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Aetna / Denied Maternity coverage 12 weeks into the pregnancy

1 Winter Haven, FL, United States

My daughter has dependent coverage on my health insurance through my employer. In March of 2013, she became pregnant.
I downloaded my policy coverage and saw in the policy that pregnancy was covered.
I called AETNA to confirm that her pregnancy was covered. One of their representatives assured me it was.
My daughter's doctor called Aetna to confirm that her pregnancy was covered. The representative assured the doctor her maternity costs were covered and gave the doctors office an authorization number
Aetna paid the first 6 claims of my daughter's pre-natal doctor's visits.
The 7th claim they denied, the reason being her pregnancy wasnt covered.
I called aetna, they told me dependent's didnt have maternity coverage.
Basically they decided after 12 weeks she really didnt have coverage, after representatives on 2 separate occasions assured both myself AND her doctor (with an auth code) it was covered.
Now we have a huge financial problem. We can no longer go out and purchase a maternity plan with another insurance company as she is already 12 weeks into the pregnancy.
I have sent an appeal to Aetna. According to their website, it will take 30 days for them to even acknowledge anything one way or the other. In the meantime, my daughter needs pre-natal care.
What should be a happy, joyous time in our lives has turned into an insurance nightmare!

May 22, 2013

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