Aetna Health Insurance

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Rosemary of Cypress, TX November 7, 2009

In September / October 2009 my husband went to his PCP to obtain a new 90 day prescription refill for his diabetes medications. We received a 90 day script. On the following Tuesday, we learned my husband would be going to Dubai to work on the following Saturday. Because we were unable to work through the mail order process, we went to Wal-Mart and asked if they could assist us with his order. The pharmacist was kind enough to call Aetna on our behalf, after we explained our situation to her.

At that time, our intention was to relocate to the Middle East by December or January, depending on how things went with my husband’s work. We were honest and explained my husband would not be returning to the United States. Aetna partially complied with filling two of the three medications, but refused to fill one of the medications (I believe it was the long-acting diabetes medication).

We had no choice but to send him with what medications we had. Eventually he ran out of the medication Aetna refused to fill. When I asked why they would not refill the medicine, the Aetna representative stated people sell their medications overseas!

I want you to know that as a direct result of Aetna’s incompetence, my husband was unable to pass his physical because his sugar was elevated. He was shipped home without work after several weeks. I want you to know I called Aetna and really gave it to some poor lady who had to listen to why I was angry. I want you to know, Aetna does not need to worry about my husband and I selling his medications abroad. My husband leaves for work overseas without much more than a week’s notice, and we try to abide by the mail order policies.

My husband expecting to leave overseas once more. Today I have requested refills on your website. Please send the medications. We anticipate leaving Houston in Mid-December. A copy of this complaint was filed with the Ombudsman and Consumer protection Division of the Texas Insurance Division, as well as the Texas Better Business Bureau.

Fred of Houston, TX October 29, 2009

I was diagnosed with Hep c recently. When my Dr. prescribed me ribivirin and pegfinterferon Aetna declined my claim for the prescriptions. I appealed and was denied. I appealed again and was denied a second time. The second denial letter stated I needed additional blood work done, which my Dr. said was ridiculous and unheard of. So I got the blood work done and faxed it over to Aenta. It'll take another 3 weeks for them to have a hearing regarding the meds, and that's on top of the 3 months I've already waited.

This medication is needed, it's not like I can rid myself of the disease without out. And right now it is a mild case with 80-90% successful with these 2 meds. The Dr. said if i start meds now, I can wipe out the disease in 24 weeks, but the longer I wait, the longer it'll take as the disease grows stronger. Thanks Aetna. I gues when I get liver cancer or need a transplant I'll be denied coverage too.

Anthony of Stockton, CA October 16, 2009

Aetna is the worst at processing supplemental sickness claims. This is unfortunately the second time I've required there service in 4 years. This time I was without pay for 6 weeks before receiving any payment (yes the bills were stacking up) & they are still now one month behind on processing my claim! I attempted to contact my claims rep only to get a voice mail saying to "please allow 48 hrs for a response". Which after 48 hrs I received no response. I resorted to calling the vmx every hour & leaving a message.

On rare occasions the rep would answer the phone. How is it acceptable to run a business with a 48 hr response or not at all? I was told that their system had not received a statement from my physician. My physician confirmed that he had faxed the document & had a receipt of confirmation. Aetna miraculously confirmed receipt. I was eventually told by a supervisor the checks were to be over-nighted. 3 days later I made a call as to the status of these "over-nighted" checks. I was told they do not over-night, but that the checks had been sent out in the mail. I received the checks 9 days later. The mail can be slow, but not that slow. To be blunt & to the point, I was lied to....... If not for the fact this coverage is provided by my employer account were self insured, I would never recommend their service ever!

Leah of Gilbert, AZ October 15, 2009

My STD coverages were supposed to help with my recovery after my car accident but having to deal with Aetna has been a nightmare. I want to know how they get away with treating people the way they do. My life has been affected in such a negative way (currently unable to pay mortgage, auto payment, utilities, etc...) all because Aetna "supposedly" did not receive several faxes sent from several different fax machines over and over with confirmation letters of all faxes. Where do my faxes go??? And how can they justify denying my STD claim when I have proof that ALL requested documents have been faxed within alloted time all because they "say" no fax was received??? Can nothing be done about this??? I am currently in appeals process but as hard as this has been just for them to get info I have continuously been faxing I dont see this working out in my favor. Isnt insurance supposed to help???

Bob of Morton, PA October 15, 2009

Jennifer is a big fat liar. She told me she had contacted companies for my records for my LTD claim, but each company I called said she NEVER called. She is a liar and should be fired. Aetna Insurance looks for anything, any little detail to dent benefits to people. Complain people. Complain. Dont let people Like Jennifer do this to citizens of the United States.

Jeffrey of Urbana, IL October 15, 2009

I am a substance abuse counselor. I have a client who wanted substance abuse treatment for his cannabis dependency. He is a full time graduate student at the University of Illinois in Champaign/Urbana IL. He is from the Chicago area. Aetna is his health care provider and he is on his parents policy. Aetna would not provide coverage saying because our facility is not in their network or providers. The insanity of this is that here is a person who is wanting help for his addiction and because he is not "in the coverage area" they will not provide coverage. Just another reason our country's health care system is a mess. I have several horror stories like this in my profession. This is just the most recent. I support a public option and for insurance companies to be held accountable to provide services to those who are seeking it.

Susan of Miami, FL October 14, 2009

We are currently on assignment outside the US. We filed several out-of-network medical claims with Aetna. We sent them Fed Ex and they were signed for by Aetna more than 7 months ago. It has been an endless nightmare of "not received, sent for translation, can't find, must have not filed, need more info, oh, we have the info, need to translate, can't find, oh, maybe we have it, need more info."

A few small claims have now been processed, but they continue to delay on others, specifically on two of the larger claims which would result in a payment to us of about 4,000. For example, their most recent question is why I needed to stay overnight in the hospital after having a complete hysterectomy. What are they thinking?

They do not return calls, and each person I speak with tells me something different. No one seems to be researching anything. They simply parrot whatever the file says... Unbelieveably poor customer service, which seems to be geared toward not paying claims. Waiting more than 7 months for action. And my husband has since been laid off, so this money is desperately needed. Any help would be appreciated.

edward of bluff city, TN October 12, 2009

Aetan oh`d shoulder surgery in early 2009. Months later after many, many, delays and lies, hospital bill is still unpaid. Paying out my backside for this insurance and the joke is on me. Stay away from Aetna at all cost. I have records to prove what i`m posting here. IMHO, the actions of these insurance companies is criminal and they should be prosecuted. Someone, please show us the way.

Sherry of Palm Harbor, FL October 11, 2009

Aetna!!! stay away, consumer beware.... It has been a nightmare to deal with them, I had employer group insurance and tried to obtain a CT scan to diagnose symptoms of a stroke with numbness and tingling and severe headache and they denied the test and all subsequent MRI's that were ordered, I have no prior treatment and no pre-existing conditions and they kept stating that since a headache was present along with the other symptoms that the MRI's and CT scans were not necessary.....after a four month fight I got the CT scans approved but it took me using an outside advocate group and even then the turned back around and denied some of the MRI' that were completed after they authorized. I also had short term disability with them and they turned me down to receive short term disability pay even though I had paid for this coverage and and fully entitled to short term payment while out of work being treated for what turned out to be a herniated disc in my neck. These people are crooks and buyer beware......I have no prior medical conditions and no pre-existing conditions and they have denied basically every test and claim that has come their way. And this was group insurance that my company paid over 1000 per month toward my premium....as far as I am concerned they should be closed down and their executives prosecuted.....putting honest hardworking people through this kind of hell is unethical, illegal and BAD BAD business!!!!!!

Traci of Orem, UT September 17, 2009

Yesterday was the most frustrating day. I placed an order with my pharmacy mail order company. I got a call back, "Sorry, we can't place your order, you owe 125 that we sent to collections." Hmmm. Never knew about that one. I asked them what the charges were for. "I'm sorry maam, you'll have to call the collections department."

Called collections department. "We don't show where those charges came from. We'll have to investigate. I'll call over to the pharmacy and call you back in 15 minutes." 6 hours later, I was still waiting. Called three times in 2 and a half hours. Every time I got, "he's on break." Damn. Where can you work that you can take a two and a half hour break? Oh, my health insurance company that charges me an arm and a leg and then isn't available to take my calls.

Finally got a hold of guy I talked to in collections department. Told me, "I sent an email over there. I never got a response." (What about the CALL you said you were making??) Than had the nerve to say, "I'm doing all I can on my end maam." (ARE YOU KIDDING ME?) Then had even more nerve to tell me, "It's five o'clock out here. I really doubt I'll be able to get a hold of anyone over there." (I'm competitive, bet me!) Hung up.

Called over to mail order pharmacy company. "Yeah, I called collections like you told me too, and they can't figure out where the 125 charges are coming from. He said he sent an email over six hours ago and doubted he could get a hold of you this time of day. But yet you're still here. Maybe you can help me?" Associate laughs, mumbles something about collections than looks up my account and tells me there were three seperate prescriptions that were sent but never charged for. "How can that be? You charge my account right when you send the order. You know, like that 90 you charged me for my husband's insulin and prescriptions but won't send out because there are past prescriptions from a year to almost two years ago that you claim I didn't pay for? Why wasn't I told this earlier?"

Check out the associate's answer, it's classic! "Well, in the past we've just sent out orders without payment. With the recession we have a lot of people that owe us money and we're just doing what we can to collect money owed to us."

"So Ms. Associate, what you're telling me is, some of these unpaid prescription's are from over close to two years ago--way past the time I'll be able to track those on my personal account, and you charge me for my current prescription but fail to send it out because I owe you money from a year to two years ago that you tell me about NOW? How many prescriptions have I placed since October of 2008? Why didn't an associate EVER say, "Hey, you owe us 55. We didn't charge for it, but it's due. I would've HAPPILY have paid it. But no one EVER did. You've sent out 3 different prescriptions that you never charged me for but charge for all of the rest of them. And then you send me to collections so it's on my husband's credit on something we didn't know about!

This is yet another classic example of great customer service. Now you're withholding vital medication that my husband has to have and that we've paid for because you forgot to tell me about past charges I've had for over a YEAR?!? You've continued to send out orders to me for the PAST YEAR and never notified me I've had charges that weren't taken care of when I've called and placed orders? I'm sorry you're suffering, but I'm suffering too. I've just paid you almost 100 to NOT get my medications. Now you tell me I HAVE to pay you before I'll get my medications. You give me no time at all to pay you, but yet you take all the time you want sending me out medications my husband has to have in order to survive? We leave in a week. I don't have time. The least you could do is help me out a little so we can get these prescriptions to us before we leave." "Let me see what I can do. Well, I could take a partial payment of 100 before we send them out."

Post Note: Today: Tried again to see if we could work out an arrangement to pay at a later date. Told associate that the charges for my order that was never sent were still on my account. Associate said it was a "temporary charge" until the order was completed than it would be processed. What the ??? does that mean? Managers I've talked to are unwilling to agree to allow me to pay the 125 next Friday and send the order because it was over a year old. Talked to manager about why I've been allowed to place so many orders without them ever telling me I owed money and the associate said, "because we updated our system." I asked the associate if it was done Monday night, and she said, "awhile ago." So shouldn't I be allowed to make an arrangment and still have the order I've paid for and is pending sent???

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