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Aetna Complaints 113

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10:27 am EDT
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Aetna Awful customer service

I was talking to Audry a case manager at Aetna today. She was very rude and did not care about my patient. She seemed angry and when I gave clinical information about the patient she made fun of the symptoms and the situation my patient was in. I was about to turn in a apl for Aetna Insurance for myself but I am going to tell my agent to find me some other options! I would recommend that Audry learn more about health care so she will not be so judgmental about patients symptoms. This is private health care information and not something to judge or make sarcastic fun of.

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JaneDoe
Fort Johnson, US
Jun 25, 2010 6:09 am EDT
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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 ;)

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Justin806
US
Feb 01, 2010 10:36 am EST

I to spoke with this Audry lady. I have to agree she is the worse customer service person I have every been in contact with. I am angry, that it states something right on the EOB and she reads it to me and then says no we don't do that. What the heck!

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10:17 am EDT
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Aetna Terrible experience

Yep. Same problems with Aetna RX - Asthma medications won't get refilled for ANY number of reasons! Twice it was because they "didn't receive" the faxed in prescription. Then it was held up because insurance denied it (?) then I was told they would get it filled, then i got a call from my doctor saying the Aetna RX wouldn't fill it...

I have spent HOURS on the phone with these people and want to file a formal complaint - anyone know how to do this. This has seriously gotten out of hand and is the most cluster freaked business I have had the misfortune of dealing with.

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Mackman
Bigfork, US
Sep 11, 2010 5:59 pm EDT
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My doctor called in my RX on August 24th and still no meds onSeptember 11th. Aetna told me Meds mailed on Sept 3rd and after nine days zip. They claim it takes two weeks through postal service. Even 3rd class beats this. I can walk to Kansas City in less than nine days. They lie cheat and their customer snervice{no typo] mensa members cant find their rear ends with two sharp sticks. I will be lodging a complaint with the Montana Attorney General and the Insurance comission. My funeral should be over by then. Aetna you suck.

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Mary H
Dalton, US
Jun 30, 2009 8:09 pm EDT

Go to the ER every day for your medicine... every single day... they can't deny ER visits b/c it's subjective aand according to what you call an emergency... you'll definitely end up on a report to the higher ups... then they'll call to "manage" you... then they'll solve your problem b/c it's costing too much to keep paying ERs:)

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3:00 pm EDT

Aetna Billing

I was a member of Aetna through H and R Block from March through July of 2008. I received, on October 15, a letter with Aetna letterhead purporting to be a bill for pharmacy purchases billed to Aetna from CVS Pharmacy and Bridgeport Pharmacy.
Here's the problem: I was never a customer of Bridgeport Pharmacy; the CVS purchases were made in August and September, and the pharmacy staff knew I was no longer a member, so they would not have billed Aetna; and, the so-called "invoice" is a bad copy printed on cheap paper: Aetna would never send a legitimate bill that looks like this. I'm not worried about paying the "bill": my concern is that someone has my pharmacy information.

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JaneDoe
Fort Johnson, US
Jun 25, 2010 6:06 am EDT
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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 ;)

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10:57 am EDT
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Aetna SRC okays every thing and pays nothing! This should be their moto. I have 50K hospital bill from my surgery which was required, plus 20K in doctor bills I am still trying to pay off. The hospital verified my coverage and payment, but Aetna stated is was over my coverage, why pay 280 dollars a month for nothing. We need our Congress to help or better...

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8:31 am EDT
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Aetna Scam and cheating

Aetna’s Short Term/Long-term Disability benefits are the worst. You pay for it- oh yeah, you pay. Try an employee of over 10 yrs filing one claim and not get pd for the last 4 months. (one denial as the Dr didn't put my resting blood pressure rate down!) Don't believe what they tell you about the IHD (Integrated Health Disability “Model”). It’s suppose to help manage your medical and any potential disability you might face. It’s a lie! It doesn't work! They've been my company’s medical ins provider for years and the only info they conveniently find hurts me. literally- hurts me. I've almost lost my car, my mortgage is months past due... They play legalese word games, if you aren't a lawyer you'll need one... look up complaints against Aetna Life Insurance on the web. I located where they've been fined tens of thousands of dollars (recently in Texas) for violations. They are Evil—- be warned.

**** Above is a posting I listed to complain about Aetna's STD/LTD issues to one of their new clients.

every word of it true. Can you provide me any in-site or suggested direction?

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Sruthbrown
Memphis, US
Jul 24, 2014 9:36 pm EDT

I am in my third year of chronic illness that has caused me persistent fever; constant pain; heart, thyroid and adrenal dysfunction; breathing difficulties; joint inflammation; foot, ankle and leg pain; difficulty swallowing; numbness; depression; confusion; anxiety, sleeplessness, etc. I have "objective" testing that has garnered me each of these diagnoses, simultaneously: Lupus, Rheumatoid Arthritis, Persistent Endometriosis (despite surgery), Adrenal Failure, Babesiosis, Bartonella, Lyme Disease, sinus tachycardia and arrhythmias, Morton's Neuromas, Hashimotos, Depression, and GADD.

Nonetheless, Aetna, along with my employer FedEx Services, have continued to deny every claim and appeal. I even tried to return to work at one point, but FedEx turned me away due to the fact that I had a PICC line in my right arm for IV antibiotics (it was hidden beneath my clothing).

How is this possible? How do these people live with themselves? I have spent hundreds of thousands of dollars on medical treatments and am now deeply in debt and facing bankruptcy and the possibility of losing my home. My family is now broke, and my brother recently took his own life, in part, due from the stress of this enormous injustice.

Please, SOMEONE at Aetna must have some ounce of humanity left in their soul. Whoever you are, please speak out before thousands more like myself die as a result of this abject injustice. We are as human as you, as your mothers, as your fathers, and as your children. This cannot continue. Just because you are member of a terribly corrupt company, and not country, does not make you any less responsible than the SS officers of Nazi Germany who believed their fellow brothers and sisters to be less than animals, and thus undeserving of life. The bodies are piling up, and speaking out will not cost you your life. Yes, it may cost you your job, but you can find another job. These victims will not find another life, and many of ours are ending because we can no longer afford medical help, clothing or even food. The government is overwhelmed and Social Security has been pushed beyond its limits, all because you continue to remain silent while the atrocities pervade.

Be a hero, not an accomplice. It's not too late, but before you even realize it, it may be, and by that time, you could even be among its victims.

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JaneDoe
Fort Johnson, US
Jun 25, 2010 6:11 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

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 ;)

You can also keep going to the ER ;)

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fiter
US
Jun 02, 2010 9:09 am EDT

I am with a man who I THOUGHT I was going to be marrying. The problem is, he is already married! When I asked him WHY he won't get a divorce he made up every excuse in the book. then i find out from his WIFE! He is on her insurance policy and has been for a long time. They have been separated for the past 15 years and his address is at another place other than hers. Is there anyway they can prove he is no longer living there? HELP!

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enough already
Tucson, US
Aug 07, 2009 12:41 pm EDT

Still waiting and now in the appeals process. I have had to go to an attorney to do a bad aith claim against Atnea as i will not be able to supplement my income right now with my conditions. I even had a enw MRI which showed even more damage to the spine with dissicated disks, fissures, and athrophy of the facet joints. I am out of work indefinately as I can not even lift 10 pounds. This is just the lumbar spine. I have still to go for a newer MRI of the cervical spine. Ortho doc says one thing at a time. By the time this is over my credit is ruined, my home is in jepordy, and my family is suffering. I am now forced to use food stamps and try to get medical through the state plan here. Degrading and embarrassing and quite the situation. This does not have to happen to people. After reading all the complaints on this board I realize that I will more than likely never see a dime from aetna cause they pay you they wont make their profit for the month and that is all that matters to them.

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cjosea101
Tucson, US
Jul 14, 2009 11:12 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

I have
aetna short term diabilty and Aetna Health Insurance and let me tell you this is a double whammy. I have 3 herniaed discs in my lumber spine, 5 buldging diacs in my c-spine, 1 in my thoratic spine, spinal stenosis, degenerative sisc disease.

I have been out of work since April 7th 2009 and have only recieved 1 payment from Aetna which took over 6 weeks to get. I too can not afford an attorney as I am not working and also a single mother. We are going to loose out utilites this week and there is nothing I can do about it.

Since I am on family medical leave at my job and going on long term leave I will be loosing my medical insurance this friday. My doctor requested a MRI last wens. but the Aetna Medical insurance is requiring more information before approving the MRI. IAetna short Term will not consider my claim with out this MRI and there is no way it will be done by Friday.

Basically, I am going to loose everything, my home, everything!

Bottom line is Aetna is in the business to make sure that they don't pay you a dime rather than approve your claim. theya re not there to help people in need and they don't care if you pay for their services or not. They will do anything they can to not pay you.

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hermosa75
Charlotte, US
Jun 26, 2009 3:35 pm EDT

Hello. I am currently going through the same EXACT situation with Aetna. I have been on shot term disability for about two months. The same exact scenario. I've turned in the paperwork they say they require yet I haven't received a check yet. I am a single mother with 2 children. The only thing Aetna has done is frustrate me and contribute to further financial disarray. The customer service is horrible. The information you get may or may not be accurate so BEWARE. I depended on Aetna to process my FMLA claim and it was denied because they told me that I could wait until my next appt so I would have very detailed health info. As a result my FMLA was denied because my time expired! and there is no appeals process.. I had to fight for my job b/c now they had the right to consider the days as unexcused and terminate me! Aetna's CSRs are not proactive or knowledgeable. I recommend you trust nothing they say. Always call back and ask the same questions. Odds are you'll get a different answer. Also if you are depending on your money ... definitely find a supplementary source of income because it will probably be time for you to return to work before you see a Short term disability check! Aetna as a Short Term Disability and FMLA administrator is horrible!

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10:10 am EDT
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Aetna They will not pay for the surgery

I had back surgery in 12-07 & United health care says my surgery was not medically necessary! I was in excruciating pain for 7 years before I decided to undergo surgery in the Laser Spine in Tampa. The total cost of the surgery is $70, 000.00 & as of today-united health-care says that their doctors say that I got surgery for my convenience & not for my necessity. I do not know where to go from here. If anyone out there has any advice, please let me know...Do I contact a lawyer that I cannot afford?

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10:03 am EDT
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Aetna Stay away from them

I went to see a specialist. After checking Aetna's website to make sure the doc was in network, I called Aetna to make sure as well. The doc even called and transcribed the call because of problems with Aetna in the past. The claim came. They charged the doc as out of network. After I called, the customer service rep just did not care. It was not her problem. My doc had to go through and get Aetna to pay, but the *** paid about 28 dollars. What am I paying a monthly fee for if the *** wont cover in network doc visits. Aetna has the worst customer service, worst marketing, and worst fees. I hate Aetna.

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MB
Nov 17, 2008 2:53 pm EST

My company uses Aetna. I have access to Aetna Navigator but have to re-establish myself with the employee self service site to re-choose my benefits. That's because, according to the self service rep, Aetna Navigator allows you to print cards and see status of claims but ESS lets you establish coverage. And the point would be? Let's talk about the fact that the form one fills out to create an ID on ESS has cookies that stores my SSN and displays it each time the form is displayed. Oh, and an ID that I'll use once a year, I'm told, for ESS is generated for me. I'm told to write it down and store it for future use - that would be next year at open enrollment.

Oh, and if you're a member of their HMO, you're not covered until you choose a primary care physician. They don't tell you that.

I've hated Aetna since they canceled their contract with Northwestern years ago and did not notify us. Northwestern did. While that's old news, it speaks very highly to their total lack of customer service, which has not gotten any better.

There must be something better. I pay way too much out of pocket to have to deal with poor handling of sensitive data and overall crappy customer service.

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Lee
Jul 21, 2008 6:51 am EDT

I agreed.

I called this morning for my son dental x-ray that was covered by aetna and when I talked their custome service, she was not courteous, confrontational and when I asked her I would like to talked to the manager she put me on hold for a long time and I ended up hanging up the phone.

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6:02 am EDT
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Aetna Denied me upper and lower jaw surgery

Aetna Health Insurance has approved me part of my surgery but denied me the upper and lower jaw surgery of my surgery. I have an underdeveloped upper and lower jaw (hypoplasia), non union of jawbone, decreased airway at 4mm (normal is 11mm), decreased ROM at 5mm (normal is 40mm), misaligned jaws, pain, headaches. It was determined by a world renowned surgeon that I needed joint surgery combined with jaw surgeries to completely correct my problems. They denied me on the grounds they feel the jaw surgeries are cosmetic despite the fact that six different doctors have written letters to Aetna stating the medical necessity of my surgery. My surgeon even stated my airway is not increased could be life threatening and my non-union of bone could cause infection or eventually loss of bone. Despite this Aetna continues to deny the jaw surgeries. My surgeon even wrote a letter to Aetna stating I have a 4mm transverse deficiency which falls under their guidelines to cover Orthographic surgery.

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thesporksofdoom
Albuquerque, US
Feb 03, 2011 5:54 pm EST

I have the same problem with my insurance just not as severe. I have an underdeveloped lower jaw and worsening tmj problems. I meet every factor to make this surgery medically necessary according to my insurance yet despite my efforts they still choose to claim that is is a purely cosmetic surgery. The fact is that it is clearly worsening as I get older and developing new ways to affect my quality of life and ability to live properly. My doctor had warned me that all insurance companies have their heads up their [censor] around this particular issue, and I must say it seems to be very true. I got here by scouring the internet for clues and help trying to convince my insurance company. I wish you the best of luck!

I get what your saying ticked about people expecting everything to be taken care of for them. I however do not see how you relate the need of this surgery to obesity. There is now choice that you make that ends up putting you in the position of needing this surgery. It is something that you develop from your time of conception, there is no life choice here. Also why would you buy insurance if its only going to cover the little things that you could probably handle on your own? I believe most people buy insurance to cover their [censor] when something happens that they cannot afford. Like for example a ~$15, 000 surgery on the low end to fix your jaw. You might not see jaw issues as a severe life affecting problem but thats because its quite clear that you have not experienced them. Come back to say how whiny needed this surgery makes you when you can't eat because your jaw hurts after a few bites (think about that your jaw hurts so bad that even after being ravenous a couple bites in you loose your appetite), after talking for a couple minutes, not being able to eat many foods, having your jaw lock and become immobilized so you cant talk..ect. If you want to reexamine your argument and actually make it relevant to this issue please feel free.

Good point oldster! You get insurance to cover your [censor] despite your life choices thats why high risk people have to pay more!

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oldster
Arlington, US
Mar 09, 2009 10:33 am EDT

Dear ticked - -Wow - where did you get that anger? Maybe you should ask your insurance company to pay for some counseling? I am sick of insurance companies asking their CUSTOMERS to make lifestyle changes, healthy choices - -like not smoking for example - --and then denying coverage for things like obesity surgery. You can quit cigarettes - - you cannot quit food. Sorry - -it's not as simplistic as you make it out to be. Obesity is caused by many factors - -and it's a shame that insurance companies are willing to replace kidneys, hearts and lungs of people who have abused themselves all their lives - -with cigarettes. YET - -they won't cover a surgery that will help someone change their life. My husband is trying to get the obesity surgery to help himself live a better life - -to help himself get off some of the medications he is on - -diabetic and blood pressure - -to help him live longer, to help him exercise better WITHOUT so much expense for health care - --
You can't say that about cigarette smokers or alcoholics who have ruined their organs and need transplants and other costly interventions. Most of them (at least from my experience)if they don't need or are qualified for transplants suffer eventually from emphysema, COPD, heart disease/congestive heart failure, cirrhosis, etc. I do expect our insurance company to cover his surgery - -just as they would cover any other necessary surgery.

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ticked123
NA, US
Feb 20, 2009 3:31 pm EST

I am so tired of hearing people moan and groan about insurance companies denying them services. What people fail to realize is that the bottom line with services that are not covered or denied for whatever reasons is that 9 times out of ten if a procedure or service is not covered it is the fault of the employer that group insurance policies are obtained through. A perfect case in point is Bariatric surgery I cant even tell you how many times I have talked to someone that is totally outraged over the fact that Aetna or another insurance carrier is denying a medically necessary procedure. I have never heard such a whiney society! First of all, the customer service rep that you call and yell and scream at because you need this surgery because you are morbidly obese cant do a thing to change the fact that this is not covered; Have a conversation with your employer if you are ticked that you cant have this surgery. I am the first to admit that Bariatric surgery is a necessity for some people but for all of you people out there that want to eat whatever you please and gain tons of weight and then have an invasive surgical procedure to fix it don’t expect your insurance to cover this. The deductible and co insurance rates as well as co-pays are no exception to this rule, the employer works with the health insurance carrier to put together a plan that the employer can AFFORD. In reality if they pick the lower co-pay or deductible they are going to pass that expense along to you in your premiums, then everyone will complain about their premiums, which again the health carrier has NOTHING TO DO WITH. We as a society expect that everything be free in life, especially health benefits. NEWSFLASH nothing in life is free and anything pertaining to the health care field is going to be expensive. Don’t expect to get insurance or health care for free because its not going to happen. It is very frustrating to take calls from members who are screaming and yelling at you about things that you cant change and have nothing to do with. So the next time that you get on the phone and are screaming profanities at the customer service rep think twice about where your anger should be directed. Your plan is mostly based on what your employer is willing to pay for and what they want YOUR premiums to be. Think about this, you don’t buy a car without first doing research on the vehicle luxuries and gas mileage you want to get the most for your money. When its time to renew your benefits do some research LIKE YOU WOULD ON ANYTHING ELSE YOU ARE SPENDING MONEY ON!

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3:01 am EDT
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Aetna Outraged

Aetna has prohibited Houston members from receiving Airrosti therapy (rapid recovery therapy) on a self-pay basis for the past two months.

Airrosti was an Aetna participating provider. Airrosti physicians perform their services within primary care physician’s offices here in Houston. The problem began when Aetna and Airrosti entered in contract

negotiations two months ago. Aetna threatened their PCP'S with contract violation and possible contract termination if their Houston members

received Airrosti therapy on site. As such, Houston Aetna patients couldn't receive Airrosti therapy on a cash or out-of-network basis.

Aetna's legal department recently ruled that members could receive Airrosti services on a self-pay or out-of network basis. Such services

would be process under Airrosti separate tax ID. Aetna's recent communication

to their PCP's reiterated the risk of contract violation and termination if PCP's violate their fiduciary responsibilities to Aetna by referring

to out-of-network providers.

It is illegal for a health care provider to limit access to medical services for their members on a self-pay basis. Aetna commands approximately 30% of the Houston patient population.

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ticked123
NA, US
Feb 20, 2009 3:33 pm EST

I am so tired of hearing people moan and groan about insurance companies denying them services. What people fail to realize is that the bottom line with services that are not covered or denied for whatever reasons is that 9 times out of ten if a procedure or service is not covered it is the fault of the employer that group insurance policies are obtained through. A perfect case in point is Bariatric surgery I cant even tell you how many times I have talked to someone that is totally outraged over the fact that Aetna or another insurance carrier is denying a medically necessary procedure. I have never heard such a whiney society! First of all, the customer service rep that you call and yell and scream at because you need this surgery because you are morbidly obese cant do a thing to change the fact that this is not covered; Have a conversation with your employer if you are ticked that you cant have this surgery. I am the first to admit that Bariatric surgery is a necessity for some people but for all of you people out there that want to eat whatever you please and gain tons of weight and then have an invasive surgical procedure to fix it don’t expect your insurance to cover this. The deductible and co insurance rates as well as co-pays are no exception to this rule, the employer works with the health insurance carrier to put together a plan that the employer can AFFORD. In reality if they pick the lower co-pay or deductible they are going to pass that expense along to you in your premiums, then everyone will complain about their premiums, which again the health carrier has NOTHING TO DO WITH. We as a society expect that everything be free in life, especially health benefits. NEWSFLASH nothing in life is free and anything pertaining to the health care field is going to be expensive. Don’t expect to get insurance or health care for free because its not going to happen. It is very frustrating to take calls from members who are screaming and yelling at you about things that you cant change and have nothing to do with. So the next time that you get on the phone and are screaming profanities at the customer service rep think twice about where your anger should be directed. Your plan is mostly based on what your employer is willing to pay for and what they want YOUR premiums to be. Think about this, you don’t buy a car without first doing research on the vehicle luxuries and gas mileage you want to get the most for your money. When its time to renew your benefits do some research LIKE YOU WOULD ON ANYTHING ELSE YOU ARE SPENDING MONEY ON!

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J don gordon
Sep 19, 2008 1:36 pm EDT

Aetna has provided my wife and me great service over the past nine years.

Surely there are always complaints about Health Insurance Providers and Physicians and other Health Service Providers. However, these complaints are small in number in comparison to the total amount of service provided.

I have had my issues with Physicians; however, we are not perfect; and we can not expect them to be perfect. Nor can we expect our Insurance Providers to be perfect.

They do not resolve all of our complaints and health issues instantaneously or perfectly and should not be expected to do so. They do the best they can as each of us does.

I suggest we each give thanks daily for our Physicians and other Health Service Providers and our Health Insurance Providers.

They have many dedicated people who are compassionate and caring and who have to deal with the same people in the Healthcare System each of us has to deal with.

Let us work for improvement, not perfection, a step at a time, a day at a time. Let us work together. We seem to get further that way.

By the way in case you are wondering, I am and have been a senior accountant in industry for some thirty years.

Let us all breathe deeply several times, in and out of course, release slowly and welcome the state of peace, grace and thankfulness, which comes with this process.

J. Don

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Jeff
Sep 09, 2008 10:18 pm EDT

Situations involving ones health become such a testy and important event. No one feels like taking chances or playing games when they are not well. And who can blame them. http://www.phoenix-life-insurance.com. I hope health insurance providers come to their senses or they will only give more ammunition to the people who want to nationalize health care. It's a delicate situation.

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5:21 pm EDT

Aetna Denial of STD Claim

I e-mailed a detailed complaint about my STD Claim from Aetna who is BMWMC's provider through Blue Cross Blue Shield. I know you have thousands of complaint's but this injustice is happening with a company who provides thousands of jobs for this state. I am in danger of losing my job after having a complete hyterectomy with additional surgery on my bladder. They have denied the claim. I'm on my third appeal. Please contact or suggest another source I can contact for this injustice!

Helen

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5:36 pm EDT

Aetna Denial of STD. Placing 3rd appeal

I gave you my cell number. I have been an employee at BMW for almost 9 years. Feb.14, 2008 I entered Greenville Memorial for a complete hysterectomy and bladder surgery. It took 4 hrs. My Doctor put me out of work 1/31/2008. I had severe abdominal and pelvic pain along with irregular bleeding. I called Aetna and reported my claim. Paperwork takes forever at both ends. Finally I was approved for my STD a week after my surgery. The next week I received a denial letter stating I had lack of information for my 8 working days before the surgery. At this time BMW was on a 4 10 rotation day schedule. After the denial I filed the first appeal with Aetna. It went through the appeals process and went back to the home office in Portland Maine. Again they asked for more documentation. My gynecologist submitted his notes explaining that I had a bood blot in my uterus among other complications. I returned to work 8 weeks later. They just denied my 2nd appeal stating lack of evidence for those 8 days so again the entire appeal was denied. From1/31/08-2/28/08 I did not receive any Short Term Payments. I have been back at work for 2 months and they gave me points for the entire time I was out. I am filing my third appeal. My last chance to get the paperwork approved. Aetna has called my doctor and told them they needed no more information from them;but they told me I had to get more medical reasons and their nurse had to approve in order to get the claim approved. Even if the doctor sends more notes they could deny my claim. If I am denied this time I will be fired from BMW. How can this happen? How can this be fair? Please I need your help. I cannot afford to lose my job for a surgery that saved my life.

Helen Cochran [protected]@hughes.net

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Aetna Non Payment of Medical Bills

I was disabled in 1999 from the results of a car accident. I am paying for Aetna insurance through my company disability plans and I also receive Medicare A, because it is free. I have no other insurance and never have since I have been disable or have been with Aetna Insurance. Nothing has ever changed since I have been with Aetna, just my age or PCP. I have been receiving Medicare A since 4/01/2000.

I don't know what Aetna is trying to pull this year, and I understand I am not the only one this is happening too. They have stop making payments on all my medical bills and telling my doctors that I am not providing them with information needed for processing the bills. Aetna is saying that I have other insurance.

I have filled out two forms from auditors, may calls, sent messages, and have updated their database and still no one can get it right.

I have bills coming in that I can not afford to pay, and someone making calls to my home(I was not there) I was going to be dropped, plus I appear to be not responsible to the doctors office, because Aetna keeps telling the doctors that I don't return their calls.

I am going to take legal action against Aetna if I can through the state of Virginia.

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joe
Nov 10, 2008 10:08 am EST

I am new patient with Aetna right off they refuse to pay my lab work no referral, etc.
bull. i was sent by my primary care physician with a slip to lab corp this should be paid, no questions
they want it to be a med emergency i say they are trying to intimidate me into not seeking out services
joe sang vineland nj

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Aetna Scam and cheating!

My wife has been disabled since 1988. She receives a monthly disability check and is enrolled in Part A only. We opted not to enroll in Part B since she is covered by my health plan at work. We reasoned why pay out the additional monthly cost. My wife and I are both in our 50's. I have had no problems all these years until a few months ago. I noticed Aetna was holding all claims with the reason being additional information was required. After many many calls and emails to Aetna Customer Service (or lack thereof) I found out that they showed my wife was in both Part A & Part B. The representative was told that in no uncertain terms that my wife has never been enrolled in Part B. She then confirmed this with the local SS office. She told me the claims would be resent to processing.

Now the bad news.

All of my claims going back to May 7, 2007 were then re done as if my wife had been enrolled in Part B. So far (it keeps changing ever time I visit their web site) I have gone from about $700 out of my pocket to over $20,000. The new EOB (Explanation of Benefits) now states and I quote 'Your plan reduces covered expenses by Medicare benefits for which you are eligible, whether or not you are actually enrolled in Medicare.' My question is what are my options, is this legal?

I am concerned too, that next they may say my wife was eligible for Part D and they will quit paying for her prescriptions. Which run over $1500 per month.

Any insight is greatly appreciated.

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Bruce Shaw
US
Jan 28, 2024 8:44 pm EST
Verified customer This complaint was posted by a verified customer. Learn more

Their customer service is the worst possible! They are so rigid and dont listen to logic...They try to blow customers off instead of helping them, withholding crucial drugs on a technicality, and thru no fault of the customer..

Piss poor, stay away from them!

S
S
StupidBenifitCard
Barkhamsted, US
Apr 03, 2023 1:54 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

Wife & myself have tried to use benefits card at Gieslere grocery,Shop rite , Costco - NONE will accept it & blame "the card" or "the software" its printed in black letters - debit card but was finally accepted at One gas station as a credit card ..how can u use the frkn thing? I believe administrator of card FORCES u to use their internal system!

M
M
Mike Michalak
US
Aug 15, 2018 10:57 pm EDT

Aetna Insurance
Charles M. Michalak
Claim Number [protected]
2/9/2018

Aetna has done nothing but make my Short Term Disability Claim a nightmare. They have stalled, made false claims of not getting paperwork and failed to talk to my Doctor. They denied my appeal. They are dishonest and causing me further stress.

I
I
insurance expert
Nov 28, 2008 4:40 pm EST

are you on a retiree plan or an active employee plan? certain plans are designed to work as secondary to medicare, meaning, they are there to supplement medicare. If you chose not to take medicare, the plan malfunctions, meaning, the plan will only pay what it WOULD have paid, if you had medicare. So they assume the Part B payment. Its a very legitimate practice. Unfortunately, you were never made aware of this so now you are stuck with these very large bills.

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About Aetna

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Aetna, a CVS Health company, offers a range of health insurance options. Their services include medical, dental, and vision coverage. They also provide pharmacy services, Medicare plans, and Medicaid services. Aetna focuses on wellness and preventive care, aiming to support individual health management.
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Overview of Aetna complaint handling

Aetna reviews first appeared on Complaints Board on Jan 23, 2008. The latest review Provider relations was posted on Apr 17, 2024. The latest complaint Terrible Service/Lies was resolved on Sep 13, 2013. Aetna has an average consumer rating of 3 stars from 115 reviews. Aetna has resolved 49 complaints.
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