Aetna Health Insurance

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Indira of Clemront, FL October 9, 2008

Indira of Clemront FL (10/09/08)
My husband had begun suffering from a severe and unusual headache that would come on suddenly, lasted for hours and was so severe and unsual that whenever it occured, he would literally have to grab the side of his head on which the head is and go down in pain. At first we were scared and not sure what was happening or going to happen.After several attacks of this kind we decided to go to the emergency room. We didn't want to take the chance, thinking it could be a stroke, or some other serious problem. The ER diagnosed him, with a pinched nerve in his head after several hours of testing.

However, in his medical records, it was mistakingly recorded as a Headacheby the ER doctor of South Lake Hospital (Clermont Fl). has tried to re-code the visit and resubmit it back to Aetna but they ignored that and billed us an invoice for 984.00 This ER visit was 10/29/2007.

To date, I have been trying patiently with customer service reps and supervisors from Aetna for help, explaing every detail - from the severity cause for the ER's visit to the doctor mistake of putting the wrong code but they all refused. They have stated that - we choose to go to the ER for a headache and that will not be covered! Sure, I totally understand that concept - but this was not done with intent as they are stating, and it is very obvious that they prefer their patients assume and put their lives in danger, by staying home even when the systoms seemed so dangerious, instead of being sure and safe.

Tabatha of Lavallette, NJ September 24, 2008

Tabatha of Lavallette NJ (09/24/08)
i cant get my son seen by any doctor for his adhd because aetna wont cancel his plan. i have insurance of my own for him and doctors wont see him now cause he is covered by 3 insurance plans now.

my son cant get the help he needs and its interfearing with school and his daily life

Karen of Medway, MA September 11, 2008

Karen of Medway MA (09/11/08)
2/27/08 Went to ER late night with severe strep throat. Was already diagnosed but antibiotics were not working. Instead of getting better my throat was completely white (no longer jsut spotted) and more alarming, I was having difficulty breathing as the swelling was causing my throat/airway passages to close. Once seen at the ER they immediately gave me a steroid shot and something else to help open my air passages. They suggested admitting me... I declined since I had 2 young children at home. They switched my antibiotic to a more potent one. I went home and 1 week later it finally resolved.

I am the primary card member and had coverage on this date. My ER visit should have been 75. Instead I have a bill for almost 1500 because according to Aetna I did not meet the criteria for an emergency visit I've appealed their decision and have not heard back. It angers me that my throat was closing and I was having great difficulty getting air... yet they do not see this as an emergency. I wish I had agreed to being admitted... this is absolutly ridiculous!

One more thing... I had several throat cultures for myself and family in relation to this illness. We went directly to the lab where we had throat swabs taken. WE DID NOT SEE ANY DOCTORS, yet Aetna charged each of us office visit copays since the building that houses the lab also contains medical offices, so they use a code saying it's an office visit though it obviously isn't. Aetna is the worst company for covering any type of claim. I feel terrible for all those people that are not capable (old, impaired, unable to speak english, etc.)of jumping through all hoops that Aetna uses to avoid paying legitimate claims.

Sarenne of New York, NY September 4, 2008

Sarenne of New York NY (09/04/08)
I updated and renewed all of my insurance information on time, however, when I went to the pharmacy over a week later to pick up a prescription, I was told I was not covered. When I called Aetna, I was told that they are very busy, and that it takes time to process the renewal. I would have to wait until they could process it to pick up my prescription or pay out of pocket and attempt to be reimbursed later on.

Considering the amount of money I pay for comprehensive insurance for my family, this is unacceptable. I paid, on time, and stopped receiving benefits because they are too busy to process my information in a timely manner! I was told that since I called, they would attempt to expedite the processing of my information, and would let me know within 48 hours if it was successful. I wonder how long it would have had no benefits that I paid for had I not called.

Natascha of Farmingville, NY September 1, 2008

Natascha of Farmingville NY (09/01/08)
My health insurance was terminated as of June 30, 2008 because my payment for July was received on August 4, 2008 exceeding the 30 day grace period. My issue is that I was never made aware that my health insurance had been terminated. I scheduled a non-urgent doctor appointment in August that could have waited. I was made aware a few days after my appointment that I had no health insurance and was billed for over 300.

After calling Aetna on August 19th and asking what the problem was they said I had been terminated and not covered since June 30th. I asked and demanded to know why I was not told and why a termination letter was not mailed out. I also inquired as to where my check was since it was the middle of August and I had not yet received a refund. They said that an invoice was created on August 14th. On August 20th I received the termination letter and refund check, almost a month after the 30 day grace period.

I have no health insurance coverage and I am stuck paying a bill of almost 400 for an office visit that was not urgent or necessary this month.

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