Aetna Health Insurance Reviews

Aetna very recently denied Rx coverage for my Enbrel - they want me to take methotrexate for 3 months & then they'll decide. Funny, they just paid claims for not 1 but 2 cervical ESI's - which are NOT FDA approved for the cervical spine - and need I add, they paid for my Enbrel for close to 3 years back in 2010. Not a word was said about the methotrexate requirement, which by the way is a low dose chemo med. I have psoriatic arthritis, not cancer **.

I lost my anxiety medication 10 days before I was able to pick up a new prescription. If anyone has gone through withdrawal of getting off of these medications you know you wouldn't even put your worst enemy through that. If you don't know what it is just google it. There are countless pages of how painful it is. So in order for me to get the medicine I would have to pay out of pocket for $140 compared to the $7 insurance covered meds would cost. I don't have that much money. I have never asked to get a prescription early. Yea losing it is on me. I get that but I'm pretty confident I'm not the only person in the world to make such a mistake. I also get some people may try to abuse any system in place to get refills quicker and sell them or abuse the drug. Like I said I have never done that and my history with the insurance should show that.

I am dealing with nearly 2k worth of bills that were conveyed to me as covered. Aetna communicated with my medical professionals before each procedure and confirmed coverage, but then refused to pay anyway. I went through the appeals process (they only allow a one step appeal, so make sure you write the appeal yourself because the representatives do not give a proper explanation. And make sure you include all evidence in that one appeal).

I actually work for a dermatologist office and we obtained a prior authorization from Aetna before the services were rendered and we received the prior authorization approval in a letter directly from Aetna with a prior authorization number. Aetna originally paid the claim and then 9 months later, Aetna retracted their payment and denied the claim stating no prior authorization was obtained, which was evidently not true considering we were sent the prior authorization directly from Aetna. I had sent numerous reconsiderations and appeals and Aetna is upholding the denial stating they received my reconsiderations and appeals after the timely limit, which again all of our documentation shows it was sent within the timely limit. I've been working with our Aetna Provider Representative but am still getting nowhere with Aetna.

Last week I contacted RX Home Delivery via email with a concern that my primary HIV medication was no longer visible via my online ordering portal as provided through AETNA. My message stated it was critical and urgent for someone to get in touch with me ASAP due to the fact that I only had 10 days left of my Epzicom. I reiterated that living in Ketchikan, Alaska would dictate immediate action so that my RX would arrive on time.

I have a history of chronic pain from back surgery. Only thing keeping me going were injections. Aetna decided to deny, after 2 years pain so bad, they'd pay for pain pump which doesn't work and cost thousands of dollars, but if they'd have paid for injections, maybe I would be ok. They lie about providers in network. Customer service is horrendous. Appeals process was handled by a pediatrician instead of pain doctor. Don't trust Aetna. Don't sign up with them!!

I have been having several issues with Aetna. I needed an MRI, then I needed an MRA, I was constantly denied. Because I have Systematic Lupus, my primary physician said, that I should get the Shingles vaccination, but Aetna says NO! I have to be 60 years of age, but I am 53. The manufacture says that you can be as young as 50 to receive the vaccine, but I am still denied. The vaccine costs over $330.00.

After a year and a half with Aetna prescription coverage, I am saying adios. I just read another complaint from a client who no longer can use her current pharmacy and going elsewhere is creating hardship. I have been denied on a third of the meds I was taking before joining Aetna, now three more have been eliminated from the formulary. They are "prior auth." - crazy and my doc is pretty disgusted.

Got coverage through emperor, waited for cards, nothing. Called, was told it had been sent Dec 28. January 9, called, told a new one had been sent on Jan 3rd. Called again on Jan 22, was told it may be stuck in the snow up north. It's now Feb 6 and no cards. So you pay for coverage but can't use it.

Aetna has been my provider since 2013, under a PPO plan. They "discontinued" that plan, according to the MCO service I used to select replacement--effective December 31, 2013. Before the Medicare enrollment deadline, I elected to enroll with the replacement coverage with them, which was to be effective January 1, 2014. Because I am on an absolutely limited income, I had the MCO representative repeat that to me, and I repeated it back to him, twice. He confirmed my info already in their system to ensure it was current.

I have been covered 2 years with Blue Cross on my adult ADD medication. When TEA switched teachers insurance to Aetna, they would no longer cover my medication. I hope TEA brings back Blue Cross.

I am a retired space scientist. My former employer changed all employees/retirees in January 2015 from Blue Cross plan to Aetna plan. Mine is the top one available, Aetna Medicare PPO Premier Plan. It ostensibly puts control of health matters into the hands of the physician, but Aetna actually tries to influence and delay every action.

This year has been filled with hours of time being spent trying to rectify the absolute poor behavior, lies, being hung up on, treated like a liar - never mind doing this while being ill and feeling sick. I made sure this time I picked doctors that were in fact "in network". The reason as I was told and denied payments in the past, so at my last pain specialist visit...my doctor called Aetna and they told him he was dealing with a covered California patient (which I AM NOT) and my payments to Aetna were raised 3 times to almost 700.00 a month. They then told him other fables. I worked with his billing specialist for a long while, twice in the office, to get to the bottom of this one mess they have produced while taking my money, my peace, and health.

Plain vanilla requests are processed fairly quickly. However, God help you if ever have any questions. The monkeys in the mail room can never separate the mail correctly. I've had to send letters 3 and 4 times and still have to call in order to get any action. The people on the service line can only spew company line scripts and do basic things so they're no help if you have any real problem. Between that and their phone system I absolutely hate when I have to call, but maybe that's by design.

When facing bad customer service, I never bother to post online since it is a hassle to create an account and reveal personal information just to complain, except for Aetna - they really frustrated me this time. My dental claim on 12/11/2014 was denied because their system showing my coverage ended in 7/1/2014, while I am 100% sure it should be 12/31/2014, since I have it in my employer's record, and I did go to dentist during 7/1 to 10/1 and those claims weren't denied. I was transferred to 5 different people. They were just like, "this is what the system says," "let me transfer you to this department", and the problem is still not solved because they didn't even try. One of the CR was really rude. I hope she's just being in a tough time so she forgot what a customer service should be. I wasted 1 hr on this, but I'm glad that my employer change the insurance to other providers because they also say that Aetna is difficult to work with. Stay away from Aetna.

I have cancer, and frequently need blood transfusions. Aetna's default coverage is that they will not provide this, no matter how medically necessary it is. Totally ridiculous because transfusions are needed for thousands of different reasons, including after ulcers, after operations, after anything to do with the heart, and frequently in cancer like in my case.

My physicians & prescriptions had been covered until this yr 2015. I'm disabled, in wheelchair & cannot always run errands especially picking up Rx's. My main pharmacy delivers: a small business woman trying to make a living & help community. Aetna now refuses to process my Rx w/ this pharmacy. Pharmacist has made several attempts to contact & renew contract, but Aetna won't respond. Now I, & 25 others, must find another pharmacy; unfortunately no others deliver. BUT due to complaints, Medicare will do investigation & is giving us to Feb 1, 2015 to change plans if we want. I dread having to spend hrs comparing plans for my Rx's & physicians all over again. Sad situation...

My husband's company offers insurance but to add myself and our son on his policy would cost $800 so I did the responsible thing. Went on Marketplace@healthcare.gov, researched policies, found one and made my first premium payment of $251 with an (Advanced Premium Tax Credit) APTC. Then tried to use my plan and found none of my doctors and for some reason my compounded prescriptions were not covered. I'm out of work and my husband is horribly under-employed. We made payments in May, June, and July but then his commissions weren't included in his paycheck and couldn't make the payment in August or September. I called The Marketplace and provided the new income amount and was given an adjusted premium with a lower APTC that was very affordable. I have made my premium payment every month since, however, I am getting notifications from Aetna that says I now owe $634.57 and "If we do not receive full payment by the end of the premium grace period, we will end your coverage. Your last day of coverage will be the last day of the first month of non-payment." This was definitely written by a lawyer.

I have had headaches for the last 3 weeks - Every day. I made appointments with my eye doctor and primary care physician. Eye dr. said everything looked good. PCP said maybe sinus infection but wanted to do a CT scan first. Aetna denied the CT scan and said to go on 4 weeks of antibiotics...meaning they wanted me to just take some drugs before they even knew what was wrong. Instead of properly diagnosing the problem, they opted to save money and leave me suffering with headaches while I take antibiotics for an issue that nobody can pinpoint. Customer service is a bunch of brain-dead robots reading from scripts.

I have a claim for 162$ with Aetna HMO and have been calling them from the last 6 months. Every time, they have told me that a check has been sent. But I have not received the check yet! The reference number for customer service calls is **. The phone number of insurance company is 800-323-9930. Appreciate any help in making Aetna actually mail my claim check.

I require an Albuterol inhaler in order to breathe in times, where my asthma and COPD get bad which is daily. I've had Aetna for 14 months now and they've done everything in their power to make my medication out of reach. I was prescribed Ventolin 1st, which worked great. It was affordable and it was exactly what I needed. 5 months later Aetna decided that they weren't going to cover that anymore. I found this out after being treated in the hospital and sent to get my medication. The doctor came back and told me that I was out of luck. I had to go see a specialist in order to obtain a different medicine, all the while you can't breathe and Aetna wouldn't call me back. Specialist authorized me to get Proair which was the same medication but different company. Again, worked great and it wad affordable.

My family enrolled in a plan with Aetna in Dec 2014 after carefully looking at the doctors who accepted Aetna purchased through the ACA marketplace. To our dismay the list is not accurate. Most of the doctors listed would not take it. That's their choice...understood. When I called Aetna for assistance with finding a doctor who would take us they were no help. Besides not being able to understand them due to thick accents (calls routed to Philippines), they were just useless. I decided to cancel the policy before it even took effect. I will await my refund which according to 3 different people will take 3 different amounts of time to go back into the bank. One to three days, seven to ten days, or three to five days. Not sure who is right so I will watch my account closely. I switched back to Blue Cross.

I had two visits at Savin Dermatology Clinic in New Haven, CT in the fall of 2014. Between the two visits, I was in the office for no more than 1 hour. The medical professional that saw me was not an M.D, but rather some sort of glorified nurse. I came about a chronic skin condition that I’d had for 12+ years. I’d seen a general practitioner over a decade ago who hadn't told me anything particularly useful and only gave me a steroid cream that I found to be unhelpful.

Let's just say we have spent about 50 hours on the phone - they keep telling us we owe, then we overpaid, multiple times, every month, then they retroactively stop our service and we get a bill from the doctor, then we get it "fixed" and then they go back again and retroactively take out the coverage and we are constantly hearing from Aetna people in different departments telling us different stories. This is not easy to deal with for anyone - I would avoid Aetna whenever possible!

I have Aetna insurance through my work, have had it for years. I'm relatively healthy and rarely need hospital visits. A couple months ago I was too sick to work and visited a nearby clinic called Patient first and were diagnosed with pneumonia. Missed about a week of work and had two follow-up visits. I had x-rays done twice, and was prescribed antibiotics and ibuprofen, which I had to pay for. I had to pay a copay of $70 for the first visit.

I have been on long-term disability for 18 months and have had my disability check shortened multiple times. Harassed by the account managers and lied to and have had to call multiple times which has made my condition worse. Told they were not receiving my paper work from all my doctors and had to pay for extra paperwork to be filled out multiple times because Aetna stated they did not have the documents. No one should have to go through this when they are already ILL.

Aetna is breaking the law. Under the ACA birth control must be covered. If there is not a generic version available they must cover the name brand. I am on OrthoTricyclin Lo. There is no generic version of this type of birth control available. I am on this brand because every other kind I have tried makes me chronically nauseous and prone to vomiting. Aetna refuses to pay for the medication. The only way they will pay is if I switch to a generic version which would be detrimental to my well being, as noted above. It costs me $120 per month for one pack. It should not cost me anything.

Prescription rates are more expensive than regular pharmacies. Customer service is NEVER helpful. They do NOT have a Pharmacist seven days a week. If there is an issue with your prescription, they do NOT contact you to notify you of any potential delay. They charge a fee for "quicker expedition" for a prescription!

We live in CA and were in MN during the summer when I came down with pneumonia. I called Aetna and they said since there were no in network facilities we would have to go to another facility and be sure it was during urgent care hours. We did that and then for the last 2 1/2 years my wife has spent 20 hours on the phone with Aetna trying to resolve this and get the bill paid. Every time they are polite and claim that the issue is resolved. And then a month or two later we get a stating that the bill is still due.

My insurance coverage ended on 8/30/2013 and I filled a prescription on 8/29/2013. Although my pharmacy has contacted Aetna on 2 occasions to inform them of this, Aetna insist on the 9/3/2014 date that Aetna has on file and want me to re pay them $350.00 for medication.

Prior to a scheduled preventative procedure (digital mammogram) that is 100% covered "in network" I called Aetna & asked if St. Anthony's breast imaging for such procedures was in network and she said yes it was. My service date was 9/30/14 & soon I began receiving invoices. I called Aetna but as I spoke to a claims representative, he informed me that it was "out of network" at the time of service but they became "in network" on 10/24/14... Only 3 weeks after my procedure..the information given to me was wrong and for a 3-week difference I'm now responsible for $1,327.26 which includes the $206.00 bill from St. Anthony's. Appealing process is extremely confusing and my insurance agent is unwilling to help me.. I pay my $647.00 premium (or close to that amount) on time every month & I feel like they're taking advantage of people like myself. How many others have they done this to? My Aetna Member ID is **, Frances ** dob cannot display personal info. Claim ID with Aetna **. Date of Service is 09/30/14. I can provide copy of invoice if needed but no scanner available now...

Aetna really has my wife and me in a bind and we cannot wait to start with a new insurance company when I start a new job soon. I sent a prescription which Aetna makes me pay $270 for 1 month at the retail pharmacy or $80 for 90 day mail in. The prescription envelope was tracked and arrived 11/18/14. I asked to have it expedited so that I would get the prescription gill prior to leaving the country for Thanksgiving.

My employer offers this Cruddy insurance- they want me to take a health assessment or ELSE they will Charge me 600.00 for not doing so. Can you say Blackmail? I will lose my MD if I get this insurance through my Work-AND everyone KNOWS Quest Diagnostics Is a lousy lab and it is expensive. I used to work there drawing Blood. Aetna says I am required to choose a new PCP- bite me Aetna. Not happening. And it has a HSA attached to it. The deduct is so high you cannot reach it, and 100 percent out of pocket to go to the dr etc. This is insurance?? No, it is not. And if you think they want you on Generics to save YOU money, guess again. Your md went to med school, your MD tried other meds and put you on a name brand for a reason. BUT name brands are expensive. They do NOT care- they need to save and make as much money as possible. I'd rather give uncle Sam 95 bucks a year than to have this. I cancelled it with HR. I just will go without or go to the marketplace but take Aetna, NO WAY!

Prior to a preventative procedure, I looked at three sources of information - 1) What my company provided re: coverage. 2) The website given to me to review for information. 3) I called and spoke with a representative and gave her all the information she asked for and asked what the coverage would be so I was prepared when the bills came. I was told the procedure would be paid for 100%, with no copayment and the deductible would be waived. When the bills started to come in, they paid 80%. I had to pay copayment toward the deductible. I called Aetna and was told I had been given the wrong information and should have called a second time for information. I called Aetna again to see if I would get the same information. The representative had a copy of my claim(s) and was told to call the MD and get the code changed and I was given a code that would remedy the situation.

My employer offers income continuation coverage through Aetna Insurance. I have religiously paid my premium for this coverage for the almost 8 years I have been an employee of the State of Wisconsin. I had not made any claims until April of this year (2014). I injured my two lower ribs on my last side. I saw a doctor, he, like my employer asked if I was hurt at work. I could not honestly recall having been injured at work. The doctor said my ribs were not fractured but were probably just sprained. Aetna submitted some forms they requested my doctor complete and return, he complied. I was not made aware by my doctor or Aetna what the doctor had written on their forms. I informed my employer that I was going to have to be out of work for awhile. They told me that I would need to have my doctor complete FMLA paperwork. I obtained the paperwork and dropped it by my doctor's office. When I handed it to the receptionist I told her that I had highlighted the fax number the paperwork was to be faxed back to. Again my doctor did this and faxed it to my employer.

I recently got pregnant with a fertility specialist, and he administered a transvaginal ultrasound to determine the state of the fetus. It was found to be viable, and signed off on releasing me to my regular OB/GYN. I had an appointment with the OB/GYN the same day, and she gave me another ultrasound to check the pregnancy. Aetna refuses to pay for the first ultrasound, because they say that they already paid my regular OB/GYN. There's nothing in their available information online to tell me that they won't pay for two ultrasounds from two different providers for the same day. I've appealed the decision and was turned down, so I'm submitting a second appeal with the clinical records from my fertility specialist.

Aetna is auditing many of our small health care providers for what they claim to be fraudulently filed claims. This insurance giant will continue to push our smaller independent Doctors of various practices into bankruptcy with their sudden suits of fraud. How can a struggling practice fight this when they're barely making ends meet as it is? The first step is to drop Aetna immediately! You don't need them and you're better off going to a cash practice all together. That's the only way to survive the Aetna bomb if it hasn't hit you already. Sure, many of the other insurance giants are just as bad if not worse. That's why I say, go to a cash practice. It's not your fault. It's not your patient's fault either. They can file their claims through their insurance if they so choose, but you must get the bomb out of your office. As for your patients, most of them likely have a $5,000-$7,000 deductible anyway. What's the point of having this frivolous insurance in the first place? Thank you Obama-care! for allowing the crooked giant to hold all this power over our great nation's people. Take action people.

I have had chronic HEP C for over 35 years and have been through 4 different, unsuccessful treatments. In the last 10 years my liver condition has degraded from a grade 2 to a grade 4, severe scarring and cirrhosis. I suffer from severe fatigue, insomnia, headaches, chronic indigestion, and depression. I will eventually face a transplant if I cannot beat this virus. I have been seeing the same liver specialist for the last 12 years, and have been insured without interruption for over 35 years. A new drug was approved this year designed for people in my condition, and while costly, it's cure rate is over 90%. Aetna recently denied pre-approval of the treatment based on "no medical necessity". To claim this treatment is not medically necessary for me is nothing but an insulting transparent excuse to save money. What is health insurance for if not to assist in payment when needed treatment is not affordable?

Since 15 October I, my husband's employer, my doctors and my pharmacies have been trying to deal with them. On 15 October I went to my usual pharmacy to fill a prescription for an antibiotic. Was told I had no coverage. Went home and called Aetna who said I had no coverage because someone at the husband's company had cancelled the policy. Called HR, who called the broker that sold them the Aetna policy. Broker said all employees were covered. Called Aetna back and was told again - no coverage.

I am disabled and have both part A and B of Medicare and used Silverscript as my prescription plan. Three weeks ago I wanted to switch prescription plans because Silverscript keeps dropping medications I am on off their formulary. A representative with E-Health named Morgan talked me into a combined Aetna HMO/Prescription plan saying it would save me a lot of money but that I would need a Primary Care Physician listed. What he didn't explain is that you have to have a PCP in their network and that PCP has to refer you to specialist in the network for anything outside of normal doctor care. I am a disabled Chronic Pain Patient and don't have a Primary Care Physician as I see a Rheumatologist and a Pain Specialist for care and pain management only. This representative picked out a PCP in my area from the Aetna network and we proceeded to get me onto this plan. He told me to go see this doctor so I would be covered.

My wife and I have used Aetna for several years now. The company has accepted all claims and processed them without issue in most cases. At times they request more detailed information from the physician's office and then complete the claim processing. They recently notified us of a change in pricing for a prescription drug that will be generic in Jan. 2015. This change will help us save quite a bit of money and it was a good customer service practice to let us know.

This insurance does offer several options depending on how much deductible you can afford to pay, however there are several things you need to consider before hiring this company to manage your or your employees' health matter: 1. BAD CUSTOMER SERVICE: Took 6 months to find out the amount I had to pay for a lab, the reps had an attitude, I was hung up on the line 3 times and once I was transferred to "the escalations" where the person providing information did not show any empathy. In the meantime, I had to deal with the very unfriendly letters from THEIR lab provider: Quest diagnostics.

I had to have endometrial ablation last year. My doc's office called AETNA to verify what would be covered. Doc's office was told that I was covered 100%. Have to procedure and then AETNA decides that, "Oh we are sorry we forgot to mention that you have to have a biopsy performed first." Oops! Now $2300 later, I have appealed 3 times and went thru an external review and lost! How can you tell someone yes you are covered and then say no and admit that you were wrong about the coverage??

I was shopping for my Medicare Advantage Plan and had to unfortunately speak to Aetna Service Rep. From the onset, she sounded as if she was in a hurry to hang up and was clearly reading from a script. She sounded more like a robot, no really. When I inquired whether my existing drug plan will still be available prior to Aetna plan kicking in on the 1st of the next year, the answer was NO. Excuse me?

I am a federal retiree enrolled with Aetna and also on Medicare. I am subject to Remicade treatments every other month at our local hospital. I'm very satisfied with my care. My wife and I have been attempting to straighten out hospital and Aetna insurance payments/reimbursements since February of this year. My wife has been on the telephone dozens of times with various hospital and Aetna officials involved with billing/reimbursement/customer service to no avail. Now we are being contacted by hospital collections people. We always pay our bills and both of us have credit scores north of 800. However, we are loathe to pay more than we are obligated to pay between Medicare and Aetna.

AETNA PREMIERE 2000 - Review: Not good. I have submitted lab work to MRI's and they are not covering any of it. This is terrible. Everything that was supposed to be covered is not. I am going to cancel my insurance and will never use AETNA again. It was supposed to be the best plan and it has turned into a nightmare.

Aetna is dropping my OBGYN along with 300 other doctors in Florida. They did this after open enrollment. They refuse to negotiate with high quality doctors and are leaving many people in despair. I have so many problems with this greedy company. I used to have United and I loved them and never had a problem. Unfortunately my husband switched jobs. Have had nothing but trouble from Aetna. They always make you jump through hoops. As soon as we get the chance we will be dropping them and finding our own insurance.

This is my first time ever giving a review, and it's because I have never seen anything like this. I have a surgery scheduled for next month. Prior to switching to Aetna, I was covered under my parents' health insurance. Since I recently turned 26, I was required to subscribe to my university's plan. I have scheduled and attended a number of appointments in the past month to diagnose a problem that I had been experiencing. I had spoken to a representative of Aetna prior to switching because I was new to the insurance and knew that some quirks would inevitably come up. I was reassured that everything that I did prior to switching would allow me to proceed with the surgery that I had scheduled for the end of the year just fine.

Aetna is my insurance thru work. I have been on long term disability since May. They have told me on numerous occasions that I only need Medicare part A but now they have decided that I should have had Part B. So now they are rejecting my claims. They are a bunch of idiots that are costing me a lot of money.

Once again, Aetna leaves me with a Sophie's choice: pay $417 in lab work myself or go without the blood test ordered by my doctor. When I called Aetna to make sure it would pay the 80% for the tests, the young person told me that this amount would be applied against my deductible. I have never met the $5,000 annual deductible in my life and doubt I ever will. I can't afford the premiums if I choose a plan with a lower deductible. In the meantime I have had to forego physical therapy that I desperately needed on my back and many a lab test because I hadn't met the deductible. This company gets thousands of dollars from me every year and what do I get?--bupkus.

I've had Aetna as my health care provider for more than 1.5 years now and every experience has been absolutely outrageous. There is absolutely NO sense of care from the health care provider from how they train their supporting staff to review member plan information, what the member is asking, their extremely poor scheduling system via their website. All looks great from their pamphlets but once you are a member, you are absolutely ON YOUR OWN!

So I just started with Aetna, a plan that was supposed to be a Cadillac plan through my employer. As a healthcare professional with years of dealing with health insurers, I cannot imagine how many consumers figure out who to get anywhere when they have questions. They push using the website, but I have found that worthless as it really does NOT tell you where to get the information you need. Their health providers status are not up to date, and there are few providers in my area taking new patients. If you require special medical care or medical equipment, good luck in trying to figure that out.. It took me some 10 calls to figure out where to get my child's special needs products. The prescription quotes they provide are in no way close to what is charged. It is just overall frustrating to work with this company and get what you need. And thus far, each of our claims has been denied, even though we cannot figure out why. Call to ask and we get "well let me check into it" and they put you on hold never to be heard from again.

I have the unfortunate pleasure of having polycystic ovarian syndrome, and the only marketed and proven BC for preventing cysts is Yaz. However, Aetna used a "clinical pharmacist" to decide to deny me from this BC. First of all, pharmacists do not prescribe or choose what medication you take, they fill it. I am sure it is illegal for a pharmacist to decide I cannot have that medication. Also, my father is a pharmacist, a good one, and he has never said I should take something else for my PCOS because it is "unnecessary". When I am on other BC's I get extremely ill, with multiple trips to the doctor, vomiting, and pain due to cysts. I spoke with them right now and they told me I should try something else and it is my choice for not wanting to follow the guidelines. First of all, this is a doctor prescribed medication, and it is NONE of their business or not their right to dictate what medication I am on for my PCOS. I am horribly disappointing. Horribly. If I get sick, like I always do if I'm not on it, they'll be hearing from an attorney.

These people are crazy. Unprofessional and disgusting. I've been working for them and sick. They have denied my disability claim hence forcing me back to work and denying medical tests my doctor is requesting for me. It’s the worst company I ever worked for and I’m trying my best to get out. Some of the people where I work is a joke. Very unprofessional and kangaroo. I hope they all get their payback for what they have done and are doing to people. They wouldn't care if you lived or died.

What this insurance company considers to be in-network and out-of-network is nonsensical. How can Aetna cover the clinic and the doctor that I went to, but NOT cover the clinic's own lab that is in the SAME building? My doctor wanted me to get labs done and told me the lab was downstairs. I did what my doctor told me to do, and the labs were not routine. They were done because there was a serious concern for my health. But Aetna will not cover the labs because the clinic's lab was out-of-network and now I am stuck with a bill for over $1000! It's not like I went to some random stand-alone lab facility, I never even left the clinic that Aetna considers to be in-network.

After years of being with this company and Never missing a payment and I had shoulder surgery about 6 months ago and that's it. Done. I still paid a 5000 deductible. Out of nowhere they sent a letter of cancellation and did not even give a reason. It is impossible to reach a representative of this company as well. I've made over 100 attempts to contact a rep over the past year to change our policy and not one person ever returned our call...

I am leaving on a trip and will be gone when my next dose of osteoporosis preventative medication is due. Aetna refuses to authorize my monthly osteoporosis medication four days early. I will have to go without. Apparently they think fractures and crushed vertebrae serve you right if you have the temerity to travel. There have been nothing but complaints since Aetna took over the administration of the Alaska retiree health benefit plan. It is a truly awful company in the business of making money by denying health care to sick people.

Who in their right mind approves a medical group in the city that I live in including all the doctors in my area, but does not approve the hospital to which those doctors are contracted with. I was pregnant and told I could have my doctors up until I go into labor, then I would have to deliver at a different hospital with an entirely different staff and doctor!! To top that off, all the approved hospitals were more than 20 miles away. I live in SF Bay Area/Silicon Valley which means that traffic is awful between 5-10 am and 3-7 pm!

I and my husband had blood tests done which were abnormal in past. Tests were ordered and dr's office was surprised that they are not covered. Aetna should be dealing with or have program to inform patients. Also, call Aetna get different info, first I was told it's all us covered and paid. Keep getting the bill and I was told appeal denied, send second appeal. Did not even look at it and denied saying that it was part of first appeal.

I have a diagnosis for my child, the hospital and the doctors are all providers for Aetna. So, every visit is documented and billed to Aetna. But I was denied coverage for lack of supporting documentation. So I called Aetna and it takes 4 phone calls to track the right department. They want medical history and the clinical diagnosis. I am surprised they require fresh documents which is already in the system. I believe it is a tactic to make the person tired and hang up the phone. It took me nearly an hour and had to explain to different people the reasons over and over again. Why is it my responsibility when the providers already have sent the information. They are getting billed and Aetna does need the reason for billing. Just to harass the patients, these people make up things so they do not have to pay for services.

I filed my first claim with them 05/07/2014. I have a $3000 deductible. Met deductible back in end of July. They started paying out 80%. Sept 11 tried to get two prescriptions filled and my pharmacy said I hadn't met deductible according to Caremark. My prescription benefits are integrated with medical plan. I called Caremark. They said I had $87.38 left on my deductible. Called Aetna. They said Caremark didn't have my first claim on 05/07 so they "re-processed" it on 09/15. I had already paid my doctor the full amount, and supposedly they are mailing me a check for 69.90. When I asked why they are not correcting the problem in full with Caremark (87.38 - 87.38) they said I had to call Caremark. Called again to Caremark who says Aetna is lying and they did have that claim. Somewhere between Aetna and Caremark is screwing up.

I found it extremely difficult to avail Aetna Pharmacy's prescription refill. I submitted a request for a 3 month supply for a certain medication on 7/6/2014 and on 9/10/2014 the pharmacy was still not able to fill this... when I finally cancelled and went to my local pharmacy to fill it within an hour. I found that unless I call them (which I did 4 times) in the 2 month period... Aetna will put a prescription on hold but not contact me by email or phone to notify me that the medicine was not being processed. My doctor called a few times... I called 4 times and Aetna could not get this prescription filled. They always had some excuse or the other... I finally had to go to a local pharmacy. Will never try to use this horrible service again.

William ** was refused admission to TIRR Memorial Hermann because Aetna did not believe he was capable of following the Program. There are two Neurologists... his Surgeon Stephen ** and his Neurologist Dr Cindy ** believe in him. No one from Aetna Insurance Company has seen or talked with my husband. Everyone's focus was on his Brain.... there was no injury to his legs... his muscles are hypotonic at this time. The last time he was at TIRR in The Medical Center... Dr ** observed him during Therapy Session and wanted Stephen **, MD to check for fluid on his Brain. CT Head ordered... and Glenn was positive for fluid on his Brain. Dr ** placed a Shunt in his Head to drain off the fluid into his stomach. It has increased his alertness and his memory!! Now because he turned 65 years old... he was dropped by Cigna and the City of Houston placed him with Aetna Insurance Company. I voiced concerns but to no avail! I do not believe Aetna Insurance Company is "looking" at the whole picture. "THIS IS WRONG". He is a Husband and a Grandfather!!! And we LOVE him.

My wife received emergency services in Germany. We spent over $15,000 out of pocket because we were out of network on top of which they discounted the already low charges by 30 percent. Aetna failed to recognize our out of pocket expenses.

Aetna is no longer using Walmart in the pharmacy network. Aetna a part of what's wrong with big insurance companies are only bottom lined concerned. Walmart provides low cost meds for customers, however Aetna sees this as a negative. I say get rid of Aetna.

It is now August, and I'm past my 20 prescriptions a year. I have major depression, anxiety, degenerative arthritis. I took out insurance at my work, the only plan I could afford. Now I get sick, no doctor. I will probably have to do without my medication. Which will harm me. And another problem, this insurance does not cover any mental disorders. If I go to the doctor for feeling anxious or severely depressed, I have to pay out of my pocket. I have you know depression is a medical condition, and it is a illness. For anyone that believes otherwise I pity you, and you need to hope and pray you never have it.

Aetna is a horrible medical insurance and I would never recommend this medical one to anyone. Their representatives are very hard to understand and they cannot do anything right. I always had a problem like claiming. I missed a payment and I never did and they terminated me without giving me any kind of notice. And the people are just downright rude.

This is absolutely the worst experience I have ever had with an insurance company and customer service in general. Representatives have hung up on me, been incredibly rude and shown little patience or understanding. I have never been employed in the insurance field and am fairly young (a year out of college) so I required some guidance when it initially came to learning about my new insurance provided by my current employer.

My daughter has type 1 diabetes and requires many supplies and life sustaining insulin. I order my supplies through mail order and order a 3 month supply so I have fewer copays. My daughter's primary insurance is Bluecross and her secondary insurance is Aetna Better Health which I chose because my daughter qualifies for Medicaid and Aetna Better Health is one of 5 insurance companies that I could choose from under Medicaid. I was told that my primary insurance covers most things and Aetna Better Health covers everything else. Well they have covered nearly nothing! They refuse to reimburse me for copays.

Despite following every procedure as outlined in my plan and despite having written documentation from Aetna that expenses are approved and covered they, repeatedly deny my reimbursements. I always get paid but only after appealing 2 times every time. It's no wonder health insurance is so expensive with these bureaucrats. I am escalating to the insurance commissioner.

Each month Aetna/CVS violates our agreement, I lose time, money and risk heart failure and even death, not to mention the frustration and anxiety they cause. 1. December 2013, I enrolled in Aetna Medicare CVS Part D prescription plan. 2. I pay the premium amount of $45.00 per month for this CVS/Aetna policy coverage. 3. Resulting from several breaches, I met with CVS Pharmacy District Supervisor on several occasions to discuss a system/method which would allow me to receive my regular monthly prescriptions in an uninterrupted, trouble-free manner because of several past failures and the risk of severe physical injury/damage without these medications (see item #10). 4. CVS failed and continues to fail to keep their end of the bargain, which is to order in advance my regular and necessary prescription(s) so they are on-hand when I present my monthly written prescription. 5. On July 7, 8th 2014, they failed and refused to fill my regular required medication. I was told because they did not have them in inventory as agreed.

I was diagnosed with PAH and my previous insurance was Aetna...no problems. I was authorized for my special medication with a $40.00 co pay per month. I considered that reasonable. But, by the month was over and I needed a refill, my insurance had changed due to the company my husband worked for sold out to another and this other company changed the policies. They are still with Aetna but the serving pharmacy which was Express Scripts has now changed to Aetna Direct which is just a pharmacy, not really associated with Aetna. They would not authorize the drug I needed, Adcirca, because I am a woman. If I was a man and can not perform sex...he would get it, no questions asked but I need it to live each day for as many days as I have left and I needed special dispensation.

I had surgery on June 19th. I stay for 2 nights on the hospital. I have a hospital Medical benefits plan that pays for anytime you are hospitalized as long as it not a preexisting condition which mine is not. I submitted all my documents as per the instructions and first of all they only need my itemized bill. I've called every morning since and it's been something else each time. Now it's July 18th I still have not received any notices by mail at all. I had to call again and I'm told now they want me to send them codes. So I do that.

I had Aetna student health through my graduate school and because I live in a state where health insurance is mandatory by law, I had to choose Aetna or pay a lot of money out of pocket for another insurance (this was before Obamacare). Aetna is the WORST insurance I have EVER had. The following is why I will NEVER choose this health insurance again: They don't know their own policies. As a graduate student, I had to use my school's health center when school was in session. Only after visiting them, I could get referred to an in-network provider. When that happened to me once or twice, the school suggested a few providers and I picked one and called Aetna to make sure this provider was covered, which I told was the case. Imagine my surprise when I received a bill for the provider that Aetna said was not covered, even though I was told the opposite by my graduate school, who kept a list of in-network providers, the Aetna website and the representative I spoke to on the phone.

In May, I signed up with Aetna through the Exchange. I was told that Aetna plan had good coverages with doctors and hospitals, and that I would have no problems. Unfortunately, that's all I have had is problems! In May, had a doctor and hospital lined up for life threatening surgery. 4 days before surgery, Aetna told me that the doctor and hospital had been removed from my in network, taking my deductible from $1,500 up to $23,700! So, I started over on the Aetna website. Found a good doctor, IN NETWORK, and he is employed by the hospital, works out of the hospital, is paid by the hospital, and only has privileges at that hospital. 6 days before surgery, Aetna told me that the doctor was in the network, but the hospital was not... deductible now up to $23,700 again!

I had a Flexible Spending Account with Aetna through my company UPS. It was a horrible experience. Every time I faxed in receipts for reimbursements, I made sure that the date, the amount & purchase or prescription name and quantity and date was legible. I cannot tell you how many times that I was told that they had not received my fax, even though I received a confirmation that it had been received. It got to the point that I was faxing the receipts 3 times still being told the same thing. When they did receive it, they claimed that part of the receipts were not legible, including the printouts that I sent for prescriptions from CVS. How crazy was that. Every phone call left me angry and upset.

Since December of 2013, I have received ID cards for no fewer than THREE separate insurance accounts, including one where I was listed as a dependent. Of course, this threw a wrench into Aetna's system and it still hasn't been fixed, despite countless phone calls by myself and my employer in a vain attempt to get this problem (of Aetna's own making) straightened out. The biggest problem is that Aetna can't figure out how much money I've applied to my deductible and how much I haven't. The website told me I met my deductible in January, again in March and then again in April - which correlates to the payments I've been making.

I have been a member since 03-01-14 and to this day I can not get a plastic ID card for myself or my family. I have called 17 times and get nothing but the runaround! They all tell me you will get your cards in 7 to 10 days. I guess they just didn't tell me what year! So I starting emailing them so I can save their emails. The first one said they were sorry and my cards were going to be sent by overnight mail on 5-08-14. Well I guess they got lost. So I email again and again and they deny they ever sent that email. I said "Let me send it to you." It's nothing but LIES, LIES, LIES!

I finally cut back on living expenses enough to buy medical insurance in April 2013 because of the "mandate." What I've got in return for my money is a joke. Aetna and all insurance companies in the US are nothing more than legalized organized crime! I pay almost $400 in monthly premiums and have $2500 deductible, yet I'm still having to pay the lion's share of every doctor's visit. Also, every prescription I've had has been rejected for coverage, demanding "prior authorization." The latest "rejection" was for a drug that has no generic alternative. I have already tried and had side effects for the alternative medicine "recommended" by the insurance company - someone who has no medical knowledge, just looks at the cost. Because prior authorization is an obvious ruse by Aetna to avoid paying for prescriptions, this process takes hours, weeks and sometimes months.

I first called to start a short term disability claim with them and on day one was told that I had no short term disability claim left and was not covered. Day 2 after further investigation on my end through work and union reps, I called back and was given another person to talk to and this time my information she entered in was incorrect. Come to find out that she was looking up on a claim from the previous year, but I didn't click for the existing claim instead on the start a new claim. So, how this got misconstrued I have no idea. Day 3 still have yet to get my new claim started because of the lack of service that I have been dealing with on the other end of the phone once again. Though I am talking with someone different, again, I am now being told that it shows I have no coverage available for short term disability. So they have to send an email to someone over in HUMID who can verify I have coverage and was told it would take 3 days, after wasting 3 days to get to this point.

I'm filing my 2nd appeal because Aetna refuses to pay for my emergency visit. My back went out on Thanksgiving 2013, had to work on Black Friday and Saturday. The next day I could barely get out of bed and walk. The doctor examined me, wrote out 3 scripts and was charged over $1,000. Aetna has ruled it wasn't emergency or life threatening. How could the hospital charge over $1,000!!!!!!!? BS.

My wife had three days in intensive care. On the second day, a hospital staff person came in and told my wife her insurance had maxed out. In intensive care. We had a county aid come to help pay the bill because our Aetna was inadequate. We ended up paying off a $10,000 bill to the hospital when it all settled. I sent doctor bills that Aetna refused to pay. They should be put out of business.

I am also on AlaskaCare. Aetna is the administrator of this plan since Jan 1st. The rollout has been rocky to say the least. After reading Pauline of Craig's submittal, I thought I would post this. If you are in the same situation, please contact the Retired Public Employees Association (RPEA) Sharon **, and/or Local 52 Liz ** with your complaints. They are collecting information. The state encouraged posting concerns and complaints about the new plan, the window closed yesterday. RPEA has documented at least some of the meetings regarding the new insurance... Excellent information. Some problems have been fixed and DRB is aware of others.

Signed up on January 14, 2014 via healthcare.gov. The web site advised me that the company would contact me to schedule my first payment. When that hadn't happened a week later, I reached out to them and offered my money (which they took) and set up automated payments (which they failed to do). So February was paid for, and I never heard another peep about it until today when I got paper mail telling me my coverage was terminated.

NO STARS IF I HAD THAT OPTION... Had to reset my password at least 5 times already... Website said I do NOT EXIST! Very aggravating especially since I had my member card in hand. Finally I called and the guy there was nice and he said the site was not working and he will call tomorrow. But before we hung up, he gave me another address to go to... HOWEVER THAT ONE WAS DOWN TOO :-( No stars if I had a choice!!!

Aetna's model is to snap up smaller and profitable insurers to gain their business contacts then term the employees from the smaller companies to be replaced by temps with no vested interest in the company's success. From terminating employees that are out on FMLA and short term disability, to wholesale terminations of infrastructure replaced by temps. They also had the absolute worst insurance plan for their own employees. It was horrid, from the pricing to the providers available. If they are happy to treat their own like dirt, what do you expect as a third party consumer?

I signed up for health care coverage with Aetna on 2/26/14 with the Marketplace and was told to wait until I received an invoice from Aetna to pay my first month premium. I waited and waited, and finally received my first invoice on 3/21/14. Because it was late, the invoice was for two months (March and April). I called Aetna the same day I received the invoice to ask if I could just make a payment for one month's premium and then I'd make my next payment in a week or two. I was told that I had a 90-day grace period so that was not a problem.

After being on hold for 45 minutes I'm finally connected to a woman who barely speaks English. She couldn't even verify my plan or my coverage. Each time I call or email them I get a different explanation. They are worthless and incompetent.

I am going on holiday and only have a week left on my high blood pressure medicine. I tried to refill but my pharmacy said Aetna would not allow me to refill as it was not time. I explained I am going on holiday. The pharmacy girl said, "Oh we can help. We will call them and get a vacation request." However, Aetna said as I was not going out of the country, I could not have a vacation request. So I called Aetna. The girl told me my choices are: 1. Take half a pill; 2. Take them til they run out and then do without. Do without.

I'm a new member of Aetna SRC, which I get through my employer. A week and a half after my coverage supposedly began, when I tried to use my new insurance to purchase a medication at my pharmacy, my pharmacist said it wouldn't go through. So I called Aetna's member svcs. line and they said matter-of-factly that it was because my information hadn't been "loaded." Uh... were you waiting on me to ask you to "load" it? They said they'd do that, and I checked back an hour later, and they confirmed it was, but that I should double-check with their pharmacy dept. to make sure my information was now showing for them too. (Wouldn't that be their responsibility?) So they transferred me, and the pharmacy dept. said they'd look into it and put me on hold for 10 minutes, until a person picked up and said "Hello?" and I explained what I was waiting for, and this person had no idea what I was talking about. I guess she worked for Member Services? Not clear.

I have a son with a chronic illness. I am having to change my individual plan with Aetna but my son must be covered for providers in Baltimore, MD at Johns Hopkins Hospital. I get completely different answers from different phone representatives about whether I need to be on the plan with him or not in order for him to get coverage. The telephone service at Aetna is so very disjointed that you get different answers from different departments. No one really knows what they are talking about there... and this is very urgent and important.

I suffer from chronic pain. I don't look like I am in pain but I injured my cervical and lumbar area of my spine and I can't seem to get a true diagnosis but when I can't get my medication regularly, it creates a problem. My life is at a standstill. I can't fight fires and I am paralyzed at times. I have place on the beach and had to move back home, back to my parents at 40 and inconvenience my Mother who is 72 with ten grown children. They won't ship to Florida b/c of the "regulations". Why can't I be treated like an individual? They think with the meds I have been taken, which I have been taking since 2009 and in higher doses before and I need to have a local pharmacy b/c I live in South Florida and b/c they have kids and even adults abusing it? Is that my fault?

Horrible dental insurance. 99% of the preferred providers in my area are places like "You chip 'em we fix 'em" or "Mister Happy Tooth." Not much of a choice - either a quick fix auto body for junker cars or "Mister Happy Tooth." Thanks but no thanks. I'd rather go out of network & pay the extra to see a real dentist.

I tried to call Aetna's member services department to cancel my insurance as I became eligible for medicare. I was put on hold in first attempt for 45 minutes and gave up. Tried again and was put on hold for 30 minutes and gave up. I wonder how they handle customers who have an urgent issue! I will just have to stop paying and see what happens. I will do my best never having to deal with them again!

This is ridiculous. They sell you policy when you are a student. Whatever "non-refundable" terms there are, they are under the title "student insurance plan". However, if you have left (graduated, drooped or even sick) the school and become a non-student, they will not allow you to cancel your plan and keep charging you the premium. So now, I'm having two health plans (another one from my employer). Thanks to Aetna! I made quite some calls and even talked with their director, but the response is the same - no cancellation, no refund!

Been with my family physician for 18 years and have had a myriad of health insurance companies. Nearly Every Prescription is denied stating it needs to be pre certified. I called to straighten it out, there is no getting to the bottom of anything. Excuses are that's the precert department not my department. Your Physician hasn't... (I know they have done what they are supposed to do)! Finally, I said "OK you can assume the responsibility then" when I can't take the prescription my Doctor says I need. I hope they save a bunch of money because it's going to go to legal fees! Aetna is the WORST Insurance Company I have ever seen!

I've switched over to another insurance company and still have claims outstanding with them. They are denying almost everything. This is really, really low!!!!!

3 months of calls and Aetna cannot fulfill my prescription. Excuses range from Dr. hasn't called them (I know he has) to the faxed prescription can't be read and they're awaiting another (I know it was sent). Repeated promises to call with an update but no one gets back to me - not once. 5 years with my doctor and I know his office is professional and efficient - 3 months with Aetna and I know they are a hapless bureaucracy. If this was a life-or-death med, I'd be six feet under.

I am a retired teacher that had a great retirement insurance through AlaskaCare. The paper work, phone calls and payments were made smoothly. Then things changed unexpectedly to Aetna Insurance. I did not receive information of the change until January 5th. The card arrived later. The information sent indicated that coverage were going to be similar.

I, too, used the mail order pharmacy from Aetna for many years & due to their routine screw-ups, i.e. when ordering each month, being put on hold for 15-25 minutes, late or no deliveries, having to miss work in order to be home when meds are delivered, etc. Two of my drugs were immune-suppressants due to a liver transplant & so it was a matter of life & death that I always had them available. We finally had to change to an insurance plan that allowed us to obtain our prescriptions locally - they were always available that way & even less expensive!

We have Aetna health insurance. When I picked up a new prescription at our local pharmacy (we have 4 in town), I was told I would be required to use Aetna Specialty Pharmacy because of our insurance rules. When I called them, I was told we would be required every month to phone them to schedule a delivery. They are based in Florida and we live in the Northeast. Every month I phone them, am put on hold for 20 minutes, to schedule a delivery. Then I must stay at home from work to receive the delivery (can't get delivery at work). They cannot give me a 2 or 4 hour window of time for delivery so every month, I am missing an entire day of work.

I had severe neck and upper back pain, and due to the pain I could not focus. I also had diarrhea and body was weak. Doctor's office and urgent care was closed. My family rushed me to Kaiser Permanente emergency. Aetna refused to pay my bill and their explanation is services do not appear to support the prudent layperson definition of emergency. And it was not an imminent threat to life and I could have gone to other facilities. What other facilities are available at midnight? How ridiculous is this??

My husband retired and I had to go on group plan at work. Aetna. The first time my doctor prescribed my blood pressure meds they denied it. She changed it to what they wanted, Diovan. I switched Sept 1, 2012. Our plan changes 1st of each year. I had it 9 months of 2013, last refill of the year they denied it. Tried, and tried, they even told me I needed to change doctors. No meds for 4 months. Went to doc today, denied again!!!!!! I am calling my state senator.

I have just refilled my medication from Pharmacy RX. And it cost me $250 for the co-pay for 30-day supply (yes. $250). It cost me $65 in 2013. I asked them for my detail medication copay and benefit. They don't know and refer me to the member service. When I called the member service number, they told me the copay for non prefer brand injectable is $200 and they don't know what additional $50 Pharmacy RX charged me from. They also asked me to call the Pharmacy RX for explain. Very much, they will send you around until you give up.

Doctor ordered prescriptions Jan 6th. Prescriptions were delivered Jan 28th. Prescriptions were filled correctly but it took Aetna Pharmacy 22 days to fill and deliver the prescriptions.

Logging complaint is a mess. Work hours are short, they close by 06:00 PM EST. If you call you will not be able to talk to anyone the machine takes you around. If you log in complaints you will not have any reference to it left in your system. So no history to refer to and speak about. You will get a email response after some days/time. This will be in secure html attachment. Opening it tells aetna you have seen it. There will be no reference to your complaint there too. After lot of disclaimers in broken English there will be independent couple of lines which means nothing most of the time. If you write again it is new story!! So either you give up or you go the whole 9 yards for zero outcome.

My mother broke her hip and they had to keep her in the hallway and couldn't give her care in the emergency room as the insurance company was slow to give approval and the hospital kept telling us if she just had Medicare they could have taken her straight in. Trying to transfer her by ambulance around 100 miles to another hospital, again, Aetna insurance prevented this and the hospital told our family if she just had Medicare she would had been transferred right away. We had to transfer in a private car - scary. Shame on them.

I was scheduled to have a cervical spine fusion for which the use of, "cages", a device which holds a bone graft is the standard of care. Aetna would not authorize the implant cages, citing one article which found that cages are not necessary. The article conceded that the healing time is delayed without the use of cages. Other studies have concluded that cages are helpful for recovery and outcome. My surgeon is affiliated with the renowned Hospital for Special Surgery, where cages are used all of the time for this procedure. He was kind enough to use the cages, absorbing the cost, because it was in my best interest. He is considering dropping Aetna from his accepted insurance because they are the only company who has refused to approve these devices. I was lucky and am healing well, which is one of the functions of the cages. Aetna is practicing medicine by refusing to allow doctors to use standard devices and treatments. Additionally, the surgery was not approved until the day prior to the procedure. They could have approved the surgery but denied the use of the device, but chose not to take that path. We have switched insurance companies as of the beginning of next year.

Between Aetna, United Health Care and BCBS, physicians are being bombarded with requests for records. United Health Care is actually set up an entity to review claims and want all the records from the provider - by all I mean x-rays, consults, and any other records plus a statement. The doctor is having to pay his employees, buy the ink, buy the paper and pay the postage. Also, they will give you several reasons for denials and all of them will not be correct.

I work for medical office. We have consistently had problems with obtaining correct information regarding a patient's benefits. It seems as if their customer sales representatives are not as well schooled on providing these benefits more often than not. More recently, as of 11/01/2013, the medicare replacement plans Aetna has, have decided to kick back claims with certain CPT codes and denying payment stating that this is not a covered service when in actuality... it is and always has been. They are stating that Medicare announced this on their website and that we have to file an appeal.

My fiancé went to have his regular eye exam. We called to find a Dr in network. He was told by the Dr he needed to go to a specialist since he had cataracts in both eyes. We called to make sure the eye dr recommendation was in network. They were. The specialist told him he would need to have surgery. We called to get approval. After some run around, they said the surgery would be approved; we would have to pay out of pocket expenses, which we knew. The surgery was done on the worst eye first and then the second eye would be done at a later time. When it came time for the second eye to be done, Aetna said we didn't meet the deductible the first time. I know we did because our deductible is $1,000 and we paid over $1,400. They said they denied the claim because our Primary Dr never sent in the referral. I told them our Primary Dr has nothing to do with his eyes. He was referred by an Eye Dr in their network. They said that's not the way it works. The Primary Dr has to make referrals for any work to be done.

To get the scene . . . I have the Aetna Medicare Select plan (although it makes no difference) and this past June I was admitted to an approved hospital for about six days. The hospital bills an extraordinary amount of $44,000+ for those days.. The claim was not approved because Aetna said it was not a "capped" hospital on there list. When I told them it was, they said "Oh that was Aetna's error, and we will resend the claim."

I pay my premiums through my employer biweekly. I've had medical procedures done and surgeries. When I receive the out of pocket portion of the bill that I am reliable for, there is always some discrepancies about Aetna not paying its portion. I am in deep debt because of it. Whenever I have a problem with a bill, it will take 2 to 3 days to resolve the issue. Today, I received a bill from the dental office saying that I owe $82. The procedure cost $259. Aetna is my primary insurance and was billed first and paid only $41.10. The minimum amount that Aetna agreed to pay for a particular procedure $220. My supplemental insurance is Metlife. They are responsible for 70% of the bill. Metlife paid the dental office $96.60. The dental office billed me for $82. Aetna should have paid the minimum $220 and Metlife $39.

I enrolled in Aetna Medicare Advantage about 1 year ago. Before I needed to order prescriptions from their mail order pharmacy (I take 6 medicines all the time), I phoned the number in their brochure for information about mail order service, to find out how their service works (what I needed to do to use it). I asked for something in writing about their policies and procedures, etc., so that there would be no snafus when I needed medicine. I was told something would be sent. 3 weeks later, I still hadn't received anything, and now I needed to order medicine.

It should be against the law what Aetna does to their customers. I am over sixty, but not yet Medicare eligible. I was "job abolished" by my employer in 2008 and have had the same Aetna policy since then. The premium on this policy is $1178 a month OUCH!

I have been going to a fertility specialist, knowing that I am the problem, that I cannot have kids after already going to my appointments. I was finally called back three weeks later by Ruth for enrollment in the program and then told I am being denied due to being a single person, even though I mentioned me and my ex-husband divorced two months ago and never able to conceive. Her response, “go out and find someone to have sex with for a year and then call back if you can't get pregnant.” Even though I was told and my dr that my plan will cover and pay for all services including artificial insemination. RUTH the agent I spoke with is horrible. Managers are horrible. I am currently looking for new insurance. Horrible customer service.

Of course when disputing a claim, their documentation wins even when it's obviously wrong. My only recourse is to hire an attorney and when the dollar value is only about $900, it's just not worth it. I have documents from both the Dr and Aetna that the Aetna review process denies, or didn't look at but either way insurance is a scam and Aetna just finished scamming me. Not such a good feeling. I think perhaps I'll move to another insurance co. Might cost me more but this is the second time this has happened with Aetna and even more throughout my family.

I have been told 3 different stories about my dental procedure and given the runaround about what I will get reimbursed. They gave me an estimate and then said it was only an estimate and it's never accurate. Then why the heck even give estimates if they are always wrong and way off? They now claim after processing and completing a claim that it's not dental. It is medical and they made a mistake. No I made a mistake by having Aetna as my INSURANCE PROVIDER! They are rude on the phone, harassing me about this issue. I think their business model is to upset you enough you will leave them alone. I NEED MY MONEY AND THEY WILL PAY! Please anyone with issues against Aetna file with the BBB.ORG and if anyone knows an attorney class action for misleading estimate and please!

I called today to check claims and this customer service was extremely rude. Her name is Patricia ** and the ref. # for the call was **. I called to check what is going on with the claim and the way she talked was really rude and yelling and insulting the customer that she has to spell every word that she is saying like I am stupid, not even let me talk to ask her what I really need to know. And she said she would transfer me to another dept without even listening to what I am trying to say. I have talked to her too before and this kind of attitude should not be tolerated.

Aetna is a bad idea. They won't let you cancel their insurance so they can keep pulling money out of your paycheck plus they wouldn't let me add my wife to my policy. All you hear from them is no, no, no and they pick and choose what they want to cover. I had to quit my job to get away from them so good luck with them folks.

If your company happens to provide behavioral health benefits via Aetna (i.e., grief or marriage counseling, substance rehab), Aetna REQUIRES the treatment providers to provide all notes of all sessions, which then can be shared with the employer paying a portion of the employees insurance. This is clearly unethical! Do not choose Aetna!!!

Do not buy anything from Aetna! They take your money and run with it! I have now paid them three months for insurance, and yet they say they don't have the payments at all. I have sent them my bank statements, proof from my bank that they took my money and all, and yet they still deny getting anything! So they took $807 of my hard-earned money and ran with it! I have emailed them, mailed them, faxed, talked to them on the phone and still nothing! THEY ARE A WORTHLESS COMPANY!!! I Would not recommend them to anyone! BEWARE!

Joined in April 2013. First of all, they jacked my 301 premium to 350 per month because of a preexisting depression. Now anything pertaining to my depression is covered they say, but in the next breath I am subject to a 5500 deductible before they pay 70%. That is NOT coverage. So basically I'm screwed. Plus, I decided to get a full checkup which is suppose to be covered 100%. I have a list of stuff I need to get done but will probably put the rest of it on hold until Jan 1.

Having a terrible time with Aetna with getting prescriptions. They just lie every time you talk to them. I finally got one to admit that the doctor had sent in a request and they had denied it after they kept saying the doctor hadn't submitted anything. I had the denial in my hands from them and told her that and she finally, after a long silence, said "Oh I see he did submit it and we denied it. It isn't covered on your plan." I told her it was on their formulary and she said, "Yes it is but your employer specifically chose to exclude that drug"!!! What employer goes through and picks and chooses specific drugs not to include in their plan?

I have been taking Diovan for high blood pressure for years and it works wonderfully. Aetna notified me a few months ago that they will no longer cover that drug and that I have to go through a pre-certification process to use it. I felt it sounded like a simple solution. But in reality what it will require is that my doctor will need to try other drugs first before she can prescribe Diovan again.

I been depositing $40.00 per pay check 2 time in month since January 2013. I was waiting for my debit card until March, nothing happened. I contact them. They advised they will be sending soon and expect in 5-7 days. Nothing happened. I been contacting them since March. They advise, "We going to replace another card and be there 5-7 days." Until as of today no debit card. Every time I call they say they sending replace card. And blame postal. I am getting all other mails but not this one. Few months left in this year, my money will be gone. No more flexible care spending with Aetna.

I have been on the same 5 heart meds for 6 years. Initially I was put on Lisinopril and it gave me a horrible cough. My Doctor then put me on Diovan. It has taken years to adjust to the meds, and for my ICD to help heal my heart a bit. I used to always be exhausted and now I have a short "battery life" where I can go out and run errands, but then I need to come home and take a nap. I realized my script was late and called the pharmacy and my Dr's office. The Dr. said that they had been trying to do a Pre-auth and appeal for 2 weeks. Aetna says I must take 2 different blood pressure meds for 2 separate months before they will consider prescribing Diovan. I was told that an Aetna medical director, board certified in Family Medicine, a complaint and appeal nurse, and a complaint and appeal analyst participated in the review of this appeal.

On June 10, 2013, my doctor sent in a prescription for Lantus Solostar Pen Insulin. It is now July 30, 2013 and I have yet to see anything in the mail resembling the needed drug. On July 17, 2013, I contacted customer service at 800-227-5720 to inquire about the status of the prescription, as the information on Aetna's website had changed from 'future fill' to 'cancelled'. The song and dance routine I got involved 'it was marked as too soon to order' and he would 're-place the order'. He even gave me a confirmation number.

I was a happy Aetna PPO member for 3 years (filing my own claims). They paid on time, issued payment electronically, and I had no issues. Then I was laid off and my COBRA kicked in. After paying for my COBRA my files were to be transferred from my company's HR department to Trion (a billing administrator) then back to Aetna. However, my claims kept getting denied because "I didn't have coverage" even though I did. After 6 months of repeated calls to several different people, waiting on the phone, getting different explanations, I finally figured out the issue. Aetna lost my files and the people working for Aetna were too stupid to figure out the real issue.

My doctor put me out of work for 5 weeks due to excruciating pain from a tumor in my ribcage. It feels like a knife in your side and then throughout the day, the knife turns and doubles me over. My STD was denied because my doctor didn't put a game plan for treatment of the tumor. I was also told that since the medication they gave me for me made it impossible to drive, that I needed to be in a carpool. The reason I was out of work was because of the pain, not not being able to drive. I was so angry. I then filed an appeal, which they denied, stating that my doctor didn't respond to their request, which was a lie.

We have had our HSA through Aetna for over four years. They have always been slow to process paperwork and difficult to reach by phone, and sometimes we've had to resubmit various claims. However, it seems to be on an entirely different level for the past year. We submit for the essentially same few health expenditures, with the same providers, nearly every year and this year has been a real nightmare. We are moving into July of 2013 and still, despite numerous calls, discussions with various supervisors and subject matter specialist, submission of a whole host of additional paperwork that has never been required and we find out, yet again today, that they have failed to even submit our claim or begin to process it.

I paid for COBRA on May 8th... It is June 12 and they have or marked me active yet. I have been on the phone for over 4 hours in 2 days and have gotten nowhere. They need to send an email to their eligibility department and have them get back to them via email. Where is this legibility department and can they not afford a damn phone??? My claims are getting rejected and medical professionals are getting pissed. I paid for this service THROUGH June 30th and I'm still not active. I have been in sales and customer service for over 20 years. This has been one of the most horrible experiences I've ever had to deal with. I will never use Aetna again. In my opinion, neither should you!!!

My daughter is a dependent on my insurance. She became pregnant. I called Aetna to confirm her maternity coverage. They assured me she was covered. My daughter's Ob/Gyn called Aetna to confirm her maternity benefits. The doctor was assured her maternity costs were covered and received an authorization number from Aetna. The first 6 or 7 claims from her maternity doctor's visits were covered. Then I got notification that this last claim was denied. I called Aetna and they told me that her pregnancy wasn't covered because dependent coverage doesn't include maternity.

My medical follow-ups were refused because Aetna failed to pay my existing claims. I contacted Aetna on numerous occasions and their representatives said the claims were satisfied. However, Aetna's online resources reflected that the claims are not paid. Also, I'm refused medical follow-ups and being contacted by collection agencies for non-payments. The collection agencies forwarded this information to the credit bureau. Presently, I need medical attention and medication, but worried about accumulating additional unpaid claims. Aetna is causing me more medical problems and anxiety by refusing to satisfy the claims in question. This crisis still exists.

My fiance has Aetna insurance. He has had a lot of foot and ankle problems for the last year and Aetna paid the first $250 and nothing else will be paid until he hits his very high deductible, $2,750! He doesn't make much money, and his medical bills are piling up fast. He has over $1,000 until he hits his deductible. You would think that Aetna would cover the costs that were an emergency matter (ultrasound at the ER when they thought he had a blood clot, blood tests for a potential autoimmune disease, etc.). This insurance is terrible. They cover nothing and won't help my fiance out at all. I can't stand them - worst insurance ever!

I was hospitalized in October of 2012, had emergency surgery and was in ICU on a ventilator for 10 days. The hospital I was taken to by ambulance wasn't in my husband’s health insurance network. However, because it was an emergency, it was to be covered in network. I am still receiving bills for services that should have been covered at 100%. I have contacted Aetna numerous times, sent copies of the bills, yet nothing is done. Then in December, I developed complications and my family doctor sent me in the early evening for a STAT ultrasound, thinking I would need more surgery.

My first call to Aetna resulted in several push arounds to various departments and then being hung up on while I was on hold because, "We are now closed". The next morning, I spent an hour being pushed around, finally getting someone who supposedly "expedited" my request to have my provider of 15 years paid for a cancer diagnostic procedure as a preferred provider. After having my doctor forward necessary "clinicals" on Thursday morning, I waited until Monday to call again. I was pushed from place to place, on hold, etc.

I was covered by AETNA Insurance from 2-2011 through 8-2012. I needed to elect COBRA coverage from September 2012 to January 2013 and submitted my payments as required. I did not receive my insurance card from AETNA until November 2012. In September 2012, I needed to fill a prescription for my daughter, but I did not have a card. I contacted AETNA Customer Service, for which I was transferred to three different people, and had to tell my story over and over again. I was finally informed by Shamika that I just needed to submit the claim form, which she assisted in locating on the AETNA webiste, and submit the receipts for reimbursement. That was back in October 2012. I have since received two denials for a covered benefit and assurance from an AETNA employee that I would be reimbursed. So where is it?

$450/month is a lot for a family plan. When you do get sick, your limited to only urgent care that diagnoses you to just get by through the day or Aetna’s new online preventive care. Just to register with help through the phone, surcharges in every way. No point there. Then you call Aetna’s free nurse service for advice to see if you should go to the ER, only to get rejected and to proceed back to an urgent care for more service because there are chances you will not be covered. Meaning Aetna have to approve the situation to be covered? What's the point in insurance if you can't use it without being approved upon situation or cause? What online free service is mended here? To the outcome of this situation, I didn't fool with the preventive service to diagnose me. Waste of my time.

So, I ended up with Aetna Health Insurance through my work. I pay quite a bit weekly and my employer pays quite a bit too, in excess of $1,500 monthly. My wife and I both tried using our new cards and were told account terminated. On my webpage with them, it clearly shows I had no coverage for two months. My employer got things fixed so I ask if I had no coverage, then where did the money go? Thus far this year, they have denied coverage on 100% of our claims. Why am I paying this company? My most recent claim took 3 months for them to request my life history and then they said an acute injury I had was pre-existing. Even the billing department at the hospital billing office has commented on this denial. I will look at buying my own coverage I guess, I am already paying through the nose for nothing.

My prescription was denied. The company would not pay for it. I called the number provided, and the woman was obviously guessing at why it was denied. I finally told her and she looked further - all the while just being rude and nasty. I did ask to talk to someone who might better understand my question. She went into a tirade. After a long spate of nastiness and quotes about policy, I finally had to ask her to stop talking as she was hurting my head. We were getting nowhere and she would not stop this "canned" speech, and I had to wait it out. She refused to let me talk to anyone else. I still do not have my medication. I’m a client for more than 20 years.

I have been submitting a monthly claim for a particular healthcare provider for many years. Five or six times in the last year, Aetna told me they never received the bill and I had to resubmit it. The claim is for a sizable amount of money and I believe they are intentionally ignoring or misplacing it. I rely on this reimbursement and I am severely inconvenienced by them delaying it.

For infertility benefits, you need to have it authorized through Aetna before they cover procedures. Every time that I tried to have a procedure done, I had to call many times until they would finally approve it. Since the medication needed to be ordered from their specialty pharmacy, I could not get the medication until the procedure was approved. If I did not keep calling, I never would have gotten my meds in time to start my procedure. Did several IUIs and they were not working. The doctor's recommendation was IVF. Aetna was giving them the runaround. They kept asking for more and more papers, but this is only when my doctor's office would call to see what the hold up was. Aetna does not inform the office of what they want.

At my 69.5 years of age, an Aetna-preferred provider doctor prescribed Zostavax for shingles vaccination. His office doesn't keep this medication due to shelf life and storage requirements. I went to Kroger Pharmacy where I have had one time prescriptions filled (maintenance medications require mail order). I got the $200 vaccination, and Aetna denied claim because Kroger isn't part of their plan. I'm still working full time, and I am covered by an employee plan. It seems like they have set up a loophole to keep us working seniors from getting benefits.

I received prior approval for an operation for an in-network hospital, which required a 4-day hospital stay. My plan clearly states a maximum of $200 per day fee deductible. However, Aetna refused to process my claims in-network and are processing them as out of network claims. I have made numerous calls and they continue to deny the claims. This is clearly illegal and against the plan, which I pay for and have agreed. The US government needs to investigate their process of claims and investigate what they do to their customers. They also denied an emergency room hospital one night stay for reasons not related to my case.

Aetna refused to pay for my emergency room visit when I had to go because my throat felt like it was closing. I couldn't breathe regularly and I had a 100+ degree fever. To make matters worse, my primary care physician could not see me for 2 days because he was unavailable, so I had no other option. They were incredibly hard to reach and inconsistent in the appeal process and disregarded my personal statement completely. Because they can. Aetna based their decision solely off of hospital records, which of course were made to be less severe than my actual dire condition.

Aetna changed my Medicare Part D plan without prior notice. I found out when I went to pick up my scripts and was told that they did not cover until I met the $325.00 deductible. What I had signed up for was a tiered plan that had been costing 0 deductible. If I had known, I would have changed Medicare Rx plans during the open time period. Why on earth would a person buy this high deductible plan with co-pays when for less than $2.00 a month more they could get a plan that is 0 deductible and 0 co-pay? And then, of course, when I called to complain, their dispute department said they did mail out a notice. We all know how that story goes. So now I am stuck with this crooked company until the next open enrollment period. I suggest that no one sign up for any Aetna policy. They are greedier and fraudulent than any other insurance company.

I am appalled at Aetna! My 18-month old son had a cold for a week. One Saturday night, he broke out in a horrible painful cry for almost an hour. My son has never had colic or have cried for that long. Something was visibly wrong (frankly, I should have taken him in much sooner). I put him in the car and rushed him to the emergency room after an hour of crying. There are no urgent care facilities open on a Saturday night nor would I have the time to stop and look if there was, when my son was in such agony. The ER doctor only diagnosed him with upper respiratory infection. I was sure there was something else wrong, so I took him to his pediatrician first thing on Monday morning and sure enough, she diagnosed him with two ear infections.

My employer switched health insurance when United Healthcare's contracts were not approved for all nearby doctors and facilities. The boss chose Aetna. I have pulmonary hypertension, a killer disease where I need to take Tracleer twice per day. Aetna refuses to pay for my meds stating all kinds of excuses which were met on the onset, anything from, "We need doctor clinical tests," supplier authorization, and such. I have been on the phone with Aetna specialty pharmacy, every day for 15 days, crying and begging as I ask, "Why? Who is deciding my fate in the company? Please help me, I beg!"

I was denied pre-approval for surgery and appealed. It was denied so I wrote to the President and Chief Executive Officer, to voice out my displeasure with the procedures of Aetna. I also indicated that I would do everything within my power to have Aetna's Health Care Administration of my State's medical policy, cancelled at the end of its contract which is of course my right to do so. At that point, Aetna in retaliation for my complaint, initiated another appeal without my consent or knowledge. I received a letter saying that my arbitrary 2nd appeal had been denied. Finally, I received a call from Aetna indicating that my surgery was not approved due to my doctor's notes.

Aetna accepted my application with pre-existing condition of high blood pressure. However, when I have a doctor's visit for regular check-up of high blood pressure, they will not pay because it is a pre-exisiting condition.

On July 17, 2012, my doctor faxed a prescription for Plavix to Aetna for me to take after being treated for a mild stroke. I contacted Aetna and updated my current address, but the medicine was delivered to a PO box of my daughter that was on my account when first established. Because UPS does not deliver to PO boxes, the medicine was returned to Aetna. I contacted Aetna on several occasions about the delivery of the medicine. I was told that there was nothing that could be done until the medicine was received and logged back into their system, which would take about 30 days. On August 11, 2012, I informed Aetna to cancel my order because my doctor had given me a script for 380mg Aspirin, which I had already begun taking.

I have been diagnosed with rare cancer, Thymoma, and Aetna refused to pay for x-ray and CAT scans ordered by Convenient Care doctor. Their explanation was that Convenient Care doctors can't order two diagnostic tests from same category on the same day. The fact that those two tests revealed that I have stage 3 cancer didn't help. Next, they refused to pay for PET scan ordered by specialists, because my cancer didn't meet their clinical criteria, altogether about $16,000. Customer service was more than rude. It was as painful to deal with them as it is to deal with cancer. Shame on Aetna!

They had okayed the procedure then failed to pay. I had to argue for months to get a bill paid for a procedure that they had previously okayed. I recently received a notice from Aetna that my monthly premium is almost doubling.

I agree with everyone as this company (Aetna) lies, misleads and does whatever to pay as little as possible, deny as early as possible, when processing a claim. The company waited till the day before the surgery to approve the major back surgery performed on June 20th, 2012 (63030 Laminotomy/Hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral Disc, 1 interspace, lumbar 1 time. The paperwork was completed and sent to Aetna in April. I received the letter after I left the hospital, and I never received my benefit payment until I had to call after surgery to ask where it was. I finally received a partial payment the first / second week of July!

I recently applied for health insurance with Aetna Health Insurance for myself and my son. I went through a very difficult process in filling out the application, supplying all relevant information regarding pre-existing condition and previous health insurance information. Actually, I had to do this three times. After a long process, I was approved for insurance. I visited my doctor for a cold and routine check up and paid my $40 co-pay as required. Now two months later, I received a bill from my doctor for the remaining $217 of the bill. When I contacted Aetna regarding this, they claimed the cold was considered pre-existing condition and refused to pay the bill unless I could provide them again with my previous health insurance company policy to see if I ever visited a doctor for a cold. I found this to be extreme and crazy that a cold is considered preexisting. I would warn anyone considering Aetna for insurance to look elsewhere.

This company is obviously dead set on spending as little money on clients as possible. I know they have a right to make money, but when you and your company pay in for coverage, then the insurance company should be held responsible to provide that coverage without constant badgering. I would say 50% of my family's claims require at least two phone calls; one to apologize to our service provide that they have not been paid, and one to Aetna to find out why not, and why no one was notified of the claim denial for 4 weeks or more. Often it takes multiple calls.

Aetna has refused to reimburse me for what is clearly stated is covered in their policy: A preventive health exam (the first exam when I was first covered). They have refused to pay and it has been over a year. Another bill they refused to pay (over 1 year) because they are waiting on a questionnaire from a doctor I never even saw. Such a sleazy company. I can't imagine actually being sick and needing care and having to fight them for coverage. This company needs to be taken down.

I have had Aetna insurance for about nine months and nearly every claim has been denied. A couple were understandable, but most were not. Some have taken many calls to resolve even though they promise me it "has been taken care of". What a lousy experience.

Aetna stole my money. On 9/14/12, Aetna demanded I pay $173.11 on the spot to my pharmacist for a shingles vaccine that they had told me would be covered 100 percent. That was a Friday afternoon. Monday morning, I immediately started calling Aetna. On 9/17, I got through to someone who apologized and said the refund would be in the mail. On 9/20, I spoke to someone else at Aetna who said the check would be coming in 3-5 days. Seven days later on 10/1, no check. I call and I’m told the "claim was sent back for re-processing" and they have no idea when a check will be sent; thieves and liars. Consequence: I went hungry and could not pay my electric bill. Yes, I would be happy to join a class action lawsuit.

I take about six different scripts daily - all generic brands are not covered and neither is anything else out of the realm of the six daily medications I take every day. Recently, I needed a peg solution named "Half Lightly" for a colonoscopy prep that costs $30.00 and they do not cover that. They do not cover antibiotics when I have the flu and they actually cover nothing other than the six daily medications I take. This company and coverage is totally and medically useless. Do not sign up for this prescription service: it is useless. And to make matters worse, they are linked in love with CVS Pharmacy, a more useless pharmacy that employs nothing more than morons who could not be more useless and detrimental to your health. Both companies should be put out of business altogether. Seniors beware of these two companies! And yet I have to pay these idiots a monthly premium - for what? Zero, that’s what. Beware.

I lost my job due to Aetna's mistakes. I paid coverage for 14 years and had never taken advantage. When I found out I was pregnant, it was quite a shock. My doctor ran days and days' worth of test due to a preexisting medical condition. I called Aetna to use STD for the 3 weeks it took to complete the test and they said, "We will send you the paperwork." My doctor completed and returned within a day. I went back to work thinking everything was fine. I received a call from my case manager, who said that my pregnancy was not high risk enough to be considered for STD. I asked to speak to her manager and she said, "Look lady, I wasn't the one who got pregnant. You deal with the consequences." I have not heard back from the manager. I did however write a letter to my company's CEO and the BBB with regard to my experience. I work for a multibillion dollar company and I am hoping that they pick up a new carrier.

I have had Aetna insurance for several years now as it is one of the only options offered by my company. I have been deeply displeased, angered and frustrated in dealing with them over the years. I have had quite a few medical problems, doctor's visits, specialists, procedures, etc. while with them. During this time, they have not paid on items they were supposed to, forcing me to waste months at a time chasing them around just to get them to actually pay the agreed upon amount. Sometimes they have refused to pay it anyway. They have some truly underhanded practices at this business and if you do not know exactly what your plan says, I would recommend not getting any services done before checking.

I have several problems with my back that cause pain in my back and legs. I was getting nerve blocks that gave me some relief for 2 years. Then Aetna stopped covering the injections and when I called, the customer service reps told me they would be paid in 2 weeks. This happened 3 times so I continued getting the injections. They never paid and then said that the nerve blocks were experimental. We appealed and they are still saying that something that has been done for 30 years is experimental. They don’t care about the quality of people’s lives. They are very unprofessional in dealing with their members. I can’t wait to be able to change our insurance.

I found out through a rep that a claim had been filed on my insurance. She assured me that it was going to be denied because the name was different and it was a different state. I called two more times and it was still there. I was assured it would be "handled.” Their method of handling it was to change the name to my name as the patient and then they paid the claim! I cannot reach any manager and was told they don't have managers, only supervisors. I called corporate and was transferred back to an agent. I don't believe it will be fixed and now I'm filing a complaint with the state insurance board. They won't pay my claims, but they pay for a stranger.

I signed up for the Aetna DMO. I researched to make sure that my dentist was listed. When I went to the dentist, they told me that they do not take the DMO, they only take the PPO. I told them that they were listed on the Aetna approved dentists and I was told that yes, but only if I had the Aetna dental prior to 2007. I am now paying for a dental plan that I can't use. I refuse to change dentist as I have been going to them for years. I feel that I was deceived by Aetna. I will not be using them again at renewal.

I've been having serious issues with Aetna that I feel are unfounded. I have prescriptions for the name brand drug, Amrix, and one for the generic of the drug called Cyclobenzapr. I had issues before because the pills looked identical (the name brand and generic) and I followed their appeal process because they informed me that both medications were made by the same manufacturer and are indeed, the exact same in every way chemically, etc. I reordered the generic Cyclobenzapr and they sent me the name brand Amrix and charged me the name brand co-pay. I was not notified that they no longer make the generic. I was just sent the name brand.

I bought insurance when I moved to VA in 09-11. I bought AARP_Aetna and paid a premium each month and never used it. When I called to ask if I was getting a rebate, they said they are not giving rebates to Virginia. Why is that? I had a policy in VA underwritten by Aetna.

My doctor's office called for benefit verification prior to my procedure. All diagnosis codes were provided. Aetna reps (twice) said it was covered by $25 copay only. After I had the procedure done, they refused to pay unless I met a deductible first. The reason I had my doctor's office call for benefit before I agreed to the procedure was because I did not want any financial surprises. Now, I feel victimized. They should honor and back up their reps. I requested that they re-educate their reps, but they ignored that request. They simply told me it's my responsibility. I would not have had the procedure done at this time if I had known it was deductible first. They admitted they gave bad info, but still insisted that I pay a deductible before my doctor's office will be paid. I appealed twice. Their Appeals Unit agreed that they gave my doctor's office incorrect information, yet I am still required to cover the entire deductible.

Aetna denied my claims. They are late on payments and offers no investigations. They failed to respond to letters and complaints and failed to provide requested information. They are not clear on policy and more.

Aetna specialty pharmacy does not want to allow patients under any circumstance to get the medication they need on time. They do not care about a patient's overall well being and would rather get the money through their pharmacy than put the patient first. They insist on their patients waiting, even if medication is needed same day, for pre-certification and for it to be filled through their own pharmacy. Very convenient. They are very rude and unapologetic. They need information to be repeated and they do not care.

I am writing to express my complete disgust on how my short-term medical claim has been handled. I originally called in April and requested to be on a short-term disability leave. I was asked a host of questions, and I provided all information needed and so did my physician. I then called back towards the middle of May, requesting an extension. My physician also sent information supporting this. Then, I received a voice mail message on May 25 stating that my claim has been denied and my leave would be unpaid from May 16.

My husband went to the ER with stomach pain. About 3:00 a.m. the doctor came in and told us he had cancer on his kidney which he was 99% sure was malignant and was admitting him to the hospital. My husband has heart problems (defibulator) and is a diabetic. The doctors ran tests on him all week. We did not know if they were going to do surgery or what they had planned. They told me that they were checking to see if his heart was strong enough for surgery. They had put us in the hospital early Monday morning and released us on Friday. We were to come back a week later for the removal of the cancer and part of his kidney.

I was denied short term disability through FedEx (represented by Aetna) and am being forced to return to work in a wheelchair with a PICC line in my arm in constant, persistent and extreme pain (Lyme disease). Aetna exists by exploiting the impossible circumstances of people’s lives and making them unbearable. This company is unquestionably the incarnation of evil. If you have an option, steer clear of this company at all costs.

I called to see if a doctor was in-network. A customer service rep told me, “Yes, the doctor was in-network and everything would be covered 100%.” After taking my two sons to see this doctor, I received a bill for the out-of-network charge. I called Aetna who asked for his address. He said he was not in-network at that address and if I had taken them to his other address, it would have been in-network. Funny, they did not tell me this on my initial call - and it’s funny they only asked for the address after being serviced! It sounds like a scam to me! I've been fighting with Aetna for over a year for them to take partial responsibility and they refuse to take any ownership for their lack of forthcoming information. I am so mad! I did finally pay the out-of-network expense after realizing I was not going to get anywhere with Aetna.

As of my last post. I cancelled my insurance with Aetna on April 26th. I was told it usually takes 1-2 pay periods for it to stop being taken from my paycheck, but my request would be expedited. As of today, they are still taking money from my check. When I called to arrange for that to stop and get a refund, I was informed that there is no such thing as expedited. They interrupted me several times, talked over me and basically told me I'd have to file an appeal. I'm sure that result will be satisfactory. They take no responsibility for inaccuracies or misstatements, unless it's in their favor.

Last month, I went to refill through Specialty Pharmacy and was told I need pre-certification, but without any warning, so I had to obtain medication directly from the manufacturer on emergency basis. Over a month later, I assumed it would be done. I have now called 4 times today and although had all the info and clinicals required to authorize, no one would contact me back. I spent hours speaking to various people 8AM, 11:30, 2:30 and 3PM on May 11th. This is not something the customer, who pays over $2,000 for insurance, should deal with. It could have simply been approved. There is no coordination between departments and total incompetence!

My list of complaints against Aetna is so long that I just won't bother you all. The short version is this: I could tolerate pretty much any insanity they were inflicting against me except one: Illegally and without my authorization, taking funds from my credit card/checking account. I got it replaced but not without a huge, time-consuming and irritatingly frustrating amount of exhausting energy. They honestly thought it was acceptable to take whatever money they deemed I owed them out of my account at their discretion! I'm here to tell you all: There is a way out of Aetna. I googled "generic inhalers" and not only did I 100% reduce the insanity, but literally reduced my out of pocket cost of $465.00 to Aetna to (are you ready?) $156.00! For the same identical meds, only generic.

I went to work part time and opted to have Aetna insurance that covered wellness visits for my daughter. This was to cover those visits until my husband's new insurance began with his new job. I signed up in early February. I waited two pay periods (that's one month) for the coverage to come out of my pay check, which is the indicator that the coverage has begun. I called to see what was causing the delay. They informed me that they were having a communication issue with my company and it should be starting soon. Sure enough, on the next check, it was there.

I'm looking for an orthopedic. I made several calls from your list. Your list sucks. There were disconnected phone numbers, different addresses or doctors out of the network for the last two years. **! Aren't we paying enough to get someone to update this dumb list? Never mind. You guys want the money only. Sorry, I forgot.

On April 15, I placed an order for a refill of one of my prescriptions. Aetna canceled the order without informing me. Evidently, the medication is no longer covered under my plan. To unilaterally do something like this without making sure the patient is aware of what is happening is unconscionable. I am a type two diabetic and rely on my medications to keep my condition under control.

policy available to my husband at no further cost to my husband or CSC. The cards we have says Aetna CSC Traditional Choice with RX, as it has from the beginning. With this year's enrollment, everything has changed. Aetna is now charging us $6.92 apiece for medical coverage and $64.96 apiece for drugs, for a total of $143.96 a month for the two of us. Aetna told us CSC knows about this and has agreed to pay for the revised policies.

My son turned 19 and was dropped from coverage. He is a freshman in college and is still a dependent of mine. It was a nightmare getting him reinstated. He was on a prescription that takes time to be effective and has adverse side effects. He was on the medication for 3 months. We went to the pharmacy and they said it would be $400 because his coverage was denied. After a month of incredible hardship by Aetna, he was reinstated. Now, CVS is declining coverage of the medicine even though prior to them dropping him in error, he was on the medicine. Now, we are going through the trouble of getting him approved again for the medicine he was already on. These companies will do everything they can not to provide reasonable, prior approved coverage!

Mail Order Pharmacy Incompetence - I received a phone call from Aetna pharmacy saying they were out of my meds, **, plus now they cannot fill this prescription by mail order for 90 days any longer due to new laws in two states, one of which apparently is mine. Then they turned around and returned one prescription and filled the other for 90 days! So next due date, I resorted to requesting from my doctor three separate prescriptions, the second and third stating do not fill until after such and such a date. First one goes fine. Second one, I called after two weeks because it never shows in process. I find that my prescription had been voided because it is a duplicate (same date as previous one when all three were written). That's as far as the pharmacist read before voiding. I had received no notification and by now was out of meds.

I have had this company for over two years and seemed to going well. Now, since I was added to my wife's insurance, Aetna refuses to pay even secondary. I called and they said that I had to file a claim for reimbursement and I did. Aetna still refuses. I wouldn't recommend them at all. Aetna is all about corporate greed. Be aware, fellow Americans.

Orthopedic Prescription & Dental Nonpayment: Aetna is, by far, the worst medical provider in my 35 years of work experience. I visited my orthopedic surgeon, Dr. Thomas **, Commonwealth Orthopedics, ** Alexandria, VA 22314, on October 20, 2011, to receive a prescription (copy enclosed) for Orthovisc. I was in severe pain, since no cartilage remains in my left knee, the Orthovisc is injected over 3 weeks, and cushions the bone-on-bone pain.

I have been with my company for 14 years and never made a claim for STD. My doctor wrote me off work on 10/28. I had to see another doctor in order to be diagnosed. The second doctor also wrote me off work. Aetna approved my FMLA but denied my STD. It took them about 9 weeks to even decide. I was never paid the entire time I was off work. 8 weeks. Worried and concerned I had to go back to work in order to feed my kids, I filed an appeal and the estimated date for an answer is 3/29/12.

Aetna denied coverage for a surgery of a tumor that was found during time of coverage. Aetna pre-approved to lab tests. After the tests were completed and they were billed, Aetna denied payment. I paid for surgery out of pocket in December 2010. In the beginning of 2011, the hospital sent several claims to Aetna, which they denied to pay again. So the hospital then sent the bill with interests to a collection agency. I am unemployed and have been since after my surgery, so the collection agency is still waiting for payment.

I had surgery by an out-of-network doctor back on December 27, 2011. I was told by customer service that Aetna pays 50% after my deductible was met for surgery I had on both second toes because they were too painful in all my shoes. I paid over $7,000 for the surgery, most on my Care credit card because I was expecting reimbursement because I met the $5,000 deductible. Now they are claiming they will not pay because they don't think it was a reasonable amount that I was charged by the doctor for this surgery.

Aetna Denial of Dental Claim. On 10/14/11, I had 4 teeth extracted at my local in-network dentist's office due to fractured roots and infection. Two weeks later, on 10/28/11, I went back as I had bone sticking out from where the extraction was done and was in severe pain. I could not even get the temporary bridge into my mouth. My dentist was out of town and his office attempted to find me an in-network dentist that could help me. However, none was found. I was referred to a dentist that worked me in on an emergency basis and performed the alveoloplasty procedure in which the incision was reopened and my jawbone was ground down. This dentist was not in my network, I found out after arriving.

I submitted three medical expenses which are identical other than the names: One is myself, one for wife and one for my son. Diagnosed with upper respiratory infection, I was given a prescription. One out of the three were paid. The other two were denied. It has been less than six months and each time I call, they just say an item needs clarification and gets resubmitted. It is now getting old. Any suggestions? Maybe someone may know a special number to call for the company that actually get you some real help and action from someone in the company to solve the problem. Or realize there is no problem and paperwork looks in order. Approved, you will receive a check in two weeks reimbursing you for the medical expense which I am entitled to.

I had a CT scan test at the Association of Alexandria Radiologists. They contacted Aetna to had it approved and contacted me to give me the appointment. The day of the scan, there were no insurance problems of any kind and I paid my regular $30 co-payment. Now Aetna is not paying them and I'm being billed for $579. The only information I can get out of Aetna is that the code the radiology services is providing is not the pre-certified code, whatever that means. They don't show any initiative or interest in looking into the problem. Their customer service is very restricted. You can only reach a real person on the phone during work hours, and that with some difficulty, a representative whose duties don't seem to include trying to help.

I work here in MA through one of the consulting company and they offer only Aetna insurance. But recently I have figured that out that now I have to pay the penalty for full year of 2011 even though I had health insurance because this insurance does not meet the requirements of the state. Why they (Aetna) give this type of offer/plan to these companies? I'm really frustrated and don't know to whom I should report for this.

I'd like to share with you a personal struggle I'm having as I have recently had a "reality check" on my current choice of career versus a career that I have been pressured to pursue. I used to work in banking for year before learning fully about the achievement gap and how students from low-income communities are unfairly forced to go to low-performing schools. For this reason, I opted to go into teaching (necessarily accompanied by a severe pay cut and much longer and harder working hours) for the past two years. My long term goal is to stay in teaching for at least five years and stay within education for the rest of my life in order to push educational equity. I have always been an idealist and hope to continue working towards this bigger goal.

I received services from a provider that was not on the healthcare network. I obtained pre-approval from them to add him as a network provider as there was no suitable provider within the area. I received an approval letter. I had to make multiple calls for my initial visits to be covered and paid for correctly. The representatives would not even provide their names for documentation and would not give me phone number or supervisor information to discuss my claim.

My son takes an anti-seizure maintenance medication, Keppra, that I order via mail order due to the cost. The prescription has been filled via Aetna mail order for quite some time. I had my doctor contact mail order pharmacy 12 days ago to get the new script filled. We intentionally gave about two weeks notice since we typically have problems with mail order so this time we wanted to be certain we had the medication in time. Well, I received the order a few days later but was issued the generic product. I have been informed since my son was diagnosed two years ago that he should only be taking the name brand product.

I called the RX customer service number on the 18th of January for coverage of malara medication for an upcoming vacation for my wife and me. The representative confirmed that the medication was covered and had $10.00 co-pay. I got the RX from the Broomfield Health and Human Services. Last Friday I took the RX to King Soopers pharmacy and today I was required to have a doctor call for pre-approval. I contacted Aetna and they confirmed that their rep told me it was covered and too bad. I need to contact my primary doctor and have him call Aetna for pre-approval. They are not very professional.

I am so heartbroken that Aetna and the Kelsey-Seybold clinics in Houston cannot work out an agreement. I have been with Kelsey for over a decade and have relationships with all my doctors and my children's doctors. This is very traumatic because we will have to find a new general practitioner, pediatrician, pulmonary doctor, dermatologist, and cardiologist because of the fact that Aetna cannot work out a deal with Kelsey. Of course, interestingly, Aetna blames Kelsey and Kelsey blames Aetna. Honestly, I don't care who does what! We pay premiums to have insurance with Aetna and I am going to recommend to everyone I know that they start putting pressure on their HR departments to look elsewhere for insurance. I am surely not the only person who is mortified by this change!

I continue to have problems with Aetna. I got 2 new prescriptions, from my doctor last month, which were filled. Both are working better that what I was on before. Aetna authorized the prescriptions. I went back today and they were declined for other medicines that I have been on that did not work well.

I was on Cal Cobra with Aetna. My employer put me back on group health insurance roughly two weeks before my paid Cal Cobra premiums expired. I have spoken to both Aetna & the administrators of Cal Cobra. Both point fingers at each other & will not refund the $250 +/- premiums 'double paid'. When I directly bring up my circumstance, they give answers that have nothing to do with my questions.