The complaint has been investigated and
resolved to the customer's satisfactionResolved Aetna — Denial of coverage
resolved to the customer's satisfaction
I have so-called health insurance with Aetna. Several weeks ago I had to see my ophthalmologist for certain symptoms which she diagnosed as punctate keratitis, conjuncitivitis, and severe dry eye syndrome in both eyes. As part of the treatment she inserted plugs in the lower tear ducts of both eyes to help with the dryness and help retain the prescribed steroid drops in the eyes. Aetna refused to pay for the procedures, saying that they violated the ban on multiple surgical procedures in one visit. Instead, Aetna paid a much lower amount towards the cost of the plug for one eye. Now I'm stuck with $250 to pay for the plug on one eye.
Oh, was I supposed to choose WHICH eye to treat that day and forego treatment on the other until another day? Was I supposed to incur charges for an additional office visit? Aetna must be one of the worst insurance companies in the U.S.