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#1 Issue: ongoing since January 2016 is that Aetna Network Management indicates to my provider his reimbursement is $80-84; yet Aetna continues to process claims only paying provider $55. Week after week, month after month, Aetna has not resolved this issue. #2 Issue: really takes a long time to dispute claims, have claims reviewed, re-processed; something that should only take a few days takes 2-3 months or more. #3 Issue: customer service reps... Read more

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I have to switch to Aetna because of work. I have had a heart condition for 13 years. $ years ago my cardiologist prescribed a new medication because the one I was taking wasn't working. In this time period 3 insurance companies paid for it but Aetna denied it asked for documentation from my doctor which he sent, they again denied it saying we need 1 month proof of failure. I guess they want proof that I will dead then okay. Same thing for... Read more

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  • From mobile
  • Sep 13
  • #918113

Iwas suppose to receive a claim form they said they sent it august 26 2016 its been 2 weeks nothing i called again sept 11 she said they were sending another one my father died july 28 2016 i sent in everything they ask for. He was insured for 1,000 dollars and yet iam having ahard time collecting why hadnt i received the claim form . Poor business

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Aetna reps give false information so the company does not have to pay bills. I'm federal employee who has Aetna insurance and called the 800 phone number to verify that a doctor was in network and they told me he was. After I used the doctor now they will not pay bill the because they made a mistake and he is not in network. Costing me over $2000.00 I have Aetna HMO and they told me that I can only use doctors in the state where I work... Read more

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I have Aetna as my health insurer. I had back surgery last year due to an ongoing condition. My deductible was paid, as well as my out of pocket requirements. I had the surgery pre-authorized by the surgeon and hospital. I used an "in network" surgeon and hospital. I understood that the entire bill would be picked up by Aetna. Afterwards, I have been left with thousands of dollars of unpaid medical bills. Aetna paid the hospital and... Read more

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My mother, a 70yo public Ohio teacher was coerced into a AETNA Medicare Advantage plan through STRS last year when she retired. She was told this was a supplemental policy that would cover the additional 20% of Medicare remainders. In addition, she was further upsold for the "best policy". Last week (her first claim) she had an accident where she fell and had 2 compound fractures in her leg and required immediate surgery. The hospital told us... Read more

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Aetna has thoroughly messed up a wellwomens exam and basic labs (all normal, 32yr)- both preventative care, both covered at 100%. Have gotten many bills with different amounts over the course of 4-5 months, spoke to many people, put my claims into "review" as preventative care not tier 1 coverage, hopefully will be straightened out soon. I will give POSITIVE feedback to Customer Service Rep - Laura Blanks, she was able to understand my problem... Read more

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I've been insured twice with Aetna International while working abroad. While the website has evolved somewhat over time, the claims process remains absolutely abysmal. On the positive side, the coverage was pretty solid, the deductible was low, and not much was disputed from Aetna's side. However, virtually every claim I filed was mishandled in some way and required follow-up, sometimes five or more times for a single claim. Sometimes all... Read more

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I had to go to urgent care for a broken foot. I paid everything myself with a credit card, submitted the claim to AETNA to get reimbursed. I have called them maybe 25 times and each time they have a different excuse why they can't pay me: your doctor gave a invoice that is not right, wrong code was put into your account, the bill was not itemized correctly etc. numerous *** excuses and I jumped through hoops overtime getting them what they... Read more

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Worst insurance ever, can't get answers from misinformed customer service that are poorly trained. Getting medical care is a *** shoot , you think your covered by maximum benefits only to find out its not. One Hospital with same name at one location is max benefits but the other hospital with the same name but a different location , four miles down the street is not and its $2000.00 higher deductible , where the surgeon has privileges at same... Read more

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