Aetna

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Category: Lifestyle

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United States

Aetna Reviews

J763 June 12, 2011
Worst Health Insurance
Aetna has major problems with it's customer service and website which is not user friendly. I am working 3 part time jobs so I have very little time to contact Aetna. I wanted to upgrade my insurance but I'm told I need to reapply.. i've gone to website and have no clue where to go, I've called 3 times and the last they were supposed to mail me the form, . This was 3 weeks ago;. In fact, I have called Aetna on 4 different occasions and asked for things to be mailed and never received anything". Question: Are there any real people that work for Aetna!. Someone cashes my check every month with no problem;. The joke is that they send me emails requesting feed back and they never ever call me or respond'. Aetna-you deserve an "F" and I am looking elsewhere since you were too *** lazy to even mail me a lousy form I requested.
michelleshell May 20, 2011
lack of benefits
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.
Aetna SUCKS May 6, 2011
NO Coverage At All
Aetna is without a doubt the WORST health insurance you could purchase. It's a rip off and a total waste of money. I got this garbage insurance through my workplace last August. I work part time and they took $89 a paycheck out for their worthless insurance. I have made 2 Emergency Room trips since August and Aetna has paid a grand total of $400 towards the bills. I am now $8500 in debt. They pay for NOTHING. I dropped them this morning and was told I have to keep paying on the policy until July 1. What a joke! AVOID AETNA LIKE THE PLAGUE!!!
sickand sickofit May 2, 2011
Long Term Disability
AETNA does not pay LTD. They are in the business of denying claims. Please take a look at complain board.
NMA851 February 28, 2011
Medicare Prescription Processing/Denials/Appeals
My mother started her Medicare Part D plan in 2008. I retained Aetna for her in 2009 and I still kept them in 2010. Despite knowing the changes in their Drug Formulary, there was no need to change plans given I was ASSURED that my mothers' prior authorizations would still cover 4 medications - in writing. For those who do not know, a Preferred Drug Formulary is their "list" of drugs they will cover and at what price "Tier", Brand vs. Generic, etc. These 4 medications were covered in 2008 and 2009 via the "prior authorizations", hence the need for these prior authorizations which allowed her to get the medications for 3 years. All I did was confirm and ensure that these were, in fact, still valid to which I have correspondence that it was.

So January RX refill time comes around and I fill everything for her (14 scripts total) without a problem. 3 weeks and 2 days later, I receive a letter stating one of her RX's was filled as a "One-Time Courtesy" and she needs to find a "preferred" drug that is similar OR obtain a Prior Authorization! Mind you, as stated above, I CONFIRMED with them that her prior authorizations would STILL be in effect until August 31st 2011.

The next day, another letter, same reason, different drug. Next day, 2 letters this time (separate envelopes - could have saved a stamp given these were all filled the same day and all the letters had the same date - go figure). Now, I have letters stating ALL FOUR of the medications, already approved via Prior Authorizations, were no longer covered!! Confused yet? Good - you should be; that was AETNA'S purpose. Nevertheless, ALL four letters are contrary to the APPROVAL correspondence stating (all 4 medications) are COVERED FROM AUGUST 01, 2010 - AUGUST 31, 2011.

AETNA did this as a tactic, to lock-in my mother for ANOTHER year, knowing full well that on January 1st of EACH YEAR, ANY PRIOR "PRIOR AUTHORIZATIONS" BECOME NULL & VOID!!! I was NEVER told this, ALL letters say otherwise, this did not happen when we went from 2009-2010, and let us not forget the APPROVED UNTIL AUGUST 31, 2011!!

Then the phone calls to AETNA started - of course not ONE person was helpful until the very end, approximately 35 reps, 3 supervisors, and 2 1/2 weeks later. Let's not forget too that these "We changed our minds" letters came only DAYS before her medications were due to be refilled come February.

Her doctor and I had to BOTH file an expedited appeal for a formulary exception, which basically asks AETNA to cover it even though it's not on the Formulary. This was denied stating "PATIENT MUST UTILIZE 2 OTHER LONG-ACTING MEDICATIONS OVER A 90 DAY PERIOD BEFORE WE CAN CONSIDER A FORMULARY EXCEPTION". Before they would cover the drug again??? Ummm - this is why we had these approved already - so now AETNA wants my mother to go backwards, suffer tremendously for 3 months, in order to "prove" that they do not work? Upon speaking with them about this "denial", I advised that my mother already went through this, that's why we have the Prior Authorizations, and yet I am told that is NOT SUFFICIENT since this did not occur in the last 6 months!!! WHY WOULD IT? SHE HAD AUTHORIZATIONS FOR THE MEDICATIONS THAT DO WORK!! Now what must I do? Appeal time - and not just a regular one, an "expedited" one since we're down to LESS THAN A WEEK before she is out completely.

Nevertheless, in my 10-page appeal as well as through her physician giving me time in his office to back up the statements with medical data, ALL of this was outlined. ALL was faxed, I printed the confirmation, and even contacted them to ensure it was received. I was told yes and the doctor, who had also called the day after, was also told ALL info needed was received. 2 days later, I get a phone call stating NEITHER THE DOCTOR NOR I, ON BEHALF OF MY MOTHER, SUBMITTED RECORDS/RATIONALE WITHIN 48 HOURS!! This is when the phone-wars began. I miraculously found a manager, who just happened to get suckered into the phone call in my opinion, gave me a DIRECT fax number, I faxed all my stuff and the doctor's stuff to her while on the phone, she cofirmed receipt and faxed a signature page back to me indicating 52 pages were received, and she forwarded this to the person handling the appeal.

THE DAY AFTER her medications ran out, I got a phone call indicating the appeal(s) had been approved. While this is good news of course, the fact is that I had the chance to AVOID ALL OF THIS ENTIRELY HAD WRITTEN CORRESPONDENCE BEEN HONORED FROM THE START!!! Obviously AETNA had no leg to stand on when the only dates I have refer to an expiration of August 2011; NO WHERE does it state that the "New Year" would "void" the "prior" prior authorizations. To add insult to injury, however, it then came to my attention that I neglected to handle the "quantity limitations" on the other 2 medications. SO, I guess AETNA already knew once they heard my name that it's best to just fix it NOW, i did not have to go through all that hell AGAIN for the remaining two medications.

The point of all this?
#1: Especially when you are dealing with elderly people or worse, those who are experiencing dementia or Alzheimer's, the HUGE book you get when open-enrollment starts every November is enough for the SMARTEST OF THE SMART to be confused!!
#2: DECEPTIVE TRADE PRACTICES - Sending out not one, not two, not three, but FOUR different letters for FOUR different medications with FOUR different approvals and then turning around and DENYING they are valid due to the standard "Start of a New Year" line of BS.
#3: Waiting until the patient is ALMOST OUT OF MEDICATION to advise them there will be an issue of non-coverage.
#4: Trying to make an old woman suffer, without just cause or god-forbid HUMANITY, by attempting to demand her to take medications that are known to NOT work and cause major side-effects, for THREE MONTHS before 'considering' approval of the Exception.
#5: Having to turn myself into a Lawyer, basically, in order to put together EVERY SHRED of documentation possible, while sitting with and LITERALLY spending time at her Doctor's office with her physician to write out all these explanations and "chronologies" and "How AETNA is blatantly WRONG". I mentioned the lawyer part as I quoted EVERY piece of legal mumbo-jumbo THEY USED ON MY MOTHER to use for my Mother's advantage. Given the coverage under the policy is, afterall, a Contract, that means I will just throw the legal mumbo-jumbo right back at AETNA.
#6: Make this ALL HAPPEN within 4 or 5 days that never would have happened if I was just told, back in November, that in order for my mother's Prior Authorizations to be valid starting on January 1st 2011, I would need to start the process THEN instead of having to scramble for 4 days, non-stop, before she ran out of medications.

HOW can ANYONE sleep at night knowing they are putting others' lives in jeopardy EVERY SINGLE DAY OVER THE ALMIGHTY DOLLAR???? What is wrong with this country that companies are ALLOWED to hurt people? This is not just about my mother - this is about ALL our elderly, disabled, or retired people who have Medicare, specifically Aetna's Medicare Prescription plan. I can't emphasize these points enough over how deceptive AETNA has been. Here I think I'm being proactive in regards to my mother's health and what happens? CATASTROPHE.

People beware - and I DO NOT - I repeat DO NOT say this as an insult in the least but have others help you even if you think/believe/advised your plan is FINE. Whether you're 65 or 85, they WILL TRY to throw you under the bus and you'll be left with NOTHING! If myself, my mother's Doctor, and her Doctor's attorney had issues resolving what should have been a VERY simple matter, I can only imagine, as well as FULLY understand, what has been done to others. Luckily and with ALOT of prayer, the wool did not get pulled over MY eyes from these idiots looking for suckers to just "give in" and allow them to have their salaries and other perks. I wonder if they get bonuses for MORE denials?? Surely that's the case otherwise what is the incentive to cause THIS much grief for people?

Imagine this being your elderly mother, father, aunt, uncle, neighbor, and/or friends having THEIR medical needs just ripped from underneath them. SAD THAT PEOPLE DILIGENTLY WORK HARD AT FINDING WAYS TO MAKE THESE PEOPLE SUFFER ALL FOR THE SAKE OF THE ALMIGHTY DOLLAR!!! Then imagine having to put together a HUGE presentation for them in 72 hours or you're screwed. Like I said so many times - WHY was I not told THEN instead of NOW? Retention via Deception!!!

SHAME ON YOU AETNA!! SHAME ON YOU!
Stan P February 11, 2011
Won't pay for Celebrex
If Aetna thinks for one minute they're not going to cover my Celebrex, the ONLY drug I take, they had better think again. I'm contacting the Attorney General tomorrow, and after that, I'm going to Congress, because, you see, I live in Washington DC. And here in Washington DC, not only do people have an UNLIMITED capacity to ***, we know how to do it. This issue is NOT going away, it's not going to go away, not now, not ever. I have tried other drugs and nothing works but Celebrex. Nothing. On Celebrex, I can live like a normal person. Without it, I will be in a wheel chair.
xoLissyox February 10, 2011
denied short term disability
I had gone out of work on medical leave on August 3rd 2010 and was told to apply for short term disability thru the company sponsered plan thru Aetna. I did so and was denied in September and I thus filed and appeal with them and in the mean while had no money coming in and had to borrow from family and friends and that ran out. So I am being evicted from my apt and lost my car insurance and the cell phone was shut off. Now here it is Feb 5 months since i filed the appeal and was denied again and said i cant appeal again my case is now closed but i can pursue a civil case...And because I was deied my claim all together I have been fired from my job.Thanks to Aetna I have lost everything. But hey what do they care they still get paid every week.
Mcarrera October 28, 2010
Refuses to pay my supplemental income
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.
Klej October 20, 2010
Denying "life sustaining medication"
THIS IS INHUMANE! My doctor, my pharmacist, and I have been in contact with AETNA for 3 days. I have not had my synthroid since 9/15/10. Aetna would only reimburse for generics, so I use them for the past 3 months. I did not respond to Levoxyl(GENERIC CRAP), and my T3 & T4 are so low that my doctor told me if I feel ill to go directly to the ER. He had no samples to give me. My doctor wrote "patient blood levels improved on Synthroid", been on medication since 1980. AETNA SAID, it is not saying the medicine didn't work, just that you "improved" on the brand? WHAT???????????? going to ER and this could have been avoided!
Norman August 23, 2010
Never ever use home delivery
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.

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