CommentA year and a half ago, I was found to have two large (grapefruit-sized) tumors on my ovaries that needed to be removed immediately. I had continuous insurance coverage (since I was born) with no gaps, and obviously this wasn't some pre-existing condition. Still, when Aetna asked for the name and contact information of my general practitioner, my husband and I were completely forthcoming (knowing full well that there was nothing in my prior medical history to indicate a pre-existing condition). First, an Aetna rep told my husband it was sufficient to give them information over the phone. After several weeks with no indication that they had paid for my surgery, my husband again contacted Aetna, at which time he was told "oh no, we need the GP's information by email". So he emailed them (several times). Again, the same story - this time he was told they needed the information in writing. So he send my GP's name, address and telephone # several times. AGAIN, same story - this time he needed to fax the information. It took Aetna EIGHT MONTHS to pay for my surgery, and that was only after my husband and I started calling daily.
Recently, I had a CT scan of my sinuses and was told by my ENT that I need sinus surgery immediately. Unfortunately, Aetna told my ENT's nursing staff that they wouldn't cover the surgery - they said for the office staff to send in a pre-authorization request, they would take 20 business days to review the request and "we're going to deny the claim anyway." After the nurse told me what the Aetna rep said, I called personally. I calmly (never once yelling or cursing) asked what they would cover. After being transferred to a supervisor, she told me "no one would have said they wouldn't cover the surgery" and she hung up on me! When I again contacted my ENT's nurse (two weeks after my surgery was supposed to have taken place), she said that she had submitted the pre-authorization request three times with absolutely no indication of reciept from Aetna. She had also been calling DAILY, had left daily messages, and has yet to receive any response whatsoever.
 Comments (2) |  |
| 1. Written by Aetna Stinks, on 27-09-2008 23:52 I've been having problems with Aetna too! I've been on Aetna insurance for years and I had laparoscopic surgery last month for endometriosis. I have a $1,000 deductible, which I was prepared to pay, but when the claims were sent to the insurance, I got bills amounting to $5,000!!! Apparently the claim number from the hospital wasn't valid (whatever that means). So I called and the lady I talked to said she "couldn't find" laparoscopic surgery as a surgery. Now, I KNOW I'm not the only person to have this surgery. It's very common for women my age! I think these people are just stupid. I don't even know what to do with a bill that large...I can't pay for it and trying to explain that to an insurance rep is like trying to explain to a shark that you really don't want to be eaten. They just don't care! Some days, I'd take the shark over Aetna, though. |
| 2. Written by Angry Customer, on 20-08-2008 11:48 I also have Aetna's insurance, and it's very bad imo. I had an MRI scan in November for my knee and they sent me paperwork in December to fill out for a pre-existing condition and previous medical insurance. I called and asked and a rep told me not to worry about it. I moved and the papers were either lost in a shuffle or thrown away so I called back. I was told again, not to worry. I received a few bills from the MRI so I called back. I asked for the papers to be sent and the fourth month (yes, four months I called every 10 days) I was told I didn't need it, just that I had to fax the paper! So I finally got my old insurance company to send it to me. I faxed Aetna and called to make sure it was received. I got ANOTHER bill and so I called and was told that my papers were NO WHERE TO BE FOUND. THEY LOST MY PAPERS! So now I have claims going to collections! I have so many that I cannot keep up with CALLING them all EVERY week because of Aetna. And when I ask to speak to a manager, I'm told that no one is available. I refuse to speak to a rep anymore because of this...They're so frustrating. |
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