Aetna
Reviews and Complaints

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.

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.

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

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.

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.

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.

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 ;)

It's 2015 and I'm a 52 year old woman. I was a dancer, a snowboarder and a very active person until I started having back issues in 2011. In 2013 my Husbands new employer gave us Health insurance through Aetna. This employer hired a Benefits Managing company to handle all benefits for employee's and their families. I was seeing a Physical Therapist pretty much every week once a week from Dec 2013 until April 2015 and it was helping. I had to stop because Aetna cut me off. They decided I should not get PT any longer. They decided I'd had enough and that I don't need it any more, or I'm abusing it (like I LOVE having to go to the PT every week to feel good...) that I "Should" be better...I could SCREAM with frustration at this situation! I just want to say, WHAT. THE. FRACK!? We pay a pretty penny for health insurance every month. Am I suppose to feel bad for saying this makes me mad because Aetna IS covering my other issues? AM I suppose to say, "Oh well, It's MY fault I have a ailments and I'm LUCKY...lucky me...they're covering the other ailments, so just buck it up?"
I feel completely dehumanized. I ALMOSt feel like a factory farmed animal. I don't count, I'm just a policy number "bucking up" alright.. as far as THEY're CONcerned, I'm "bucking up" THEIR money! Clearly it's costing Aetna TOO Much to money to keep me healthy and not in pain.
what is there to do? I literally feel like this world is a lost cause and it's Big Pharma and Big Insurance Companies (among others) who are indeed conducting "death panels". it's not a "political thing" at ALL, it's a $$$$$$ MOney Thing.
This is a great venue to vent to, but, honestly, is anyone at Aetna going to see this? DO they even give a crap? ahhh what's worse Aetan or Reality?

AETNA does not pay LTD. They are in the business of denying claims. Please take a look at complain board.

my daugter's health is jepordized because her aetna policy won't cover anymoremental health benefits

Aetna won't even pay for basic coverage of primary care physicians in my plan coverage. That's not anything special, I am talking about just going to the primary care physican, they won't even pay my claim for regular doctor visits.
Aetna SUCKS.

I have been trying to get three claims from 2013 resolved for the past almost two year. The provider is in network but used an out of network TIN. I've been told that all hte information has been corrected and the claims will be reprocessed several times. Now I'm told that the claims are too old to reprocess. I get thet mistakes occur. However, I trust people to fix their mistakes and this one is strictly now an AETNA issue. The reprocessing of the corrected claims is in a loop of rejection - for over 18 months.

I am a 42 year old female who has had insurance since I was 18 years old. I've been covered by varipus plans ranging from Cigna to BCBS and I can say with confidence I have never had a more shoddy, patient/claim unfriendly, unproductive plan as Aetna. Nearly every visit to anywhere resulted in a denial of payment, which resulted in a letter to me from the provider of balance due, which resulted in my having to take time to call the insurance, wait on hold, jot down numbers, make return calls in some instances and basically coordinate payment. In truth, Aetna should have been paying ME for working. This is clearly a tactic to save money, banking on the patients who lack the knowhow, patience and/or determination to go the distance and hold these scheisters accountable for a service that has been paid for, but not received. Seeing the large amounts of complaints on here, I see this review will come as no surprise

http://www.diattorney.com/

I am currently fighting with AETNA ! Ebony Doctor is the 4th person to handle my case. According to her my Dr. has not sent the correct paperwork, but my Dr. said he has never received a request for any xrays, MRI's or cat scans. I think this is their game. They say" we don't have the correct paperwork" but they simply don't asked for it! My Dr. told me they have played this "game" with him and several of his patients for years now. My Dr. spoke to one of "their Doctors" on the phone and he totally discredited him more or less told him in so many words he was wrong about his diagnosis and treatment. I have had two surgery's and a third forthcoming. I have spoke to three managers, but I just found out that two of the "managers" were not they lied, they were just reps. I even had a "manager "named Wanda that gave me some bull story about how a whole panel of people( like a review board) would be making the final decision on whether or not they will continue my pay after May 9th 2011. I again just found out that is a bold face lie as well, a rep just told me it is Ebony Doctors decision alone! Ebony is not a doctor. not a nurse. has no medical degree of any type. I guess it's just up to her weather I loose my home, car everything. I am a single mother of two that has been with Bank of America for 18 years, yes 18years I have paid for LTD just in case something happened to me my children and I could survive. I suffer with great depression and pray many times daily. I pray for all of you as well. Unfortunately it's all about the all mighty dollar, and no they don't give a ###. why would they? It's not them or their wives or mother or child right? I wonder what happens when AETNA employees get hurt? Would they deny their own? I hope they never have to miss a bar b que or a graduation or a wedding because they are laying in bed in pain. I am optimistic though I have sent medical proof of my disability and with another surgry on the calander I'm sure they will continue my 60%. I will update as soon as I hear back . Good luck to all of you .

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 ;)

My Aetna summary plan description clearly states that 60 visits per year are covered for physical therapy. Nowhere does it state that after 25 visits the PT would be subject to medical review. I underwent radial head surgery on New Year's eve and have undergone painful and progressively active-assisted physical therapy since mid Jan. I have not reached my maximum medical improvement nor my max of 60 days. Aetna's online claim tracker shows checks issued to my physical therapy office. However, last Friday I receive a letter that RETROACTIVELY denies payment for my physical therapy after March 8 based on a Clinical Bulletin that is not referenced in my summary plan description nor was ever mentioned when the member services told my PT office that I was covered for 60 visits prior to my even starting physical therapy. Aetna's plan misrepresents its coverage and to my detriment I relied on their written words and issuance of checks. It isn't a new tactic, on Oct 24, 2003, Aetna settled a federal lawsuit with doctors over the same issues. I am appealing as high as I can go, but I can't even reach a case manager cuz they hide behind their automated phnoe system.

According to a report on the lawsuit: The settlement requires changes and commitments in Aetna's business practices to eliminate "the worst of the improper practices involved in managed care." Among the changes, which will affect all doctors treating Aetna patients:

Eliminating downloading and improper bundling and computerized denial practices.
Establishing the standard of a "physician, exercising prudential clinical judgment" for "medically necessary services, and allowing cost to be considered only when an alternative service is at least as likely to produce equivalent results."
Creating a dispute-resolution procedure, using an independent external review of decisions regarding medical necessity.
Providing a facilitator to assist physicians in enforcing the agreement.
Creating a $100 million fund for physicians to recover some of their damages.
Establishing a foundation "dedicated to promoting high-quality health care."
The agreement also requires Aetna to pay lawyers representing the doctors $50 million in attorney's fees, including $6.5 million in expenses.

Fighting with Aetna is a nightmare, but i found out though AETNA is hard to touch, their employees Doctors and Nurses and Behavioral clinicians are easy to touch they are based out of Florida, if you believe they participated in deceptive practices file a personal complaint with the Florida Department of Health, they will review your allegations of neglect, malpractice or deception and these individuals can lose their license to practice in this state! That would make them think twice before screwing someone over, and screw them if they do, keep in mind they don't have jurisdiction over Aetna or any insurance company it's self just the employees, which is good enough for me. Spread the word! They can't operate if they dont have a licensed staff!

I want to file a complaint against Aetna for deducting from my ltd a auto loss of income policy ihave had for years prior.

Aetna is the absolute worst or all insurance companies. I think a class action suit against them is just what is needed. Anyone interested in joining me please contact me by email me at Cody6723@yahoo.com. I have a really good attorney who has taken my case and would welcome a class action suit against them. Power comes in numbers and we should get what we have paid for. We are disabled and they know this, but have been getting away with not paying claims for years and years. Let's do this together. I too have been turned down for LTD though my doctors have sent reports stating that I am disabled. They set me up with one of their doctors who knew nothing about my disease. He recommended they follow the advice of my doctor and of course they didn't. What is this all about? How they get away with what they do is wrong! Write to your congressman about them.

From what I understand about Aetna and long term disability, once you have been approved to disability social security they stop payments. You actually cannot get both. I'm sure it is written in small print somewhere in your policy.

Surprised, Aetna has been sued? But, still has not paid out...
http://www.longtermdisabilityblog.com/2011/05/aetna-south-carolina-claim-denial.html

Aetna LTD is not worth paying for. The company wants to sells the insurance but, when it comes time to pay out they do not want to stand behind the insurance they sold you. They steal your money and run. Once you need to collect on the policy and you receive your payments they bring in THIER own specialist, they pay good money for to say, you no longer need to be drawing the payment and stop payments. Does not matter what YOUR doctor reports says, they do not want to hear anything from your specialist. They are the ones paying out on your policy and they want the payments to stop. Believe me I have been there and I know how they work. Don't call them and expect them to return ANY of your calls! They say they called and no one was home..And all the doctors they tried to contact never returned any of their calls or they never filled out the required paper work...Anyone needing a lawyer to fight Aetna needs to go through a disability lawyer and good luck with that. Most lawyer will not fight a LTD case because there is no big pay out for them. Unless there is a class action law suit filed against Aetna that may be the only way you could get a lawyer to help you. Either way it is all about the big money! I will never recommend LTD to anyone.

i too am having problems getting Aetna to pay my LTD benifits, I was just declared diabled by social security in a hearing and I called about my "open" LTD policy they act like they have no idea what I am talking about, they claim it was closed in July 2007 even after acknowledging to my wife that I did reopen it in September 2007 but it was supposedly closed because I failed to provide some records and I was never told. This is a lie their rep called me in December 2007 saying everything was in order and to just call them when my claim with social security was approved. Aetna is aweful, to treat a disabled person like me who is in constant severe pain like this? They just don't care! Aeta is fake and should be avoided at all costs. I will not drop this but obviously I am going to have to sue them now and that will take years, what if I die in the mean time? I HATE AETNA! If you have a LTD policy with Aetna it is worthless!

I agree totally with everbody here. Please update us all.

I too am having the same problem only mine is with prudential. My degenerative disk disease is well documented; I also have bone spurs in both my shoulders. I tried for a year to continue working but the pain is too much. I was on short term disability 2 different times dealing with this so you would think that I should just be able to roll my last std over into ltd but no! It is coming upon a year and I am still not getting anything but denial after denial from them. Social security is still going through their investigation. In the meantime I am broke. I know these insurance companies hope that people like us will either be discouraged by their denials and go away or go broke and not be able to pursue them further and/or lastly commit suicide. Those are harsh words but it's true. They would rather we kill ourselves just so they would not have to pay. I realize things are this way because so many people in the past have committed fraud and it's a shame that people with real medical conditions are now being treated like this but when you have a mountain of medical evidence it should not take an act of God to get them to pay. Does anyone have an answer to what we can do? Can anyone help? I'm at my wits end and don't know what to do. I'm about to lose my house, my car and everything I've worked hard to get. This isn't fair! Please can someone help?

I do not know if attorney Herbert Hill [protected], in Orlando, Florida would file a class action law suit against Aetna, on our behalf, but maybe if enough of us were to call him he would decide to represent us with such a suit. We have to stand up and fight Aetna. We cannot allow Aetna to get away with money that is owed to us.

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.

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 ;)

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]

I just completed a short term claim. Very slow process. Also, despite being approved and then returning to work after 5 weeks, I have only been paid for 3. I realize there was a one week offset, but because I was cleared to return to work at the end of the 5th week, there is no payment at all for that week? Good thing I had some money saved or I would be up the creek. Point is, this type of insurance can be a lifesaver or a headache.

I had shoulder surgery and was approved for leave from Bank of America from 10/31/2013 to January 1 of 2013. Even though AETNA requested and received a blanket release to request whatever they needed from my Dr, they didn't request any medical records past the first month, and subsequently ceased paying my disability for the month of December. They then of course denied the appeal after their fax machine ate some of the pages and all kinds of other excuses along the way. Their appeals person, Samantha Fariello was extremely rude and outright told me that she wasn't interested in talking about what they did wrong in the first place, just the info she needed to process my appeal. What a bunch of Charlatans and cheats. My arm still isn't right. I'd like to take a bone saw to Samantha, and then tell her to get back to work processing claims in 30 days. Advice and Counsel was absolutely useless to me through Bank of America as well. I hope Bank of America dumps them like we did Blue Cross when we started doing business with these jokers in the first place.

It suck but the only thing you can do is exhaust your options by going through all of the appeal process. Once you've done that if your claim is still denied, the next step is to hire you and attorney. You can also report them to the insurance commissioners office in your state. When the commissioner gets enough complaints about a company and investigation is initiated. I'll tell you what my attorney told me. It sucks that you have to wait but apply for all the state benefits you qualify for, and hire an attorney. If its discovered that your claim was not handled properly a capable attorney can get you back pay, compensation for pain and suffering as well as punitive damages. Insurance companies deny claims knowing that most insurers will not got through all the loop holes and the headache of fighting the insurance. Trust me when I tell you if you do in fact have a legit bad faith claim the reward is worth the hard work. Whats the saying "nothing worth it comes easy". in ACE V AETNA LIFE INSURANCE COMPANY A jury awarded Ace $27, 000 for wrongful denial of benefits, $100, 000 for emotional distress, and $16.5 million in
punitive damages.

i worked for aetna for 18 years as a senior medical claims examiner. they were very fair in all their dealings in the health management claim system. they paid or denied claims by a set of quidelines that were given to all employers and employee's that held our insurance. they were also handled on a timely basis. however, i went into short-term disability while working for aetna and my claims were handled adequately. after one year i went into long-term disability with very few problems. at this point i applied for social security and was denied twice. they said i could work at a lesser position. this is not true. i have severe bipolar disorder mixed with rapid cycling which does not respond well to meds. at this point, i face endless reviews on a yearly basis where they go back and forth with my doctor in an endless battle. a clerk at aetna slipped and told me in the end that my doctor has the last word. thanks, could you have told me before i had a true nervous breakdown..(ptsd).

Everything I have read so far I am going threw right now. I live in a state that you apply for state disability and Aetna. I was denied from Aetna cause I was receiving the max from the state. My state ran out in Oct, 2009. So I called them about long term. They told me I have to receive short term before I get long term. So I had to start the process all over again in Oct. I see my Drs. reguarly for my meds, MRIs, EMGs and also I need a spinal tap. They are absolute liars when it comes to there DRs. calling your DRs. They never spoke to any of my DRs. and they insist they are a reputable co. and she doesn't know why my Drs. would not tell the truth. Although occupational health told me I am qualified for long term and she would send me a proper appeal letter and for me to state about " the Doctors "situation.

I would like to know if anyone with a complaint about Aetna has worked for Luxottica?

Sincerely, Gloria

I am a former claims director with one of the largest insurance companies in America. I had a similar experience with Liberty Life Assurance Company of Boston. Deceit, incompetence, unreturned phone calls, failure to provide certificate of insurance or even the disability policy. I requested the policy over and over from the claim rep. After finally obtaining the policy two years later I reviewed it and see multiple areas of coverage that applied but were ignored by Liberty. I was deemed disabled by doctor after doctor. Liberty Life paid me monthly benefits for a period and then cut them off without even obtaining doctor reports to support their position. The claim rep continuously told me he was ordering medical reports however I found out from my treating provider that he had never sent for them. There appeals panel agreed with me and re-instated partial benefits. I have now been declared permanently disabled by Social Security. There denial and delay in handling my claim caused immense financial and mental health and medical problems and they failed to issue various other benefits outlined in my disability policy. In almost twenty years of insurance claims experience I have never seen such unprofessionalism, incompetence, mis-representation, and bad faith from an insurance company. I was fortunate in that I worked for several national companies that properly investigated and paid their claims fairly, in good faith and on time. I contacted their leadership team with my concerns and they also failed to contact me. It is truly appalling how they handle their claims. If your employer has Liberty Disability Insurance beware.

I disagree with the "insurance person" comment above.. READ ON...

AETNA has the worst disability claims analysts i've ever seen and dealt with... they are rude, liers, and just deny claims so they don't have to pay out, and side w/ whoever the company you work for...
they take their time and extend the appeals because they are too lazy to get it done right away.. I don't think the disability analyts there are qualified at all...
they also seem to take alot of days off, switch from one analyst to another...to another... why? because one can't handle the claim so they need to pass it on? that makes me laugh...qualified my butt...

THIS IS MY STORY AND WHAT HAPPENED TO ME...
I submitted my leave of absence on Aetna's workability management also, it told me i qualified for short term disability..
i printed out the papers needed to be filled out and when done, had them faxed to Aetna...
Aetna they said they never recieved the certificate from my provider..about a week later i was told this..
when they got the "2'nd" one, they denied my short term disability because my "INTERNAL MEDICINE DR" put on the certificate i had chronic depression, he had referred me to a specialist dealing w/ behavioral health, so i made the appt. and she diagnosed me with Biploar depression after i told her ALL the same symptoms to my INTERNAL DOCTOR..
he had no idea i had the bipolar part..

so i appealed it, they said wait 45 days..so i did and sent in more info they needed
then they had to "EXTEND" it... why? I sent in a letter related to my dr. appts. i had before i went on leave and after i went on leave, copies of proof, my dr. also sent in notes from those appts.
so...THEY HAD TO EXTEND ANOTHER 45 DAYS BECAUSE OF THOSE 5 OR 6 PAGES... come on... do your work right and stop being lazy and just putting it off...

SO... they did the peer report, calling my dr. and my behavioral health dr.. that i STILL see every week, along with my meds. dr..
my "INTERNAL DR." told them i was acting "NORMAL"
even after i told him my symptoms i had and it was all caused from work and the managers being unprofessional, saying things to me that should have never been said, gettin me upset, angry, crying, anxiety, etc...AND I COULD NOT PERFORM MY JOB DUTIES/HANDLE THEM...
as a result from those events and other things... i ended up depressed which turned into bipolar, real bad, was told it was manic depression also...

i was out from May 2009 until Oct. 09
i got NO benefits or payments, all my bills got behind, credit cards not being paid, had to cancel some of them and now my credit report is bad...

my appeal was only part of my leave, they denied me from May 13'th 09 to June 10'th 09 because my first appt. with my behavioral health dr. was on June 11'th 09..
so the approved part of my short term disability was approved from June 11'th on until i went back to work... which was Oct. 2nd 09

But...after my appeal was decided on Oct. 15'th or so...they denied me again because of what my INTERNAL DR. said, i was acting normal...which i wasn't...

the Aetna "DISABILITY ANALYST" named "TABITHA" kept telling me since Aug. 09 another week, another week or so before the decision, etc...
SHE LIED TO ME!
so i cried, my boyfriend came home, saw how upset i was and called "TABITHA"
SHE WAS RUDE, LIED, and then told him/me on speaker phone "NOT TO CALL BACK UNTIL OCT. 15'TH 09"

I had asked her in another call pryer to that one how my benifits would be paid out if my appeal was denied or approved, since i was "APPROVED" for the Short Term Disability from June 11'th on...
SHE SAID SHE DIDN'T KNOW...
WELL... this is what she should've told me because she should've known, and i didn't know until Oct. 15'th when they denied my appeal again...and when i got the denial letter and their " FINDINGS" which was the "ACTING NORMAL" part...

According to my place of employment... which is...of all the places... "BANK OF AMERICA"
do you know what their policy procedures for their "ASSOCIATES" are?

YOU CAN NOT GO FROM AN "UNPAID" MEDICAL LEAVE...TO A "PAID" MEDICAL LEAVE..

I had no clue until i got that denial letter, didn't understand and called "TABITHA"
SHE THEN TOLD ME I WOULD RECEIVE "NOTHING"
NO BENIFITS PAID OUT...
EVEN THOUGH I WAS "APPROVED FOR SHORT TERM DISABILITY FROM JUNE ON...

I called what is known as "advice and counseling" for the Bank of America, that lady told me Aetna should've known that and told me..
Advice and counseling did nothing to help me, that was in Oct. 09 after my denial letter and talking to "TABITHA" from Aetna.

SO... because they took so long on my appeal, extending it, and no benefits paid, i had to "FORCE" myself to go back to the same place that caused me to not being able to perform my job as i couldn't concentrate, focus, i cried, got angry, irritated, anxiety, dropped work a few times that was done and had to put in order again...
i lost my regular position because "BY LAW" bank of america can do that after 16 weeks on medical leave...

i was still angry and upset and worse because i was put in a position again that i could not do before "a processor", as a result given the "workflow" one that i did before my leave... that i was outcasted from...why? Because i have Tendinitis in my hands that prevent me from getting my "numbers" or "quota" for what i do..which is check processor/ check encoding...like data entry..

I know i did very good on my job, all the trianees told me i did, and i helped them more than "others" who should have, taking on their responsabilities as they weren't, and causing me my symptoms also..
workflow is only supposed to get the work, pass it out, pick up the done work, and bring to the next department..
that's all i was supposed to do...not required to answer the trainee's questions or if they needed help..that is a "TRAINER" position..
i was NOT a trainer...but doing their job on top of mine...

SO... by the 2nd day i was back to work, i cried at my machine, got racing thoughts...and still to this day, put in the training room where i worked doing workflow and watching how they "CHANGED" things in that room while i was gone to get better, which shoud've been done before i left...
and seeing the "new person" doing "MY JOB" that i had for over 3 years...
i get angrier and angrier and cry everyday that i am there...
i get frustrated and in pain from my hands hurting, doing more damage... and not able to get the "1600" items per hour...

A NEW MANAGER TOOK OVER AND MADE THE CHANGES WHILE I WAS OUT..

I HAVE TALKED TO HIM A FEW WEEKS AGO, TOLD HIM MY SITUATION AND MY DISABILTY AND THINGS THAT "HAPPENED" AS A RESULT OF MY LEAVE...
I ALSO TOLD HIM I CANNOT BE IN THE TRAINING ROOM BECAUSE I AM SURROUNDED BY PEOPLE THERE WHO CAUSED ME DAMAGE, AND THE NEW WORKFLOW PERSON, GETTING ME UPSET/ANGRY, WATCHING...AND CRYING
I TOLD HIM I NEED TO GO TO THE PROCESSING FLOOR "A UNIT" SO I CAN TRY AND SEE WHAT HAPPENS...
HIS QUESTION..."WHAT ARE YOUR NUMBERS?" NICE HUH?
I CAN'T GET MY NUMBERS...CAN ONLY DO "[protected]" AVERAGE..
I WILL EVENTUALLY BE PUT ON WARNINGS.. THEN BOOTED OUT OF THE COMPANY AS MANY OTHERS HAVE...

I WAS JUST TOLD THIS PAST FRIDAY 11/20/09 THAT I WILL BE MOVED TO A UNIT, AFTER A WEEK OF WAITING.. IN THE FIRST WEEK OF DECEMBER..
ANOTHER WEEK OF TORTURE BECAUSE OF THE HOLIDAY THIS THURS...

SHAME ON AETNA FOR LYING TO ME...TAKING THEIR SWEET TIME, NOT TELLING ME THE RIGHT THINGS THEY SHOULD HAVE, SHAME ON THEM FOR MAKING ME WORSE...EVEN TO THIS DAY...CRYING, GETTING ANGRY STILL AT WORK, ETC.. I FEEL IT WAS "BAD FAITH" ON THEIR PART, AND BY GOING BY WHAT MY INTERNAL MEDICINE DR. SAID..
WHEN THEY SHOULD'VE GONE BY MY BEHAVIORAL HEALTH DR. DIAGNOSED ME AS...
FORCING ME TO GO BACK BECAUSE OF THEIR LAZINESS AND NOT DOING THEIR JOB RIGHT...

I NEED MONEY FOR ALL THE NECESSARY THINGS I NEED, SUCH AS MY APPTS. WEEKLY, MY MEDS MONTHLY... LAMICTAL AND STRATTERA, AND OTHER MEDS I TRIED SINCE JUNE TO GET THE RIGHT ONES..
I NEED GAS IN MY CAR, INSURANCE, BILLS, FOOD, RENT, TO PAY MY SHARE W/ MY BOYFRIEND.. ETC..
MY BOYFRIEND ENDED UP PAYING FOR THINGS THAT I COULDN'T, I OWE HIM SO MUCH NOW..
IT PUT US ON A TIGHT BUDGET; ME TAKING OUT OF MY 401K TO PAY FOR WHAT I COULD UNTIL THAT WAS GONE..
I HAD TO PAY COBRA $100 A MONTH TO KEEP MY AETNA "HEALTH" INSURANCE IN ORDER TO GO TO MY BEHAVIORAL HEALTH DR. AS THEY DON'T TAKE "STATE" MEDICAL...
AND I WAS NOT ABOUT TO SWITCH TO ANOTHER FACILITY AND START "OVER" W/ ANOTHER DR OR PLACE..
I AM STILL WORKING ON GETTING THE STRATTERA DOSAGE RIGHT, AND LAMICTAL BEING INCREASED SLOWLY...AND GETTING BETTER, BUT IT'S STILL HARD..

COME ON AETNA...DO YOUR JOB RIGHT, AND MAYBE YOU WON'T GET SO MANY COMPLAINTS..
BECAUSE I'VE READ SO MANY OF THEM, AND CAN RELATE TO SOME.. I WONDER HOW MANY "BAD FAITH" LAWSUITS YOU HAVE AGAINST YOU...

AND AS FOR MY EMPLOYER.. SHAME ON YOU TOO...WE'LL JUST HAVE TO SEE WHAT HAPPENS, BECAUSE BANK OF AMERICA ALSO HAS NUMEROUS COMPLAINTS...FROM "ASSOCIATES" CALLING HR AND COMPLAINING W/ NOTHING GETTING DONE BEFORE I WENT ON LEAVE...UNTIL THE NEW MANAGER STEPPED IN...

BANK OF AMERICA SEEMS TO ALSO CARE MORE ABOUT THE PEOPLE THAT HOLD BANK ACCOUNTS/CLIENTS, THEN THEY DO FOR THEY'RE OWN ASSOCIATES..

AS FOR BOTH AETNA AND BANK OF AMERICA, I WILL TRY AND FIND AN ATTORNEY HERE IN CONNECTICUT TO HELP BRING THIS TO COURT AND "SUE" FOR DAMAGES THEY CAUSED AND STILL ARE...

I CAN'T QUIT BECAUSE I NEED MONEY, NOT IN THE RIGHT STATE OF MIND FOR AN "INTERVIEW" WITH A NEW JOB...

IF I CANNOT FIND SOMEONE TO HELP ME, I WILL FILE ON MY OWN TO CIVIL COURT...SEND LTRS TO CORPERATE OFFICES, NEWSPAPERS, MEDIA... ETC...

HECK, I THINK I'M GONNA COPY AND PASTE THIS AND SAVE IT...

WHAT GOES AROUND, COMES AROUND...
I WILL GET WHAT I DESERVE BECAUSE OF THEIR "ACTIONS" AND DAMAGES...
COUNT ON IT...EVERYONE WILL KNOW ABOUT THESE TWO "COMPANIES"

ANY ATTTNORY WHO MAY READ THIS AND WOULD LIKE TO HELP ME... PLEASE RESPOND TO THIS AND TELL ME WHAT I CAN DO, OR WHAT I SHOULD/SHOULD'T DO I WOULD APPRECIATE IT..
WRITE YOUR NAME/NUMBER AND IF YOU'RE INTERESTED AND IF I HAVE A GOOD CASE ON MY HANDS..

HAVE A NICE DAY TO THOSE WHO "DESTROY" OTHERS...
BECAUSE SOMEDAY " I WILL"

FROM: A MANIC BIPOLAR DEPRESSION PERSON HERE IN CONNECTICUT

I think you provided a very detailed informative response. Not being able to work does not a disability make. However, it is very frustrating to be "almost" well and the pay stops.

Payment of premium does not entitle you to benefits automatically. When you enroll in your employer sponsored benefits you should; at minimum read the summary plan description, or at least request a certificate of coverage. The certificate of coverage is a duplicate of the policy document that you are covered under. Your policy language supercedes any verbal statement or inferred deduction provided to you or derived on your own.

When you file a claim, you are required to prove your loss, also known as "proof of loss." As it pertains to disability insurance, you are required to submit objective clinical findings that support the basis of your claim. Just because your health care provider tells you that you are not able to work, you are not necessarily disabled. Your contract defines your disability as it relates to your occupation. E.G. if you are a secretary you are in a sedentary occupation and your 'disability' must preclude you from performing the material duties of your own occupation. If you have a sprained ankle and you are a secretary, you are not disabled. You are able to perform the material duties of your own occupation. If you have a sprained ankle and you are a carpenter, then you are disabled from the material duties of your own occupation. Inability to get to and from your occupation does not preclude you from actually doing your job. Not being able to physically do your job does preclude you from working.

I work in disability for an insurance company and if I could tell people two things it would be:

1) read your certificate of coverage, not just the summary plan description
and
2) your payment of premiums for X number of years does not automatically entitle you to any benefit under the policy if you cannot "prove your loss" as the contract you are covered under defines "loss."

Get an attorney and spend the limited resources you have if you must, but the burden of proof lies on you, the claimant. "Good faith" lies in your understanding of the contract language of your policy and your adherence to those requirements. Insurance companies are well covered and the people they hire to administer your claims are well qualified. Chances are if you've been denied and your appeals have been denied...you haven't met the contractual requirements.

There's your assistance.

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.

I think AETNA was blaming underestimating the costs of "cobra" patients for a decline in their profits at one point recently.
Maybe they want you to cancel your cobra coverage?

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

I have never had such terrible customer service in my life! I'm currently on Cobra and had to change my benefit plan due to a HUGE increase in price (over $200), with higher co-pays for doctor visits and prescriptions. I was given 3 other options to choose from but no information on co-pays or rx prices. Simple information right? Wrong! I talked to 3 people at Aetna and they could give me NO information on any of these plans! I kept asking to speak to someone else and same story. I must add that EVERY single rep I spoke with was rude, snarky, and kept me on hold forever! Finally, I asked to speak to a supervisor, and the rep rudely said, "Okay!" I was on hold for 20 minutes and finally hung up. Once my Cobra ends, I will try to locate another insurance company. I will NEVER pay for an Aetna insurance plan.

Aetna sucks. I had surgery on my neck almost 3years ago. Now I am having numbness and tingling in my right arm and fingers. This was a symptom before the surgery. They had to put 2 metal rods in my neck. I am clearly having a problem again. Aetna denied an MRI that my neurosurgeon ordered to see what is going on. Then my rheumatologist ordered one, and they denied it also. This is just 1 thing in a long line of insurance fraud and abuse by them.

We own a sm. business and have AETNA ins. until this year we have had no claims. Of the 7 claims only one was processed correctly. All of these claims fall under the co-pay part of the policy. Every time I call they tell me it should have been paid but due NOTHING about it. To make matters worse it's time to renew our policy and they have inceased the preium ove $200.00 a month

It wouldn't be so bad if you could bypass the inconsiderate reps by asking for a supervisor. WARNING! If "Mike" from Middletown picks up when you call... call back. He's rude and refused to allow a supervisor to speak with me. He told me to "get a pen, I'm waiting, now write Mike, M-I-K-E, #A243977..." and hung up the phone. I'm a teacher and our family purchased our medical benefits through my husband, chosing AETNA. Next time we will pass. I'd rather even pay more money and be treated with respect than ever be in that position again. The way he spoke to me- he had to be alone because he was loud.

they are cheaters they have you paying in but they cut off benefits

When I was a young soldier in Thailand (U.S. Air Force 1972), I was expected to speak their language when "in their country". I did find someone to teach me some reading skill, but writing was a definite challenge. Point is; I did learn to speak most of the proper dialect in a few short months. If I could have stayed another year, I would have been able to almost master it. The more I visited downtown like the markets, theatre, taxi drivers, etc., really helped me learn the local language and customs.
If you want to live in my country, please learn the language. If your country is so bad, then why don't you change it ? You are not entitled to anything here in the USA.
English is what is spoken and written here. My company does not, and will not cater to anyone who does not speak english.

I feel your pain . . .also Grace family with Aetna PPO insurnace which brings sighs of frustration from providers whenever they hear we're covered (or often not!) by Aetna . . .We also ran into the 359 day rule and were denied well visit coverage. Also had to fight for a well visit to be covered because the children rec'd flu shots several months prior! They fight every claimthey possibly can . . .becareful if your chuildren ever need surgery! The coverage is awful even when medically necessary! Aetna is considered the bottom of the barrell in the industry . . .way out in front when it comes to screwing members at any costs . . . I don't know why Grace continues with this coverage ? . . oh I know . .. it such bad ocverage and the cheapest available they can keep paying the execs big bonues while their emplpoyees children do without health coverage and necessary medications . . . Grace refuses to cover my sons asthma medication or even the antibiotics he needed for ear infections as a baby because they were not on the formulary! He is alleregic to the oneon formulary and even with a doctor's note, they refused . . .nice . . .real interested in the well being of their employees and familes . . . the almighty dollar . . Hang in there . . .I'd let HR know how crappy the coverage is . .until we all complain loud enough they will nver listen . .

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.

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 ;)

Aetne has denied payment for the difference of what EDD is not paying for my medical leave, due to Work related injury, back, wrest, and stress on the job injury. Bank Of America. I appealed with full report from Chiro and Phscy and still they deny pymnt stating report does not give details of this being work related and Medical test and analysis indicated in the report stat stress due to back injury and stress at Bank of America. and she will have to fwrd this over to the physical medical department and mental health with not approve it, I received and denial letter. not that sum other dept will review.

They go from not following your written instructions on the reorder form. to charging your credit card for refills you did not request and without your authorization. I think in most states they consider that illegal. When you try to get it corrected -they tell you all kinds of different stories. They did this twice within the past three week period. Do not I repeat to not use these people. The attorny general in Florida should look into their business practices. They have serious problem within their company. Again do not ever use these people

Where is a good lawyer when you need them.

Aetna schedule of benefits shows that there is a no co-pay and deductible is waived for routine physical exams. Did you know that routine doesn't include talking to your doctor about your health concerns? I asked about my weight and she diagnosed me as overweight. So since I have a diagnosis, it is now considered an office visit and I am responsible for the co-pay and the deductible. Since she is concerned that I might have a thyroid problem, she orders lab work. There is a higher co-pay for getting blood drawn. I was curious about my results and was told to schedule another appointment and pay another co-pay to find out that I don't have a thyroid problem. I asked the doctors office and Aetna about paying much more than I expected to pay. I was told I am responsible for knowing how my insurance company works. I was told that a wellness exam is only covered if I am well. If I am sick, or I ask the doctor if I could be sick, then it is not covered. So in the future, when my doctor asks me if I have any concerns or questions, I will answer "I am well." Actually, I am going to stop going to my doctor. Since I can't afford to be un-well, I can't afford to find out if there is anything wrong with me.

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.

The "COB- coordination of benefits" will happen at least once per year to see if there is possibly another insurance company that should be primary.
It's definitely a pain.

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

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 ;)

My husband and I are paying a lot of money for a policy that is USELESS. I was recently in the ER and they said that they can't bill me because I"m not in their nextwork..even though the people at Aetna say my hospital is in their network.

My doctors are all coming back to me and saying that I'm going to have to pay out of pocket because nothing is covered under them. Only $350 is covered...and I have to make $350 stretch out for a CT scan, blood work, chiropractor, and therapist?

Yeah, right. What am I paying for this insurance for? Do you realize that there is better health care for the uninsured in clinics than people who are insured by Aetna SRC? This insurance is a scam at best!

I have experienced it first hand with SRC. It is truely unbelieveble they can get away with what they do. I have 6 bills for 3 days of service (1 day for blood work, one day for xrays, and one day for a one hour procedure). The 6 billers for the misc services have all been unsuccessful at getting SRC to receive the bills. Even though the billers have fax confirmations, electronic filing confirmations, and sent bills by U.S. mail, they all "disappear" on the SRC end. Amazing. Its been six months and I spend about 4 hours a month on the phone trying to get them to find the bills as we re-fax them. Capitalism an at its finest.

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!