Aetna Health Insurance

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Friede of Mesquite NV (11/02/07)
I have cronic back pain that requires injections to my back which Aetna covers they even cover the doctor that will perform them however the trouble is that the surgical center that the doctor uses is not covered. I am not sure why you would cover a doctor that can see you and diagnose you but cannot treat you. I called to find out what to do and they gave me a number for my PCP to call to get an out of the network approval to try to get the surgical center covered so I called the PCP to get it started.

The PCP called and try to get it approved but they were asking for surgical codes which they didn't have because they were not the doctor that was performing the procedure so she thought that she started the claim but what I later learned is that according to Aetna she didn't. I then called the doctor that was going to do the procedure to let them know that they needed the codes and to call them with that info which she did. Then they called me back to tell me that the claim wasn't started so I called the PCP back and she called again this cycle went on for three days.

Finally I called Aetna back and said that this system isn't working and they needed to figure it out because everyone was calling them and they had no record of it. They also told my PCP I had been terminated for my health care which was not true. They are laughing all the way to the bank cashing my premiums so I should not be terminated.

Aaron of De Pere, WI September 5, 2007

Aaron of De Pere WI (09/05/07)
Aetna/SRC has been delaying the processing of my claims and in some cases, not processing at all. I've been going through this with SRC/Aetna for over 8 months. I contacted my state office of the Commissioner of Insurance. At that point, Aetna/SRC processed some of my claims. However, once Aetna/SRC realized that my employer is based in Maryland, the have continued their non-processing. I keep filing and each time I follow up, I'm told they will be resubmitted, but when calling back, they never have record that I spoke to anyone.

All of these claims were for mental health maintenance prescriptions. I was diagnosed years ago with Bipolar Disorder, ADHD, and General Anxiety Disorder. As a result of not getting reimbursed for prescriptions, I am now not able to afford these medications. This has impacted all aspects of my life. My job performance has suffered; my mental health is at an all time low. I was engaged to be married but my fiance has since called off the wedding. All aspects of my life have gone downhill as a result of this.

Lisa of Marathon, NY May 18, 2006

Lisa of Marathon NY (05/18/06)
I was in the process of starting allergy injections and was not familiar with the insurance. I called to verify my coverage and they said that I would not have a Co pay due to it was not an office visit. I all the sudden started getting bills for my Co pay. When I called Aetna I was told that it was very unclear and did not come out and say that there was a copay and she did see where i was told that there would be no copay and that she would re submit the bills and if any problems she would call me. I waited a week and never heard anything.

I called again and was told the same thing that this women saw where there was a note saying i was told there was no copay and sent a message to please process the claims and she also said it was unclearly stated in my coverage and not to stop getting my shots that i needed them and it should be ok. I called today and was told no they are not covered and it was an error and they were not going to pay for them and the lady laughed at me as i was telling her that i dont have all this money to pay to catch this up, but would find a way.

I went into the doctors office and told them what had happened and they looked at the notes from billing and said the billing person had also called aetna and was told yes she was told there was no copay but that was and error and we will not cover the injections fully.

Now I have one bill and will be getting more to pay for the days that I did go and have to stop getting my allergy injections. I was tested for over 60 things and had reactions to all of them. I am taking medicine for my allergies and alburterol and advair for the asthma that i suffer from that the allergies contribute to. I now wasted all this money for treatment that I can not continue to afford to pay for so can no longer get.

Lori of Southampton, PA May 16, 2006

Lori of Southampton PA (05/16/06)
Aetna has repeatedly denied/ignored requests for medical services and medications needed to treat two herniated cervical discs. They claim they have not received proper request forms in spite of repeated submissions of requests. It has been 4 months since my initial injury and I have filed two formal grievances.

Ongoing severe pain and emotional stress related to lack of responsiveness of Aetna. Inability to access services needed for physical therapy. Inability to access medications prescribed for treatment of condition and pain management. Need to spend countless hours of time in trying to resolve these issues, and still finding no resolution to the issues.

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