Aetna Health Insurance

mildred of brick, NJ May 26, 2009

I am sending this on behalf of my mother.

i had just gotten out of hospital for congestive heart failure, and had made a payment of 94.00 on a balance of 198.00. after several months, it dawned on me that i had not been being billed for the last 4 months. upon calling atnea the said that i had been canceled for not paying full amount. i than faxed them a brief letter explaining what had happened, i haven't heard anything from them. i am 82 years old and am living on ssi.

Romilda of madera, CA May 22, 2009

Beware. Even though my policy stated that the colonoscopy screening was covered Aetna did not pay. If you have a diagnosis of diverticulitis the testing is billed as diagnostic and the insurance will not cover the screening. This information was not included in my explanation of benefits provided to me by Aetna This common condition is being used against uninformed patients like me to rip us off. I had no signs of colon cancer and was advised to eat lots of fruits and veggies which I do already. A very expensive piece of advise! "Thank you for using the Aetna Navigator website to contact Aetna Member Services. This is in response to your claim question on 04-27-2009 in the amount of 1759.35. This claim was billed with a medical diagnosis, not as a routine preventive colonoscopy. We must process claims as they are presented to us. Since this was billed as a medical diagnosis, the deductible does apply...." My out of pocket expenses up to now are 1021.98 that is just to the hospital. The added stress of making phone calls and trying to understand why insurance wouldn't pay. Distraught breaks and lunches spent on the phone. Getting no where.

dennis of phoenix, AZ May 19, 2009

hello i went to get a loan the other day and found out that i was not aproved for the loan when i asked why they told me that i have one outstanding bill for the some of 1371 from back in 2006 after some work on my part i found out what it was i went to the doctors for a cold one night on 11/02/05 everything was fine at that point in time and then i lost my job a few weeks later.

then i just found out that after i lost my job aenta went back and said i no longer had coverage at the time of the doctors vist but my pay stubs and the aenta documents that shows that i still was paying for aenta for almost a full month after i went to vist the doctor they covered it at first they covered the bill and then a few months later took it all back and stuck me with the bill i can get any answers for aenta on why they did this or what to do about it other then they told me to just pay the 1371 because that would be the easest thing for me to do they cant tell me why i was never told about the bill not being covered and why they never sent me a end of coverage summary preety much if you get aenta your paying for nothing i have no clue what to do about this they wont even talk to me they say they cant talk to me for some reason when asked why they cant even answer that one thing for me if anybody can help me please let me know thank you for your time

Judy of Ludington, MI April 22, 2009

My mother was placed in an Assisted Living facility for medical reasons in January 2007. We contacted Aetna prior to her placement and were assured she was 100% covered. We have submitted numerous claims and they have all been denied for various reasons. All proper documentation has been submitted. My mother passed away in February 2008. >p> After many attempts to receive reimbursement of her out-of-pocket expenses, Aetna still has not paid. We have now been informed that only the medical portion is covered, not the room and board (which was what we verified would be covered in the first place). My mother/her estate are out approximately 60,000.

Dalena of Pahrump, NV April 22, 2009

aetna wouldn't give authorization for my husband to have a nuclear stress test in April eventhough he had a history of heart disease, triple by-pass, heart attack in previous years. They could find no reason for the test so instead he had regular testing.

My husband died Feb 23, 2009 at the age of 62 of a heart attack and they found two 100 % blockages plus another blockage.

Lynne of Riverview, FL April 8, 2009

Claim was submitted for emergency room visit on 11/22/07; It was initially submitted under wrong ID # and denied. We called Aetna in January of 2008, got the correct ID # and had the hosital, Wayne Memorial Hospital, resubmit. The claim has still not been paid, despite numerous calls to Aetna over the course of the past 17 months. Each time they tell us it has been re-submitted for payment, but will not confirm, and to date is still unpaid. We have even conferenced in the hospital billing department with Aetna to assist in resolving it.

We are still receiving a bill from Wayne Memorial Hospital in the amount of 3708.40.

Sharnita of Battle Creek, MI April 3, 2009

January 21, 2009 I went off work for short term disability. My doctor put me on restriction and my job do on accommondate restriciton of any kind. Aetna should be going after my company not me. Aetna has made me re-certify my clam four times before April 7, 2009. Each time I re-cert , I have to pay for forms and my benefits stop. Aetna have not sent checks on a consistance basis. At one time Aetna was almost 3 weeks behind on my payments and they had to overnight me a check. Aetna did catch my payments up but I had to call them and ask about a check from one of the reinstatement period and they simply said they had forgot to process the payment.

I had to get money wired to me. I am behind on all of my bills because I never know when I am going to get a check. I only get 66% of my weekly wages and I have to keep paying for forms and faxes because Aetna have my doctor filing out paper work after paper work.

Robert of Branchburg, NJ April 3, 2009

I retired in 1995 with 28 years of continous service. I chose retiree medical coverage for myself and my beneficiary(spouse). In 1995 the cost was 117.60 per month. Aetna Life Insurance Company is the medical insurance provider. From 1995 to 2003 my monthly medical insurance cost increased to 236,20 per month a monthly increase of 118.60 - 1,423.20 per year increase. From 2003 to 2007 my monthly medical insurance cost increased to 426.67 a monthly increase of 190.47 - 2,285.64 per year increase. From 2007 to 2009 my monthly medical insurance increaed to 589.67 a monthly increase of 163.00 per month -1956.00 per year increase.

In 2008 I spoke with The Celanese Americas Human Resource Director a member of The Celanese Americas Retiremnt Board. I was told that their cost for medical insurance have gone up and they now pass it on to the retiree. I was also told that Celanese Americas may no longer provide retiree medical insurance in the future. I stated that I had a contract with Hoechst Celanese upon my retirement that provided a medical insurance benefit. It is my understanding that the Retirement Plan can be amended but retroactively for retired employees. Each year I receive a Celanese Americas Retirement Pension Plan Summary Annual Report. In 2007 the Pension Plan increased 41,129,283 in net assets. Over the years the plan has incresed net assets yearly. It doesn't appear the Retirment Pension Plan is in any danger of becoming illiguid or justifying the substantial annual increases for retireee medical benefits. I would appreciate your imput regarding my experience with this problem.

Because of the escallation of medical cost per month which now averages approximatley 80.00 per month my retirement will disapear in about 10 years. I am 71 years of age and have serious health problems and unable to work to off set the increases in my retiree medical insurance cost. This has caused a serious drop in my standard of living. Celanese Americas has an impatient attitude about questions regarding how cost increases are decided and the conection with Aetna Life Insurance Company in justiying cost increases. In a recent agreement, announced by New York Attorney General Andrew Cuomo, Aetna to pay 5 million plus interest and penalties for consumer reimbursement claims. I have relevant documents

Deborah of Hyde Park, NY March 30, 2009

I became disabilied and had to stop working as a Teacher in Dec. 2006. I applied for disability through my work insurance (Aetna) as well as Social Security Ins. I was approved through Aetna for my life insurance Policy to be paid for but denied for disability income from Aetna. I obtained a lawyer spending thousands of dollars which was a hardship and still was denied. I was then told I would have to civil sue Aetna insurance company. That is unrealistic to happen when one is disabilied with not enough income to live on.

I have since been approved for social security disability in March of 2009. How ever the amount allowed me is not enough to live on. I know this is a growing issue with insurance companys wrongly denying people there disablity money. I have paid into this insurance for many many years and this is what I get in return when I have a terminal debilitating disease. I dont understand how one sector of the same company approves me disabled and another can deny me. I ask what dose one do in this situation to gain a fair decision being I am legaly declaird disabled. I am single and need the Aetna Insurance disability to be able to afford to take care of my medical and living costs. Please help me with this serious issue. I rather have my health then to be going through this.

The consequences here are that I am unable to affored my medical and daily needs and my elderly parents are finding it very diffucult to help me financialy. I am also having higher symptom due to the stress of this unjust decision by Aetna Ins.

Dennis of Port Orange, FL March 30, 2009

In June of 2006, my wife Pamela was diagnosed with frozen shoulder. Pamela received physical therapy treatment from Dr. Malcolm G in Daytona Beach, FL. Pamela was in Dr. G's office when the phone call to Aetna Healthcare was made to confirm insurance coverage. Aetna Healthcare confirmed coverage and her physical therapy started soon after. Aetna Healthcare paid their part and I paid my part, which was 464.11.

Dr. G is now billing me for 3,339.09. Dr. G said he is not in a NAP Contract with Aetna Healthcare. However, Aetna said he is in their network and is in a NAP Contract with them. I have a letter from Aetna Healthcare dated 6-17-08 stating that he is under NAP Contract. I hand delivered this letter to his office. My insurance card said NAP in large print on it and Dr. G's office copied it at the time of service. I have made over thirty phone calls, sent a certified letter, and still cannot get Dr. G and Aetna Healthcare to solve this problem. Dr. G's office said if I do not pay now, he is turning the bill of 3,339.09 over to a collection agency. I am disabled and have been on a fixed income for over ten years. I have done everything that I can do. This problem is between Dr. G and Aetna Healthcare!

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