOTS. YOU DON'T HAVE TO REPEAT THEM 800 TIMES. Bottom line is most of these health companies are not prepared for the onslaught of new medicare recipients. And it shows.

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    Coverage

    Reviewed April 2, 2019

    I have Aetna Medicare Advantage made available from my former employer for retirees. I have drug coverage, as well through this plan. The coverage is generous and responsive. I'm very happy with the plan.

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    Customer ServiceCoveragePunctuality & Speed

    Reviewed April 2, 2019

    After purchasing a United Healthcare plan for three years, Aetna is by far the better insurance in service and value. You cannot beat their customer service in thoroughness, knowledge, and speed. They are a pleasure to deal with!

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    CoverageStaff

    Reviewed March 30, 2019

    I have been taking this medication for over a year with the same insurance company Aetna. Now they say I can't be on it. Pick another drug similar to it. Really? It took a while for me to find a drug that works and now they won't cover it and think they know more than my doctor. My doctors send in a form for authorization and they refuse to let me take it. I must find a generic that is comparable. So let's play Russian Roulette with my life. Try different drugs that could cause me to have a terrible reaction or die. I am going to start a support group and contact all my congressmen to make them aware. Starting next month Aetna will be Caremark which is CVS Pharmacy. It will be worse. Terrible how Aetna can immediately stop depression medication. Shame on this company. I would give a zero if it was an option.

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    Customer ServiceOnline & AppStaff

    Reviewed March 27, 2019

    They continually give me nightmares about my prescription. I have had jock itch since March 12, 2019. I called my doctor on the 13th and his nurse put a request in for me with Aetna pharmacy. It was not until March 18th that they acknowledged the prescription and an email that my order will be ready in 2 to 3 days. Then, 5 days later, I get a letter from Aetna that my prescription is on hold. I check their website, and it only says on hold.

    I call my nurse and she puts in another request. It takes days for Aetna to confirm. On March 27th, I check the status of my order and it says CANCELED, with no reason. I call Aetna rep. I am nice, because I used to work as a cust serv rep, and I know it is not their fault for the problem. The rep says my prescription is "not authorized." I say, "It came from my doctor's office. What is 'not authorized.'" The rep say, "I don't know. That is what it says on my end." I called my doctor's office and gave them the message. Also, I have had nothing but nightmares in filling out my other 2 meds. Plus, I am under Medicare also, and I have NEVER paid for a blood test until now. I am told I have to pay $15 co-pay, plus $300 of the blood test. I am screwed, because I cannot get out of the "exchange" until the end of the year. UGH.

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    Coverage

    Reviewed March 27, 2019

    My husband was in a nursing home and Aetna denied him coverage. After 2 weeks I appealed and the appeal process was awful with the nursing home playing on both sides of my issues mine and the insurance company. My choices were limited to an expensive 24 hour home health care aide or assisted living. I was also informed that if I tried to take him out I was going to be reported to adult protective services. Anyway, he went into assisted living for a month and then they said he did not need their services. I was right. The nursing home was wrong.

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    Punctuality & Speed

    Reviewed March 25, 2019

    This company is the absolute worst. Tried to get a medication authorized, after 5 days come to find out after stating they received all the information, they had not. So now I have to wait another seven day turnaround time. In all my years I have never had an issue filling a medication. When it comes time to renew my insurance, Aetna Innovation will not be it!

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    Sales & Marketing

    Reviewed March 23, 2019

    I use GEHA insurance, which contracts with AETNA as the insurance provider. My wife just had surgery to have her tumor removed, and AETNA has rejected a total of $20,000 worth of medical costs associated with this procedure. They did it in such a way that GEHA has received no records of this rejection. The medical bills end up going directly to me. This despite the service providers being in-network. I will press charges against AETNA and report this scam to the department of justice for prosecution.

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    Staff

    Reviewed March 18, 2019

    I am on the Johnson and Johnson Aetna health plan and Aetna keeps on denying claims tests for amounts less than $10 or other low amount like a doctor’s visit, and I have to go through the 3 internal processes and the external process for each claim. All lab tests and doctor’s appointment are in network. I wish my employer would choose another health provider. Aetna is a waste of money. I don't recommend Aetna to any employers for their employees.

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    Reviewed March 18, 2019

    AETNA is awful. I called for refills the other day and I was on the phone for 1 hour and 10 minutes. My previous insurance company was much better than AETNA. You might talk to three different representatives before getting someone that can help you. I wish I could get rid of AETNA!

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    Sales & MarketingPrice

    Reviewed March 17, 2019

    Just switch to Aetna advantage Care for my Medicare supplement Plan. Had medication that was a generic drug. Was paying over the counter $20 per month. Aetna classified it is a tier 3 drug and was charging me over $50 which went towards my deductible of $350. Once that was met I was still going to have to pay of substantial amount more than what the walk-in price was. I went on to GoodRx and found several pharmacies selling the same drug for between $20 for 30 pills to $24 for 30 pills which was the high. I called customer service and explain this to them. They really didn't care. It's a scam, smoke and mirrors, Bernie Madoff only Insurance style. They're taking advantage of the elderly in the State of Florida to serious crime. It's all about the Benjamins. Stay away. God forbid you may need a serious drug someday.

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    Coverage

    Reviewed March 17, 2019

    Aetna is adequate for Medicare coverage. However, they have limited coverage for areas outside of large cities. I have had to go to a larger city as many providers including diagnostics are not covered. This costs me time and money.

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    Reviewed March 16, 2019

    Simply the worst. The epitome of American healthcare - zero accountability. Even if I were a millionaire and had this company for insurance I'd be broke after a couple of blood tests. Don't like the bill? Tough - there is nobody to help. Aetna doesn't care. Doctor doesn't care (they just submit paperwork). Would anyone go to doctor if they got to see the bill first?

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    CoverageStaff

    Reviewed March 16, 2019

    I’m lucky to be healthy; however the program covers doctor visits, lab expenses and extras like Silver Sneakers. My doctors seem to prefer Aetna simply because the company must be simple to work with. When I’ve had questions about coverage, I found the rep to be courteous and friendly but also knowledgeable and efficient.

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    Price

    Reviewed March 15, 2019

    As a retired education employee, I am paying too much out of pocket for office visits and medicines every month. I also pay $200 monthly premiums. Cost of living is going up while our medicines go up and our pensions stay low. How are we to keep up.

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    Reviewed March 13, 2019

    Lists preferred providers as out of network, therefore I can’t even guesstimate how much I will owe. They have been contacted by me and my providers and still have not corrected the issue. Had BCBS and will return to them when open enrollment comes around.

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    Coverage

    Reviewed March 10, 2019

    Aetna refused to cover a generic drug which my previous insurers covered for decades. Aetna covered less than $1.00 for my 4175.00 shingles vaccine. I am living for October 15TH so I can dump Aetna and sign on to a different plan. DO NOT GET Aetna INSURANCE, YOU WILL REGRET IT!

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    Customer ServiceCoverageStaff

    Reviewed March 8, 2019

    I am 24 yo dealing with insomnia for almost 10 years. I finally decided to go through with getting a sleep study. Saw a specialist and he confirmed I did indeed need a sleep study. So we made the appointment but roughly 3 weeks before the study, I called Aetna to make sure the study would be covered, or if it wasn’t how much I could expect to pay. The woman asked to put me on hold while she gathered the information. She came back and told me that 100% of the costs would be covered, and that at the most I would have to pay a $200 deductible, but probably not even that as my study wasn’t an emergency. She even sent me an email detailing their policies on sleep studies and my conditions were listed in those policies.

    Now, a month after the study, I receive a bill from my hospital for over $1700. This morning I called Aetna again and told them firmly that I was given misinformation and if I had known I would get this bill I would not have gone through with the study. She told me she would forward the phone call from January to higher ups so they could listen to the call and figure out why I would be given different information. This will also take up to a month to be reviewed. It doesn’t help that all of the people I have spoken to have been foreign and are difficult to understand on the phone sometimes, though they are nice enough. Thankfully I recorded the phone call from before the study and listened to it again to make sure my memory wasn’t incorrect; the woman did indeed say 100% of the costs would be covered.

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    Price

    Reviewed March 7, 2019

    I have been receiving ** infusions for 16 years. Been w/ Aetna since 2012. $35 copay all along. Plan/Dr/office/billing/Rx has not changed - $35 copay all along. Last year, Aetna decided to start billing me coinsurance of $3500. Said they made a mistake all those years only charging me $35. Threatened to go back and adjust all the prior years to charge me coinsurance if I didn't agree to pay from now on. I can't afford to pay, it's thousands of dollars, so I don't know what else I can do except pay now, but my plan doesn't require it.

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    Customer ServiceCoverageStaff

    Reviewed March 6, 2019

    My company switched us from Blue Cross/Blue Shield to Aetna January 1, 2019. It has been hours and hours and hours of frustration. Every time I need to call them I have to screw up the courage to go into battle yet again. I won't go into details - no one needs to hear me whine - but I really and truly wonder how good people work here. I say good people because most of the operators I work with at Aetna are nice and professional, they just can't help me because their superiors tell them, "Don't pay claims," and my company is cheap for using them.

    I am at the point where I'm either crying or angry on the phone with these poor people. I can't imagine waking up everyday and having to answer phone calls from Aetna customers. I'd need a bottle of scotch in the bottom desk drawer. In this economy, there are too many companies with good health care to suffer through this. I am seriously considering leaving my job because it's insured by Aetna, the worst health "care" out there.

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    Customer ServiceStaff

    Reviewed Feb. 25, 2019

    I work in billing in a physician's office and I'm writing of the horrible frustrations we have had with Aetna Medicare Advantage Plans. They tell seniors lies upon lies, that they can go to any doctor that takes Medicare and voila, all is smooth. I'm here to tell you THEY LIE. One example -- Aetna literally sent claim payments to a patients' home address in NJ, and we are in a different state. Those payments were supposed to have been sent to our office, and they sent them to the patient (age 83 and confused on a good day) for unknown reasons. They have the practice, physicians’ address and license numbers correctly, as well as the electronic claims, and it is unclear why they did this. They couldn’t offer an explanation either.

    They have done with dozens of claims and we simply cannot get information from their corporate offices -- El Paso TX is their main claims office in the US but no local numbers anymore, you get turned to third world call centers that then STEAL YOUR IDENTITY. It seems to us they did not process to be paid to the physicians’ office because we are not in the network. Whenever we call we get reps in India or Philippines on lines with terrible connections. They don't know what the fee schedules are for Medicare, they don't know how claims work through OWN THEIR PORTAL PAGE on Availity, in short, it's a disaster.

    I can tell you all we won't be accepting this plan because it's an absolute nightmare and if we don't get paid we will be bankrupted in no time. I beg seniors to wake up and scream at the corrupt government and your corrupt retirement plan administrators because you're being lied to and your doctors will all stop accepting Medicare within the year. Physicians and patients have to stop being bullied and start SCREAMING NO TO AETNA! Watch out, they're with CVS now too so the monopoly will be complete...smh.

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    Customer ServiceSales & Marketing

    Reviewed Feb. 25, 2019

    I tried to call Aetna to discuss an issue with my HSA. When I enrolled I was asked to provide a link to my bank account. I did that and now Aetna deducts taxed money for my HSA (in addition to using pre-tax money as they are supposed to). I wanted to call to rectify the issue but when you call their 1866 number all the robot tells you is advertisements for crap you really don't need. I tried for 5 minutes but after hearing about roadside assistance, cell phone offers and other junk I gave up. Now I will work with my bank to block Aetna from accessing my account.

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    Reviewed Feb. 24, 2019

    Aetna did not process a claim correctly. I tried for 8 months to get them to correct/adjust the amount paid towards the claim. Finally after 8 months and hours upon hours on the phone the claim was adjusted. I went from owing $5,277 to owing nothing. Horrible experience!

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    Customer ServiceCoverage

    Reviewed Feb. 23, 2019

    In many cases, it is impossible to know what is covered: The customer service often contradict itself and anyway whatever they say isn't legally binding. And the 2 provided documents "benefit plan" and "schedule a benefit" are missing a lot of information. For example, I have exchange went over 10 messages/emails/chats with the customer service and I still cannot have a clear answer regarding a question as simple as whether going to a physiotherapist without a prescription is covered.

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    Staff

    Reviewed Feb. 20, 2019

    My employer switched from Horizon Blue Cross/Blue Shield which was excellent and changed to Aetna! Absolutely the WORST EVER! Everyone should write their corrupt congressman for help! Probably won’t get much either as I didn’t from my rep. I gave other insurance and will cut Aetna and get my money back! Medications I got for years they have denied!! When you get sick AETNA will not be there!! Stop paying them!!!

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    Customer ServiceCoverageOnline & AppStaffReliability

    Reviewed Feb. 19, 2019

    I have had occasion to call Aetna customer service, 8 times today. 3 calls never got to a person, they sent me to a survey as if the call just ended. 2 people I had to hang up on due to a genuinely offensive attitude/voice. The others had NO CLUE what I needed. I asked about the vision coverage, and was told "I don't know" more than any actual concrete answer. One woman claimed her name was "Q" and then proceeded to talk to her coworker about their weekend. The website is extremely slow. It will kick you offline if you are inactive for more than 15 minutes. Problem is, it does this within 10 seconds of logging in.

    The mobile app does NOT work. Period. It does not work. I have carefully entered my credentials into the app over 15 times. Nothing. I get errors. Upon relaying my issues with the app to their IT team, I was told they do not know what is wrong but someone will call me to fix it. I have never received that phone call. Monkeys can run a better company than this.

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    Customer ServiceContract & TermsCoverageStaff

    Reviewed Feb. 15, 2019

    About 2 years ago, Aetna switched its customer service to the Philippines (obviously to save $$$). Since then, it has been a nightmare interacting with them, when you need information. The reps don't know hardly anything, are just reading/quoting paragraphs in front of them, without any real knowledge of what they are talking about. They don't understand American health insurance or medical conditions (which are complex). They constantly put you on hold when you ask a question, while they search the answer; if you call multiple times about the same thing, they give you conflicting information, they can't pronounce half the medical terms... It's irritating and tiring. For goodness sake, Aetna - move your customer service back to the States! I will be switching plans as I can't take it anymore...

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    Reviewed Feb. 8, 2019

    My ophthalmology surgeon was not in Aetna's plan (BFMG) so I opted to change insurers this year. I was appalled to learn that Aetna refuses to transfer my medications to the new provider. Any insurer changes in the past have always cooperated by transferring my medications to the new insurer. It appears Aetna punishes those who choose to leave their plan. Very petty on their part.

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    Coverage

    Reviewed Feb. 8, 2019

    Even if you have "great" coverage through Aetna they will find a way to skirt it. My wife went to an eye doctor with a clot in one of her eyes and the doctor ran a set of labs. Aetna arbitrarily decided one of the labs was "experimental" in nature despite a doctor's note explaining exactly why the lab was medically necessary. Aetna used one of their morally bankrupt, corrupt attack dog MD's to write a false justification for their decision (my wife herself is an MD, and knows the lab that was run on her is very standard in the field). We are now out $700 for a single lab. Buyer beware: the coverage they claim they are offering is a lie.

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    Staff

    Reviewed Feb. 7, 2019

    Tried to have a script mail ordered to me. After 2 months calling I still do not have my script! They never got it right... not even the correct dosage!!! I have used mail order for a number of years, with no problems. Aetna is another story. They are completely incompetent. I will never sign up with them again.

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    Reviewed Feb. 5, 2019

    I have been putting off decompression surgery to my c-spine for 26 years. 8 years ago I chose to have my lower spine fused and found "the most compassionate skilled surgeon" and proceeded. We decided that the back took priority because of the pain. Jump ahead to now. When getting approved, the insurance decided a particular device wasn't need "medically" anymore. REALLY someone at a very low rated insurance company was telling MY skilled surgeon to not do his job. After a peer to peer that changed their mind... I am recovering but now I can't get some medicine from my primary because of...you need to make an appointment. Even though you can't drive right now.

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    Customer ServiceCoverageStaff

    Reviewed Feb. 4, 2019

    Updated on 02/15/2019: I unfortunately changed my Plan D insurance company for 2019 to Aetna. Starting in December 2018, mail and phone communications caused confusion. I now believe that was intentional. I first paid the premium for the entire year via credit card. They claim that the transaction did not go through, so I mailed them a check. But the initial credit card transaction did go through. My card issuer said there had been no declines for that transaction. It appears that I was lied to by Aetna. I wasn't aware of that until after the check had also cleared. Since it appeared that I had been scammed, I closed that credit card account.

    I have been on the phone for over 12 hours with Aetna trying to get a refund for the second payment. I have been told that a refund check had been mailed to me on various dates and I should have received it by now. I never received it. Each time, they ask if I want them to make a stop payment on it and request a new one. I have said "yes" each time. I have been told various conflicting excuses -- such as they weren't ready to take premium payments for 2019 until February. Yet, no one had any idea if I was covered for January and February. Now I am receiving phone calls at all hours (one was at 7:45 am on a Saturday) advising me that they can't refund me until I request a stop payment on the initial check and request a new one --- which I had already done 5 times. I admit that I didn't handle that call well.

    I have now realized that my annual premium is well over $1,400, when it was initially published to my insurance agent for half that amount. It appears that some at Aetna set out to rip-off Seniors. But I believe some reps are not aware-- they simply parrot the words to put Seniors into an ongoing loop of annoyance and inaction. On top of all this, I also received a payment book last week with monthly coupons and one rep said that I had to make monthly payments, even though she had just acknowledged that I had already paid double the annual premium. With that, my annual premium would be about $2,200. At this point, I don't trust anyone at Aetna. I hope my report prevents others for falling for their underhanded scheme like I did.

    Original Review: My experience with Aetna, Plan D Medicare, has been a nightmare. My monthly/annual premium jumps up, up, UP. Its customer service will not help. They simply read off scripts likely written by those who set out to rip seniors off. I decided on Aetna for 2019 Plan D after reviewing valuable analysis created by my agent. I received a letter in December advising me that my annual premium would be $704.90. I called in and paid that on December 13. On December 17 I was advised that "there was an error and I owe another $704.90". I called the phone number from the card and they confirmed that the annual premium is really $1,409.80. So I mailed a second check for $704.90. Both checks cleared. Now they want another $58.70 a month, bringing my annual premium to $2,114.70 or $176.23 a month. I will not pay them a third time. I know they will report me to a credit bureau and they I will have no Plan D this year. Be careful. I have advised my agent.

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    Coverage

    Reviewed Feb. 1, 2019

    I pay nearly 1,400 dollars per MONTH 16,800 per year for my family coverage. SO I can count 18,800 a year with the 2,000 dollar deductible before they pay anything. Not to mention the huge co pays. I had to switch from Coventry because the plan was going away. I never had a problem with paying the high rate there because the plan paid out.

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    Customer Service

    Reviewed Jan. 28, 2019

    I ** hate you with a seething passion, Aetna. First, I go through 30 minutes of transfers and being put on hold try to get info on my company's infertility policy through Aetna, all to be told that my wife, who also works full time, must be on the line at the same time as me in order to verbally agree or some BS. Well, we've both taken time out of our day to call, and have been on hold for 20 minutes now! We have stuff to do! We have jobs and can't afford to be on the line for 20 ** MINUTES just to get a verbal confirmation to be in this program. This is insane. All we want to do is have access to the infertility coverage through my company. It shouldn't take a literal HOUR just to get "enrolled." This whole company is an absolute racket.

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    Reviewed Jan. 23, 2019

    Aetna RX Mail Delivery - I mailed my...sigh, perfectly monthly prescription because of non filling at any Pharmacy. (I’m too old to “drug store shop”) All I have to say is they lost my prescription upon receiving (and signing for $$$) for 6 days causing me to go without any opioid medication. They found it and I told them to mail it back (that will teach them). Now I must “drug store shop” again...

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    Reviewed Jan. 19, 2019

    Made the mistake of trying Aetna just to save a buck. The old saying you get what you paid for is true! One of the Parkinson's meds I take was 40.00 at Kaiser. Almost 400.00 with Aetna! Have a major medical condition that requires me to go to a specialty clinic. Rep I spoke to with customer service offered Spokane - a 8 hour drive! Parkinson's makes it difficult to drive more than a hour. Worst decision I ever made switching. Hopefully I survive financially.

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    Customer ServiceStaff

    Reviewed Jan. 17, 2019

    I had to get a prior authorization for a drug. My doctor sent them a prior authorization form twice. They responded to him saying I was approved for the drug. Then when I call them they have no record of it whatsoever and they tell me he never sent anything. Terrible communication at this company, quite disappointed with their service.

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    Staff

    Reviewed Jan. 16, 2019

    I am very disappointed with the way my appeal was handled twice! I called Aetna twice prior to having this procedure done and was advised it will be covered under medical. My dentist advised that they do not bill Aetna and I will have to submit the bill directly to Aetna to be reimbursed. I did everything I was supposed to do, with the paperwork, receipts and the doctor signing off on the bill. Aetna staff totally disregarded the fact that their staff gave me incorrect information, and I was misled and was denied the reimbursement without acknowledging or apologizing on their incompetent, unskilled staff doing this. In situations like this, for this amount, and not being thousands, one would think Aetna would do the right thing ethically and with integrity but they did not and continued to deny the appeal... Organizations like this should not be in the healthcare business because they are doing more harm than good to people...

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    CoverageStaff

    Reviewed Jan. 16, 2019

    My wife and I have spent about $3000.00 getting ready for bariatric surgery. When we were forced to renew our coverage in January all of the plans excluded bariatric benefits. Aetna has been completely inflexible and callous through the whole ordeal. I have paid thousands of dollars to them over the years and have rarely had to use them for anything other than prescriptions. They have become very wealthy from people like myself paying them and them not doing what they exist to do which is to assist with medical needs. Aetna is owned by CVS and CVS will never get any of my business from now on.

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    Customer ServiceCoverageStaff

    Reviewed Jan. 16, 2019

    Was put on Aetna Medicare by the employer I retired from. Previously had Blue Cross which was great. Since being switched to Aetna I have been denied coverage for 3 prescription drugs I have been taking for years. I assume since they own CVS doing this saved them money, with no concern for my health. BC/BS covered all of them. AETNA denied a CT scan because their doctor didn't approve. If you call them have a translator on the phone as you won't understand anything their outsourced employee says. Hate this company and insurance. Look elsewhere for coverage.

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    Staff

    Reviewed Jan. 14, 2019

    My name is Robin, I am 52 yrs old. I am currently suffering from a major depression disorder. Let me tell you I would not wish this on anyone. I was hospitalized inpatient for 7 days at Lindner Center of Hope in Cincinnati. I found myself "lost" when I came home. They did not have a magic pill or potion to make this depression, stress, loneliness, anxiety, darkness and gloom disappear (of course).

    I was home on late on Nov 15th and my 1St therapy was scheduled for Dec 18. I was beyond OVERWHELMED. BUT, Susan **, an Aetna RN nurse was actually the support I leaned on, A true Godsend. She is kind, sympathetic, caring, empathetic, resourceful, loving, reliable, trustworthy, patient, understanding AND TRULY DEVOTED. She was and is my ROCK. The most compassionate person I have ever met. Without her I may ended up back at inpatient psych hospital or dead without her. I am so deeply grateful and forever genuinely thankful for Susan **, my Aetna case EMmy "Rock". (Hugs) I will never forget how she gives me hope and light when I cannot see any. She is my cheerleader and support. My "Life saver".

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    Aetna Health Insurance Company Information

    Company Name:
    Aetna
    Website:
    www.aetna.com