Aetna Health Insurance

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Robert of Morton, PA September 17, 2009

I would like to file a complaint against Aetna Insurance, (LTD), for failure to act in an appropriate manner regarding my current application for long-term benefits. I have been out of work since February 12, 2009 with an injury, and paid for LTD insurance while I was at work. I filed for LTD in the middle of July 2009, and as of the above date, Aetna has still yet to make one payment to me. I am entitled to this insurance since I paid for it, but Aetna has failed to make good on it. They continue to make excuses. They have incessantly stated that they must investigate to make sure my injury was not a pre-existing one, which they should have found out by now that it wasn't, and when you call to find out, my caseworker Jennifer does not return calls.

After reading many stories on the Internet about Aetna, I am finding that many other people have had the same experience, whereas Aetna has come up with excuse after excuse for not paying the injured party. This should not be allowed to go on like this. People are entitled to insurance they take out in just such an emergency. Aetna is collecting people's money but not giving the insurance that was paid for. I have supplied everything they asked for, in a very timely manner, yet they have come up with excuse after excuse. I am planning on writing letters to every committee person I can, every Internet portal, news agency, chat site, newspaper letting them know how Aetna treats its customers. I am entitled to being paid and Aetna refuses to do such, but collected my money for the last few years.

Julia of Philadelphia, PA September 15, 2009

I am a retiree of AT&T Communications on Medicare. After thorough investigation and research on my part, I was told by an Aetna Health Insurance representative that I would not get a much needed shingles vaccine because I was on Medicare. Aetna administers the AT&T health plan(s) services to AT&T employees/retirees. Aetna informed me that they would cover only employees/retirees NOT on Medicare. Medicare Part B does NOT cover shingles vaccinations. One must have Medicare Part D to get the vaccine.

I do not have Part D because I have private secondary insurance and prescription coverage from AT&T. I asked for a one time exception by Aetna/AT&T in order to get the vaccine, but they refused. I will pay out of pocket over 200. for the vaccine which requires special packaging for refrigeration.

In addition, I will have to pay my Primary Doctor fee (over 100. dollars,) to administer the vaccine. The risks involved in not getting this vaccine is too high. Furthermore, the cost for the vaccine would be far less than to treat the virus once it has been contacted. I am in my 60's and need this preventive measure in order to avoid this very painful virus.

michael of Old Greenwich, CT September 9, 2009

very rude kept saying a refund check was in the mail for 3 months. called back said they never recieved fax of claim. had names and id # of people i spoke to. every time i spoke to a new person they would say all the other people you talked to were incorrect.

J. of Milford, PA August 27, 2009

Because I will be 55 in September, Aetna sent me a notice that they are raising my monthly premium more than 25%. I have never been hospitalized, nor had a major illness, don't smoke, my weight is fine, etc. The cost is prohibitive and seems exploitive. Is there anything I can do?

Sandra of Chicago, IL July 25, 2009

Here is my situation: I began my insurance coverage with Aetna on Feb. 1, 2009. On May 11, 2009 I canceled my insurance coverage with Aetna. I did this first over the phone and later via email (see the attached email below). I called Aetna again on May 18, 2009 to confirm that my policy had been canceled. I was assured that this policy had indeed been canceled. My initial payment (for February 2009) was made by check, all other premiums were supposed to be deducted automatically from my checking account. March 2009 was deducted on schedule from my checking account. Somwhere at Aetna things went badly from this point. I am now told that Aetna FORGOT to withdraw my premiums from my checking account for April 2009 & May 2009. I was just made aware of that fact today (two months AFTER I canceled the policy).

Around June 21st I received a statement from Aetna stating that I was being refunded 508.00. SURPRISE! I called Aetna and was told it was for my June 2009 and May 2009 premiums - since I had canceled in early May 2009. I though this was odd, but was assured that it was because they had already withdrew funds for May 2009 and June 2009 from my checking account (prior to my cancellation). I accepted their explanation and my refund. To add further insult, instead of CANCELING my policy as I requested by phone and email (see below) it appears that some incompetent employee VOIDED me and all record of my insurance out of their system. According to Aetna, this means that the bill they should have covered (for February 2009) to my Dr. for 150.00 is being rejected. This fraudulent and negligent act initiated the 508.00 refund (that I did not expect) and the refusal of the claims for services performed in February 2009. THIS IS FRAUD and it is illegal. You can not pretend that I was never a member and you can not deny coverage when I had paid the premiums for the month and the month that followed. Isn't that fraud. suppose I had had surgery during that time. the bills would be more than 30,000.00. I would loose everything.

After two days and no less that 6 phone calls, I finally spoke with someone that understood the problem. Cheryl handled my call very professionally. She took my information and worked very quickly to assess the situation - no small feat considering I was one step away from contacted someone at the Chicago Tribune. She then connected me to Kristine. Kristine also handled the situation very well. Let me be clear - I do not blame either of these ladies for the ridiculous and incompetent way this fiasco has been handled. Having said that, when Kristine suggested the Aetna way to fix this problem that Aetna had created I laughed out loud. She was told to suggest the following: In order to get this 150.00 claim paid I would need to #1 give the 508.00 back to Aetna (they believe it's a refund for February 2009 and March 2009 premiums), #2 pay 254.00 for April 2009 premium and 254.00 for May 2009 premiums. To recap - aetna wants me to pay 508.00 (that they refunded me in error) PLUS 508.00 for the two months that they were supposed to withdraw from my account in April 2009 and May 2009. All of this to cover 150.00 that was supposed to be paid nearly 5 months ago. SERIOUSLY?!?

I think Aetna owes my Dr. 150.00 for her claim in February 2009 + any interest that she is owed for carrying this delinquent bill on her records for nearly 5 months. Furthermore Aetna owes me for the stress, mental anguish and the 4 hours of time spent on the phone on 2/23/09 and 2/24/09.

Denise of Avalon, NJ July 10, 2009

Aetna refused to cover out of network costs specifically for the hospital. They only covered the doctor. Since Aetna was found negligent in not covering out of network costs in another matter, do I have any recourse in forcing them to cover the costs instead of my having to pay additional cost to the hospital?

Chrissy of Lexington, IN July 8, 2009

I sent in my prescription for my son's medication. I have been getting his 90-day supplies of this same medicine, from the same doctor and this same pharmacy, for over a year. However, this time the doctor neglected to write the prescription for 90 days and accidentally only wrote it for 30 days. This was an obvious mistake and should be very easy for the pharmacy to detect. Why in the world would a I intentionally send in a 30-day prescription and pay a 90-day co-pay? Why would I WANT to pay 300% of what I would normally pay?

I feel there should be checks and balances in place to catch obvious mistakes such as these. I was told it was up to ME to make sure the prescription is correct prior to mailing it. Considering I am mainly concerned with getting it in the mail so that my son doesn't miss a dose of medication, I don't feel it's fair to place 100% of the burden on me to make sure my doctor wrote the prescription correctly.

The sad thing is, there is an easy fix to this obvious mistake. I simply have my doctor fax a correction to the pharmacy and I get my missing 60 days of medication. However, the pharmacy refuses to give me any retribution whatsoever. They know a mistake was made, but are thumbing their nose at me. Their explanation is pathetic. After all, I AM the customer everywhere you look in this situation - to the doctor and to the pharmacy.

Fatimah of South Holland, IL July 8, 2009

I contacted Aetna's Behavioral Helath Department in December 2008 for a referral to a counselor for stress related issues. I started seeing the counselor soon after but had to stop because paying a co-pay for going three times a week was too costly. I called Aetna to see if there were any other programs that I could attend. I specifically told the representative that I could not afford co-pays. She recommended a 6 week program at a nearby hospital. She told me that I would have to attend everyday from 8am-4pm and that everything would be covered 100%. I started the program that next week and was there for 32 days.

To my suprise, after the program ended I received a bill from the hospital for 640. I promptly called in to Aetna to ascertain the problem. The rep told that I was charged the staandard co-pay for everyday I attended the program. I informed her that I was told that I would not have a co-pay. She rudely told me that it wasn't her problem. I then asked to speak to a supervisor. The rep infored that there was no reason to speak to a supervisor because they would tell me the same thing that she just told me. I told her that I didn't care what she thought the supervisor would say amd that I would still like to speak to the supervisor. She asked me to hold and then hung up on me. I called a second time and asked to speak to a supervisor. I was told that she was busy and that if I left a voicemail my call would be returned. I left a voicemail and of course I never received a call. I tried again a couple weeks later and was told that the manager was in a meeting but that she would return my call shortly if I left a message. I left a message and still no return call yet.

This is very frustrating. No one has the time to constantly call and try to rectify someone else's mistakes. What is the point of them having a job if I have to do it for them? This is not the first issue I have had with Aetna. They are the worst insurnace ever.

Alan of Santa Barbara, CA July 1, 2009

Incompetence at all levels. Random cancellation and reinstatement of policy. Failure to pay claims in timely manner, resulting in dunning notices to patient. Employees answer phone but keep no record of the call. Repeated requests for prescription refills from Aetna Pharmacy are ignored, lost,... I hate these people. I wish they would all drop dead. The CEO does not deserve one dime, and the employees are so incompetent that they should all be fired. A bunch of outright liars.

Norman of Amarillo, TX June 23, 2009

I have an Aetna Select health insurance policy through Cobra. This Spring my primary care physician dropped out of the Aetna network. Aetna did not advise me, or any other insured members who used him as a primary care physician. When I learned, quite by accident that I no longer had a primary care physician, I called a physician in the network and asked that he be my primary care physician. I needed a physical exam at the time. He, of course, wanted to meet me before agreeing to be my physicial. I met with him. He agreed to be my physician and offered to do a routine a physical at that time.

Rather than making an appointment to come back, when I was already there, I got the physical and he submitted the paperwork, showing himself as my primary care physician. I have since received a new insurance card listing him as my "pcp". However, since he was not shown on Aetna's records as my "pcp" at the time of th physical, they won't pay for it. I will pay the doctor for the physical but will argue with Aetna until I run out of breath! This is typical behavior or a greedy for profit company.

Aetna is relying on a technicality to deny coverage for a normally covered routine physical condicted by an approved doctor in the Aetna system simply to save money. I can afford to pay the doctor. But, how many other small claims are denied by this company for no good reason other than to make more money? My claim is small, under 200.00, but when they deny a few thousand small claims because of technicalities, they make a lot of money and many who submit those claims suffer because they can not afford to pay for the services themselves.

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