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Aetna reviews first appeared on Complaints Board on Jan 23, 2008. The latest review customer service medicare part d was posted on Oct 5, 2021. The latest complaint Terrible Service/Lies was resolved on Sep 13, 2013. Aetna has an average consumer rating of 3 stars from 89 reviews. Aetna has resolved 49 complaints.

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Aetna Complaints & Reviews, Page 3

AetnaWon't pay for Celebrex

If Aetna thinks for one minute they're not going to cover my Celebrex, the ONLY drug I take, they had better think again. I'm contacting the Attorney General tomorrow, and after that, I'm going to Congress, because, you see, I live in Washington DC. And here in Washington DC, not only do people have an UNLIMITED capacity to ***, we know how to do it. This issue is NOT going away, it's not going to go away, not now, not ever. I have tried other drugs and nothing works but Celebrex. Nothing. On Celebrex, I can live like a normal person. Without it, I will be in a wheel chair.

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    Aetnadenied short term disability

    I had gone out of work on medical leave on August 3rd 2010 and was told to apply for short term disability thru the company sponsered plan thru Aetna. I did so and was denied in September and I thus filed and appeal with them and in the mean while had no money coming in and had to borrow from family and friends and that ran out. So I am being evicted from my apt and lost my car insurance and the cell phone was shut off. Now here it is Feb 5 months since i filed the appeal and was denied again and said i cant appeal again my case is now closed but i can pursue a civil case...And because I was deied my claim all together I have been fired from my job.Thanks to Aetna I have lost everything. But hey what do they care they still get paid every week.

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      • Nm
        NMA851 Feb 28, 2011
        This comment was posted by
        a verified customer
        Verified customer

        I certainly do not intend to undermine the situation however having been round & round with disability payments, I sort of became an "advocate" per se. The bad part here - it's an INTERNAL appeal. Why the hell would they decide against themselves? Of course they won't. What people don't know, myself included, is that IF/WHEN you have to appeal, never go into it without representation. Yes, I know this possibly means $$ that we do not have, however there are MANY places out there that help the disabled. If it wasn't for their help, I doubt I would have obtained the disability payments while going through the social security process. I learned my lessons so I was more than prepared for SSA which resulted in that being approved.

        However Aetna, just as you've indicated, have their own doctors/nurses that read whatever is sent in and nothing more. They sent me to MANY doctors as well, of which I finally said I will NOT go again given the cost of all these exams you've sent me on equal a month's pay!! It would have been the 6th doctor - trying to get one - just one - to say "Nope he's fine" but they couldn't. Subsequently they had to pay out - plus my point of all the money they're spending on exams/tests is likely ten times MORE than what I am owed. Last time I saw, an MRI ran $8, 000. One month's pay would only be $1, 900 - and that is at the 60% level that is all we're entitled to anyway!!

        All I know is it is a shame that we pay into something and end up having to fight like mad, while we're in the worst shape imaginable, just to try and survive. Most of us do not, and those of us who do only BARELY keep on. I ended up in foreclosure and god knows how much else over them not paying. 4 months later, after plowing through savings and racking up debt, I finally prevailed. Then again, did I really prevail whenever the damage that was done, due to the delay in payment, is going to haunt me for YEARS?? Those late-pays are on our credit reports for up to 7 years! THANKS!

        At least you're doing the right thing and going to the State Insurance Commissions. I may be wrong, but you *might* be able to get compensatory damages. If not, there are hundreds of attorneys just waiting for that phone to ring & take your case on a contingency. Of course, document, document, & document EVERYTHING and get every shred of medical data available. It may cost to get the copies ($40 for all of mine & I had an entire BOX - no joke), but when the attorney knows you are fully prepared, that's showing YOU mean business, and also less work for the attorney to get the ball rolling.

        0 Votes
      • Cy
        cynko Feb 10, 2011
        This comment was posted by
        a verified customer
        Verified customer

        Very similar situation with me. I was denied and now it's in the "final stages" as they call it in the appeal process, but I hear it's not in my favor, and I asked what is my next resourse and they too mentioned civil court. I think Aetna disabity insurance is a fraud and should be reported. Who are they do decide from their nurses and doctors without meeting you and after getting information from not one but three physicians I have seen and filled out extensive paper work. I lived and worked in PA and like the person's complaint against Aetna that I just read, I too have no money and I had to move out of the place we were living because I cannot afford to live there. Now I live in another state. I just don't get why we pay into disability if they don't even consider the doctors facts and notes. I just think they will do whatever it takes NOT to pay you. I will go to the top if I have to. I am far from done!

        0 Votes

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      Aetna Health InsuranceDenial of claims due to incorrect Tax ID

      I have been dealing with an insurance claim since March of 2008 with countless denials by Aetna. Aetna claims that the wrong tax id number has been filed with the claim, in turn a new claim has been filed with the correct tax id number only to be denied. Each time I call they tell me to have the doctor’s office just resubmit the claim with the correct number and it will be taken care of. The claim has been submitted well over 15 times and they still deny the number is correct. I have spoken to at least 6 different reps some reps numerous times and there still has been no resolution. I am at my wits end with them at this point, it has been almost three years and still no resolution. The Dr office has threatened to send the claim to a collections agent. For some reason now that Aetna won't pay their contracted bills the Dr office feels it is alright to take me to collections and not return any of my calls. Thanks Aetna and Dr Fraterrigo for ruining my credit.

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        • Ti
          tide_with_bleach Dec 03, 2010
          This comment was posted by
          a verified customer
          Verified customer

          I used to work in medical billing for a large Hospital organization and we used to see this issue all the time. Really the responsibility lies with the Dr Office. You should not have to deal with this issue as it is a mistake easily corrected by the Dr Office billing department calling Aetna and resolving it. Another thing to note is that if multiple claims come in to the insurance company with the same information they will be denied as duplicate filing. The claims system for large insurance companies are automated and they receive the majority of their claims electronically. If your Dr. Office has already submitted the claim with the incorrect TID (Tax ID number) but the claim was not purged from Aetna's system then all incoming claims that match the original claim will be denied as duplicate. Typically incoming claims are identified by the subscribers ID number (your policy number), Date of Birth, Date of Service and Claim amount. The TID is only used to locate the contract information in regards to reimbursement rate and mailing address.

          Most likely the claim will have to be processed manually by Aetna and that will only happen when the Dr. Office's billing department contacts Aetna directly. There is a clause in many contracts between providers (Dr. Offices) and Insurance companies know as "Timely Filing". This clause varies but in general it is a set time period of when bills have to be submitted. If the bill was not submitted and reviewed with in that period the claim will never be paid and the provider will have to absorb the cost. Some smaller companies like Dr. Offices will try to bill the consumer knowing that they have no understanding of the billing process. Believe me in the 6 years I worked in billing it was an always changing and convoluted environment.

          Recently insurance companies have been requiring offices to use their NPI number or National Provider Identifier in place of the TID.

          Good luck to you and hope this information helps...

          1 Votes

        AetnaDenying &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!

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          AetnaRefuses 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.

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            • 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
            • 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

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            AetnaScam

            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.

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              • 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

              AetnaAetna 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.

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                • 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

                Aetna, Inc.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.

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                  Aetna , Inc. / Aetna Health InsuranceAetna 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

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                    AetnaHealth 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

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                      • 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
                      • 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

                      AetnaTake 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!

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                        • 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 ;)

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                        AetnaPoor 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.

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                          AetnaShort 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.

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                            • 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
                            • 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

                            The complaint has been investigated and
                            resolved to the customer's satisfaction
                            Resolved
                            AetnaAetna

                            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?

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                              • 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 ;)

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                              Resolved
                              Aetna And Bank Of America — Short Term Disability

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

                              Aetna Pharmacy BenefitsRefusal 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,

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                                • 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:
                                  [protected] or [protected]

                                  0 Votes
                                • 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

                                Aetna PosRetroactive 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.

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                                  Aetna Specialty PharmacyOvercharged

                                  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.

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                                    1 Response
                                    • 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.

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                                    Resolved
                                    Aetna HmoFSA 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.

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                                      4 Responses
                                      • 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
                                      • 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
                                      • 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
                                      • 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.

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                                      Resolved
                                      Aetna Health Insurancepaid 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.

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                                        1 Response
                                        • 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.

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