Having problems with Aetna?

File a complaint and get it resolved. It’s quick, effective and absolutely free!
Proudly resolving consumer concerns since 2004

Customer Service

+1 800 872 3862 (Customer Service)
+1 855 335 1407 (Medicare Advantage)
+1 800 345 6022 (Medicare Supplement Plans)
+1 800 307 4830 (Coverage)
+1 800 633 4227 (Medicare Helpline & Website)
151 Farmington Ave.
Hartford, Connecticut
United States - 06156
Mon8:00 AM - 6:00 PM
Tue8:00 AM - 6:00 PM
Wed8:00 AM - 6:00 PM
Thu8:00 AM - 6:00 PM
Fri8:00 AM - 6:00 PM
SatClosed
SunClosed
Aetna Mailing Address
P.O. Box 14088, Lexington, Kentucky 40512

Aetna Pharmacy Claims
P.O. Box 52444, Phoenix, AZ 85072-2444
 
Mail-Order Drug Ordering Address
Aetna Rx Home Delivery, P.O. Box 417019, Kansas City, MO 64179-9892

Complaints & Reviews

Denying &life sustaining medication&

THIS IS INHUMANE! My doctor, my pharmacist, and I have been in contact with AETNA for 3 days. I have not had my synthroid since 9/15/10. Aetna would only reimburse for generics, so I use them for the past 3 months. I did not respond to Levoxyl(GENERIC CRAP), and my T3 & T4 are so low that my doctor told me if I feel ill to go directly to the ER. He had no samples to give me. My doctor wrote "patient blood levels improved on Synthroid", been on medication since 1980. AETNA SAID, it is not saying the medicine didn't work, just that you "improved" on the brand? WHAT???????????? going to ER and this could have been avoided!

Refuses to pay for radiation treatments to remove prostrate cancer

I was diagnosed with prostrate cancer after a biopsy from an in network urologist. He scheduled an appointment with a radiologist to start treatment. Aetna refused to pay for the biopsy. Aetna also refused to pay all imaging procedures to penpoint the areas of my prostate that has the cancer. I am at the moment trying to pay of the imaging company and the urologist to the tune of quite few thousand dollars. I still have to come up with the money to pay for any procedures to remove the cancer.

Aetna never gave a reason for not authorizing payment other than the procedures are not authorize even though all of the doctors were in network doctors. Aetna has turned out to be a horrible company. I get my insurance through a group plan at work. The plan is provided by Oasis Outsourcing. The years that I have paid into the insurance plan has turned out to be a complete waste of money and time.

  • Ja
    JaneDoe Sep 01, 2010
    This comment was posted by
    a verified customer
    Verified customer

    I'm so sorry for what you're going through. I can't even imagine denying a patient diagnosed with cancer & needing treatments.
    I know the last thing you want to do is chase AETNA around with everything going on. Perhaps you can give a Release of Information to
    a trusted relative or friend to get to the bottom of it.
    Don't give up! Seriously this HAS to be a miscommunication.
    Try calling the "PHA" (personal health advocate) # on the back of your insurance card...
    Try calling the AETNA Case Management department for your particular contract & insist on being assigned a Case Manager to work & help you with all of this.
    Also, your doctor's office should have an insurance specialist that can help you clean up this mess.
    You can also go online @ aetna.com to get information on AETNA's specific policies relating to your care.
    ******If you really want to get AETNA's attention to this matter... call your Human Resources department & request to speak with your "Insurance Liason.
    ******Tell them everything ask that they contact AETNA for you to see what is going on during this critical time in your life when you need them
    to really come through for you. Express that they really should take this into consideration when picking what insurance to offer their employees.
    Call the head of your organization also & let THEM know also.
    Good Luck. Hope everything works out for you soon.

    1 Votes
  • Qu
    Queencreekmom May 21, 2011

    I can completely understand what you are going through with Aetna. I was diagnosed with Thyroid Cancer and I have surgery scheduled for a Thyroidectomy in a week, I just got a letter from Aetna refusing to pay for the byopsy, ultrasound, uptake scan and CT Scan. Basically everything that has led me to this point. Unfortunatley this is the only means of insurance we have through my husbands work . We had Aetna about 10 years ago and had the SAME problems with them. Unpaid claims... they refuse to pay for anything! Call your Insurance Commissioner! These clowns need to be put out of business. I hope eveything goes well with your treatment ..god bless and good luck!

    0 Votes

Scam

At the end of 2009, GE insisted that everyone convert to a more self-managed medical insurance plan.

ccThey held onsite information / question/answer seminars for employees and retires.

The information they spewed concerning assurances that pre-existing medical conditions would still be covered and answers to specific questions turned out to be totally false, and outright LIES.

What they accomplished was to turn over autonomous coverage decision authority to Aetna and a couple of other insurance companies, who's only incentive is to make sure most medical claims end up getting paid by patients. GE made sure of this autonomy by removing all GE contact information about medical issues from all of their web sites and documentation.

In addition Aetna makes the claim appeal process so difficult and their denial of claims absolute.

There is a back door to file a formal complaint, contrary to MA law, which states such a process is supposed o be readily available, which Aetna will give you the link to the form if they are pressured hard enough.

The joke to the whole formal complaint process is that a board made up of Aetna people decide the disposition of the claim and in order to appeal to GE, one must submit a formal appeal on a claim 3 times before GE Benefits will even discuss the issue. In other words, there is NO appeal process, GE made sure of that. So where are we, we can get $30 physicals covered but any thing requiring lab tests or pre-existing conditions, the patient is on his own.

This s how GE looks to the future to reduce Health care costs, make it so retirees can't afford the care and they will all eventually die prematurely, Soylent Green does not sound so absurd now.

Now I have the choice of paying medical bills or going without necessary tests and exams and pay my many other expenses on my limted retirement income.

I either die or go broke and die.

  • Ja
    JaneDoe Sep 01, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Try contacting your GE Insurance Liason in your H.R. department. They may be able to shake AETNA's tree to see what nuts fall out.
    If all else fails... just keep going to the ER. They can't turn you away & they can't demand payment from you in the ER. They have to just
    treat you & AETNA has to pay it. If you go to the ER frequently enough... like 3 times per month... AETNA nurses will definitely be calling YOU and then you'll
    get some help to keep you from going to the ER again.
    You can keep appealing their decisions & eventually they have to have an outside physician review your appeal for fairness ;)
    Good Luck.

    0 Votes

Aetna representatives lied to me over the phone

My complaints with Aetna health insurance range from August 2009 to present. The claims are regarding therapy services for my daughter who has cerebral palsy. I have two major ongoing problems: Aetna representatives lied to me over the phone, telling me that more therapy than the 60 days written in plan would be available once her doctor wrote in a letter, and then Aetna denied the coverage for these claims stating it was not in my policy and would not stand behind the misinformation given by their employees that led me to continue therapy and then had to pay for it on my own. My second complaint is regarding the copay amounts for the therapy sessions that we did have, Aetna has retroactively changed the amounts of the copays, and credits have been issued to me, however the amounts are not consistent and Aetna now is refusing to give me a detailing of what the copays were, or show me where in my policy it states what the copays are. They are now saying that they made a "mistake" in covering the therapy in the first place, so they are not giving me the information or further credits to make the copays consistent.

  • Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

    0 Votes

Health Insurance Not Covering Claims

My complaints with Aetna health insurance range from August 2009 to present. The claims are regarding therapy services for my daughter who has cerebral palsy. I have two major ongoing problems: Aetna representatives lied to me over the phone, telling me that more therapy than the 60 days written in plan would be available once her doctor wrote in a letter, and then Aetna denied the coverage for these claims stating it was not in my policy and would not stand behind the misinformation given by their employees that led me to continue therapy and then had to pay for it on my own. My second complaint is regarding the copay amounts for the therapy sessions that we did have, Aetna has retroactively changed the amounts of the copays, and credits have been issued to me, however the amounts are not consistent and Aetna now is refusing to give me a detailing of what the copays were, or show me where in my policy it states what the copays are. They are now saying that they made a "mistake" in covering the therapy in the first place, so they are not giving me the information or further credits to make the copays consistent.

We are here to help

  • 16 years' experience in successful complaint resolution
  • Each complaint is handled individually by highly qualified experts
  • Honest and unbiased reviews
  • Last but not least, all our services are absolutely free

Aetna not covering claims & giving false information over the phone.

My complaints with Aetna health insurance range from August 2009 to present. The claims are regarding therapy services for my daughter who has cerebral palsy. I have two major ongoing problems: Aetna representatives lied to me over the phone, telling me that more therapy than the 60 days written in plan would be available once her doctor wrote in a letter, and then Aetna denied the coverage for these claims stating it was not in my policy and would not stand behind the misinformation given by their employees that led me to continue therapy and then had to pay for it on my own. My second complaint is regarding the copay amounts for the therapy sessions that we did have, Aetna has retroactively changed the amounts of the copays, and credits have been issued to me, however the amounts are not consistent and Aetna now is refusing to give me a detailing of what the copays were, or show me where in my policy it states what the copays are. They are now saying that they made a "mistake" in covering the therapy in the first place, so they are not giving me the information or further credits to make the copays consistent.

A full accounting of all the problems I have had can be found on my blog: http://bit.ly/Chianna

Health Ins & disability pay - short-term

Complaints Board:

Aetna Health Insurance doing cost containment review through 3rd party consultant called ACCENT. Have worked at UPS part-time since 02/08. Accident at home on 10/30/09 and placed on STD on 11/04/09 which ends on 05/02/10 as far as pay. Aetna doing a cost containment review through consultant ACCENT. Didn't start using insurance significantly until 11/04/09 when rushed to the hospital. I have neuromuscular, musculoskeletal, cardiovascular and mental health impairments. They are looking for some way to drop me. Can you say Erin Brokovich. Very slimey people. UPS is better than this. I have never been paid on time resulting in my inability to pay for medications, copays, deductibles and transportation to appointments. This lack of timely payments has caused mental health relapses and rehospitalizations. Not a very good cost containment approach. Aetna Disability is doing a peer review. Their RNCM system is totally broker - slow and very impersonal. Recerifications all the time which cause delays. I've been a social worker for over 25 years and i have never seen such a horrible system. Think long and hard before you buy health insurance from Aetna. They like moving the ball and goal posts.

Glen Swift
UPS Part-Time Employee
Aetna Health Insurance
Aetna Disability
Veteran

  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
    I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

    0 Votes
  • Wi
    williamtk7 Aug 09, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Im sorry about you're health situation and for you're loss of inability to work. So you have worked for UPS for what 1 1/2 yrs, from what i read above...?? I'm sorry that you think UPS or Aetna is lacking in "politeness" but as far as a "part-time, hourly" employee, how in the heck can you complain about being paid 26 week of 60% of what you were making before you're injury... I myself have been working "[email protected][email protected]!!!" for 14 YEARS!!! How can you even sit there and bash the company or insurance for being "semiprofessional, rude, or following-up" on what is there job and what they deal with day-in day-0ut. I have been told that UPS IS if not the, but 1 of the best part-time jobs in the WORLD!!! So maybe you are under the influence of just not to happy right now, but I have not been the perfect employee at UPS but I darn sure cannot complain about anything EXCEPT that it take 10+ years pretty much anywhere in the country to get a full-time job. SO ENOUGH SAID and by the way, im on disability right now and was going to have a 2-level back fusion which was not worker's comp, and was going to cost around 50, 000+ dollars and 100% paid for..."FROM A PART-TIME JOB THAT PAY'S YOU'RE INSURANCE". So since the job market is so well off and Obama is getting us all those jobs for us wonderful American's, then quit UPS and go find another job that will support you're "disability's". I wish the best for you and you're recovery, and when you do find better job then PLEASE let me know, and you can post it on this website so the rest of America can go apply... GOOD LUCK and BEST WISHES

    0 Votes

Take Our Money, Won't Pay Bills

My fiance was on an Aetna plan through Cal COBRA (getting the coverage started was a three-month long nightmare in and of itself, but that's another story). For one reason or another (again, the subject of an entirely different complaint), it appears as though her coverage was cancelled as of 3/1/10 (not that we were notified this, of course). The premium check for the month of March had already been sent in and cashed, however, and now the office that cashed the check for close to $200 says that she's still "active, " yet the office that should be paying the bill for a standard doctor's visit says she's been terminated. They won't return the funds from the premium check, nor will they cover standard medical expenses for the period the premium covered--they are trying to get a free month's premium out of us for nothing!

I'm not about to roll over and take this, yet fighting them is an insanely time consuming process--no one we can get on the phone can answer a question, and we've been waiting for a call back from a "supervisor" for the past two weeks (with repeated calls from us to them in the meantime). This is only the last and most blatant piece of extremely incompetent or purposefully fraudulent activity we have been exposed to through Aetna; she is leaving COBRA early just to get away from them. Bring on the single payer system--it can;t be any worse than this!

  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

    0 Votes

Poor coverage

I had a chance to use my AETNA dental benefits which our employer so graciously provided us with. I had two dental offices tell me my coverage (for a root canal and crown) was below average. I ended up paying 60-70% of the cost of those two pretty basic procedures. People at both dental offices were even surprised and remarked (with laughter) how poor the coverage was.

Our company switched to AETNA at the beginning of 2009 and our coverage is far inferior to what we had before. We pay more than 600 dollars a month for health and dental.

Short and Long term disability

My wife received a head injury a while ago in a car accident. She was originally mis-diagnosed as being bi-polar, but over a period of time she had multiple problems at work (all related to her injury). She was terminated from work because she was not "safe" to work with patients. Two months after that she was tested and it was found she has moderate to severe brain damage. She is not allowed to drive now and cannot work due to her multiple symptoms. her employer who terminated her told Aetna that they support extending disability benefits to her and Aetna first told me she was eligible for benefits, but as soon as the first check was supposed to be mailed to her they went back on their original determination and are now saying she is not eligible for benefits since she was terminated from her job before the brain damage was diagnosed. The medical reports clearly state that her injury is from the accident, but they will not even look at that since they say she was terminated before we applied for benefits. Now that's insurance for you.

  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

    0 Votes
  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
    I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem to difficult for them to figure it out.

    0 Votes

Aetna

I got the bait and switch routine from Aetna. They got me to sign on with them by offering me a high deductable insurance plan for $190 a month. The deductable is $3000. Then they had an automated response that I was accepted but that my premium would be $251+some change because I have had hypertension in the past that is now controlled by a $4.00 a month prescription (as well as diet and exercise). I called and asked what the deal was and was old that they raised it by 25% because they could, and that it did not matter that the hypertension was under control. Then they also let me know that any effects that they deem to be cause by the hypertension were considered a pre-existing condition and would not be covered.

So why am I paying extra?

  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

    0 Votes

Short Term Disability

AETNA has the worst disability claims analysts i've ever seen and dealt with... they are rude, lier...

Refusal to fill prescription

In September / October 2009 my husband went to his PCP to obtain a new 90 day prescription refill for his diabetes medications. We received a 90 day script. On the following Tuesday, we learned my husband would be going to Dubai to work on the following Saturday. Because we were unable to work through the mail order process, we went to Wal-Mart and asked if they could assist us with his order. The pharmacist was kind enough to call Aetna on our behalf, after we explained our situation to her.
At that time, our intention was to relocate to the Middle East by December or January, depending on how things went with my husband’s work. We were honest and explained my husband would not be returning to the United States. Aetna partially complied with filling two of the three medications, but refused to fill one of the medications (I believe it was the long-acting diabetes medication).
We had no choice but to send him with what medications we had. Eventually he ran out of the medication Aetna refused to fill. When I asked why they would not refill the medicine, the Aetna representative stated people sell their medications overseas!
I want you to know that as a direct result of Aetna’s incompetence, my husband was unable to pass his physical because his sugar was elevated. He was shipped home without work after several weeks.

I want you to know I called Aetna and really gave it to some poor lady who had to listen to why I was angry. I want you to know, Aetna does not need to worry about my husband and I selling his medications abroad. My husband leaves for work overseas without much more than a week’s notice, and we try to abide by the mail order policies.

We are expecting to leave overseas once more. Today I have requested refills on your website. Please send the medications. We anticipate leaving Houston in Mid-December. A copy of this complaint was filed with the Ombudsman and Consumer protection Division of the Texas Insurance Division, as well as the Texas Better Business Bureau.
Sincerely,

  • Al
    AliceD Mar 24, 2010

    Well, if you are like us you can't just get it filled anywhere as the company insists you use mail order for long-term prescriptions.

    My experience the last three years has been hell when it's been time to get my new refills after my checkup with my doctor. In each case the doctor's office FAXed the prescriptions in my presence. Days go by, then weeks. When contacted they claim they never got the FAXes. So we do it over again. Same thing. Days and then weeks go by. Third time is finally the charm to at least get put into their system. It takes them four days to pull them off a FAX queue and then two more days to fill and ship, which they apparently do on a slow boat. Right now it has been since February 18 (five weeks) since the scripts were first ordered and I don't have them yet. They won't put a trace on the shipment until 14 days after shipping. If this was once it would be one thing, but it happens every year. I told them my doctor has done everything but hand-carry the scripts from Houston to Florida and begged for help to how to do it differently to expedite the process but they don't have any answers. I asked to talk to someone about the processes and they told me there was no one I could talk to. The doctor's office says they have constant problems with Aetna pharmacy. I know the online list of my medications is always wrong. We may just have to totally forego insurance and get them filled at Walmart, which is probably what Aetna wants in the first place.

    These are meds for hypertension and it is imperative I take them daily. They don't give a crap about the patients who are suffering and stressed out over their medications.

    0 Votes
  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
    I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.


    As far as speaking to a supervisor / manager... try calling:
    860-748-8186 or 210-771-0214

    0 Votes

Retroactive Disenrollment

My wife gave birth to my daughter Brigid on September 4th. At that time my healthcare coverage was through Aetna POS, via my employer. Being a responsible guy with a new mouth to feed and looking to cut costs I figured out that this insurance was costing me about 2, 000 a year more than the HMO my employer also offers, so I requested a change under the "life change" bubble that was offered. Now the doctor who delivered my baby has been notified that Aetna wants the 1400+ back that they paid her. Why? Retroactive disenrollment. I have paid Aetna over 260 every two weeks for several years and my employer has matched this amount. They are doing this punitively and I am consulting a lawyer but if they can do this to me they can do it with any major claim, just retractively disenroll you. Call Tim McCarthy at [protected] and ask him how he sleeps at night.

Overcharged

Aetna Specialty Pharmacy is charging me $3, 098.01 for a Synagis shot my son never received (I have proof that they have the medication) and $140 for an in-home nurse visit that never happened.

Last year during insurance selection, Aetna was no longer a choice for medical insurance. I selected Kaiser and then contacted Aetna, Sherwood clinical, and our doctors to inform them of the change.

Aetna claims that on 1/14/2008, the "patient" approved that they send the Synagis medication to Sherwood Clinical (who would send a nurse to the house to administer the shot). Did I forget to mention that my son was 1 year 3 days old at the time?! How could he have approved delivery of the medication? He couldn't even talk! When I mentioned this to them, they said that the person that put in the entry may have been talking about someone else in the household. The truth is that they never received approval and made an entry that was an out right lie.

Aetna's next claim was that they sent the medication to Sherwood Clinical. When I contacted Sherwood Clinical, they informed me that they did receive the medication, but after reviewing their records (which showed that I told them about the change in insurance) they called Aetna to find out how to return the Synagis, and returned it via UPS (I have the UPS Shipping Receipt and the name of the person at Aetna Specialty Pharmacy who accepted and signed for the meds). Aetna claimed that they don't accept returned medicine. But when presented with proof that they did accept it, they backpedaled and said that they destroyed it. Lies on top of lies, and once again--why am I being billed for medication I never receieved, which they have and probably re-distributed to another patient.

I received the first bill in April, and spoke with a representative on 4/24/08. An investigation was supposed to take place and I was supposed to be told of the results. The only thing that happened was I received another bill.

So, I called the Reimbursement Department (6/12/08)--again provided them with all of the information--again, and was told that the case would be resubmitted to Quality Assurance for investigation, and someone would contact me with the results--again.

All that happened was that I received another bill in the mail, which not only has the $3098.01 charge for the Synagis, a $140.00 charge was added on 4/25/08 (the day after my initial call to Aetna Specialty Pharmacy), for a nurse visit that NEVER happened (Sherwood Clinical will attest to this).

I've done my due diligence:
I informed the insurance company, the doctor, Aetna Specialty Pharmacy, & Sherwood Clinical of the change in insurance.

I did NOT give Aetna Specialty Pharmacy approval to deliver the Synagis to Sherwood Clinical.

My son did NOT receive a shot from Aetna (Kaiser provided him with his January Synagis shot at the Kaiser Facility (a little late--1st weekend in February)).

I have the UPS Shipment Receipt which shows that the Synagis was shipped to Aetna Specialty Pharmacy and signed for by one of their employees.

So, why am I being billed for medication they STILL have, and for a nurse visit that never happened? I'm sending a copy of this letter to Clark Howard and the Chairman & Cheif Executive Officer of Aetna, Inc.

At this point, the payment is 90 days past due. So not only do I need them to stop trying to bill me for medication they still have, I'll need them to remove whatever entry(ies) they've placed on my credit report.

I'm sending this letter hoping that getting the word out will generate enough conversation that someone will take interest and tell me can be done to help me out of this mess.

  • He
    hermom Jan 06, 2016

    they don't care if you get your meds or not on time. been dealing with them since last week of December...still waiting for shipment. For the past year I received a med from them using the regular ordering "line"..when I went to check on delivery was told it was never called in by doc office..checked with them and yes it was called in. Only to find out that it is considered a "specialty med" (after a year of ordering from regular pharmacy??). Well was told finally it would go out next day. I called just to make sure it shipped, and was told it was "computer reversed" and did not ship due to a price increase (in 1 day REALLY). When I asked why I wasn't informed of the non shipment I was told that since it was "computer reversed" I would not have received notification. This med is needed to be taken on a daily basis..life sustaining. When I told the rep this, she said "oh well". Hopefully it will be shipped today and arrive tomorrow. CUSTOMER SERVICE IS ALMOST AS BAD AS VERIZON.

    0 Votes

FSA Claims

Aetna makes it incredibly hard to submit any claim, and seems to have an automatic rejection policy for FSA claims. We have filled out every form there is and make sure that we double dot and cross every letter. But still the claim comes back with some nit pick. Luckily we were able to find a group of people who have had the same experience, and are initiating a class action.

They have also pushed us into online ordering for meds, in which they charge us more than our local grocery store.

Hopefully we will be successful and get Aetna to pay for its blatant dishonesty.

  • Al
    alito_1 Dec 28, 2009

    I agree with your comments about Aetna's FSA program. They make it close to impossible to get money back from our account, with $ I set aside from every paycheck. They want double and triple proof for almost every visit to the doctor or procedure.

    0 Votes
  • Cm
    cm03 Jan 26, 2010

    How do I get in on this? They have asked me to substantiate almost all of my purchases when they are sent through Aetna Medical Insurance!!! Why can they not talk to each other?! Now I am having to do their work for them and send them all this information. I'm sure my whole company would be willing to join in on this lawsuit.

    0 Votes
  • Kr
    kristenlindelow May 24, 2010

    We would like to be included as we deal with this every single year. Today we received a denial letter stating the claim was submitted after the Apr 30 deadline. I know for an absolute fact it was not late because it was in the same envelope as other claims that were paid!
    Kristen L

    0 Votes
  • Gu
    Gunny B Dec 18, 2014

    Faxed my claim for my FSA reimbursement four times. Followed up with calls to confirm receipt each time. Each time they said they didn't receive it. I have my fax delivery confirmation from my machine showing it was successfully delivered. They won't accept email and have no way to submit claims online. Their only suggestion is to pay for registered mail and submit the claim that way. TO GET MY OWN MONEY BACK!!!???

    Feels like a tactic to keep the money beyond the filing deadline.

    0 Votes

paid for meds and now they refuse

My fiance has had Aetna for over 10 years. He has a brain tumor that is controlled with Brand name meds only (there are no generics yet, these meds are new) These injectable meds cost $170, 000 a year. Aetna has paid for them for over 2 years but now as of Oct 1st they gave him a maximun limit of $2, 500 per year for brand name prescriptions. So they are basically dropping him after 10 years of being a member because of this cost. They will not budge. Without the meds his tumor will grow so large that it will invade his brain and he will die. We are scared to death now thanks to Aetna.

  • Sh
    shepmom Sep 13, 2009

    Contact the drug maker and see if they won't pick up the cost. Sometimes they will and also check to see if your state has a program that might pick up the cost.

    Good luck.

    0 Votes

Rude service

I waited 3 months to qualify for insurance at my employer. I went to a physician on the Aetna approved list. The doctor ordered blood tests which Aetna did pay but they won't pay for the office visit.

I have to send proof of prior insurance (which I did not have since I was out of work for a year) and fill out a questionnaire. I mean they deduct money each month from my paycheck and won't pay the doctor. I do not like Aetna and have found their customer service people to be rude. I had no choice in provider care but if I did, I would never choose Aetna.

Denial of claim for office visit

They are the worst insurance company. I had a problem many years ago and they still are a problem. Refuse to pay my doctor's office visit. Want proof I don't have a pre-existing condition even though they paid for blood work but won't pay the doctor's office visit and want me to pay it. Why do I even have insurance coverage that is deducted out of my paycheck each month and they won't pay for an office visit? Spent all morning on the phone with customer service and felt I wasted my time.

  • Ja
    JaneDoe Jun 25, 2010
    This comment was posted by
    a verified customer
    Verified customer

    Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
    You can call your human resources department of the employer the AETNA insurance is through.
    Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
    they may not want to go with AETNA as an option for the next open benefits registration.

    The liason may be able to get some action.
    This really freaks out everyone at AETNA because they risk losing the contract ;)

    0 Votes

Denial of coverage

I have so-called health insurance with Aetna. Several weeks ago I had to see my ophthalmologist for certain...

In The News

Unhappy consumers gather online at Complaintsboard.com and have already logged thousands of complaints
If you see dozens of complaints about a certain company on ComplaintsBoard, walk away.
One of the largest consumer sites online. Posting here your concerns means good exposure for your issues
A consumer site aimed at exposing unethical companies and business practices
ComplaintsBoard is a good source for product and company gripes from especially dissatisfied people
You'll definitely get some directions on how customer service can best solve your problem