Aetna
Reviews and Complaints

Very hard to get anyone to respond to a phone call.To change your demographics or make a payment!

i have had this insurance for over 10 yrs. claims paid swiftly, very helpful customer service, i have been very pleased with this Co.

Aetna has been issuing payments incorrectly to an individual provider in our group, instead of to group as credentialed, since october 2023. They have also issued a 1099 for 2023 to individual provider. I have called, emailed, faxed letters, sent messages thru availity, tried dealing with our local provider representative - christopher baker, for 6 months without resolution.

I am having trouble canceling my policy and they continue to charge me. I followed the instructions to cancel the policy by sending it back within 30 days, but I am still receiving bills. I requested information from Continental Life because they were using the name ***, and I provided my information. However, I was informed that I had 30 days to review the policy. I received the information on February 27, 2020, which stated that I had 30 days to examine it and send it back to the home office. I mailed it back on March 6, 2020, but I am still receiving bills. My daughter-in-law spoke to them on March 20, 2020, but did not make any progress. I do not want or need this insurance. My account number is ***XXXXX.

This company keeps failing to acknowledge receipt of payment. My mother who is 90 and in a nursing home misplaced the billing for the quarterly payment due. Family is currently unable to get into the nursing home to be of assistance. When we realized the payment had not been made I called the company. I explained the situation and was told this is not a problem. I asked for the address to send the payment. This was on Aug 19th, and I sent the payment the next day(due date was Aug 5th). It turns out I was given the wrong address for payment on this type of policy. I called once about the end of August to see if payment had been received. After a long time on hold I was told payment had not been received/recorded. I was told that a notation would be attached to mom's file to note the payment being sent and my follow up call to verify receipt. I tried again about ten days later. After a long hold I was told payment not received/recorded. At this time I insisted this be resolved as I was getting lapse in policy coverage notice. I was told to ignore that and mom's file would be notated as to the renewed effort to verify payment. I was still not pleased with this response since I was getting lapse in policy notice. I was told it might take a month for a payment to be recorded. I called again today, Sept 24th, and after a long hold I was told payment not received/recorded. I asked about the notice of lapse in policy. I would have to fill out a form and blah, blah, blah. At that point I ended the call. I felt I should go through the BBB to hope to have any chance at a real resolution of the matter. Mom paid a lot of money over many years to have this policy. Continental Life is going to give her aneurysm. Please help. Product_Or_Service: Insurance policy Account_Number: XXXXXXXXXH

This is the worst company, the worst service, and the worst providers. The representative even insinuated that I was a liar, so, they just don't care. I called to request a doctor in their service and made an appointment. A month and a half later when I made my appointment, the doctor's office said I needed a referral from a doctor that I never met, and from a doctor that couldn't be reached by me or the staff of the doctors office they said was on the list of providers. Also, it took 20 minutes for them to find a representative who spoke clear English, seems they can only afford an overseas staff. Beware of Aetna...

I have the highest Aetna coverage with the gold plan PPO and I work for the state of Delaware and their customer service and lack of communication is appalling. I have called numerous times and the reps do not know anything and the supervisors never call back. It is beyond frustrating. The copays are outrageous and there is no rhyme or reason to the amounts they reimburse. No one can answer my questions or explain the reasons for this. It is the worst company I have ever dealt with.

I have called everyday to member services for the status of an ordered MRI without contrast and every time I am told they need additional clinical notes. Additional notes were sent over by American Imaging and by Dr. Peter Skaliy on 8/11, 8/12, 8/18 and again on 8/21. I still do not even see a pending authorization in my account. I am being told again today that additional clinical notes are needed AGAIN! This is a stall tactic and I am not going to sit and let this go by. Next I will write a complaint to the Board of Insurance Commissioners office.

My daughter, Madeline Barker, needed an MRI. We went through all of the hoops to get it preauthorized. Then the claim was denied because she went to the wrong facility. Vancouver Clinic, in Washington state, has several locations. They do this so that patients can go to the facility that is most convenient for them. My daughter went to the one closest to us (20 minutes away) and it was denied because she as supposed to go to the one that was over an hour away. Now where on the approval letter did it state that she needed to go to a particular address. My appeal was denied and that was how I found out about the particular address.

The MRI shows a torn Labrum, which requires surgery to repair.

Today, the surgeon was told that the surgery was denied. That it didn't fit "your parameters". My daughter is 20. She can't run anymore because of the pain and can only walk short distances. What parameters deny a 20 year old surgery? Please explain.

I will never have this insurance again and I tell everyone that I know how horrible it is. You have cost me thousands of dollars because you deny everything.

Placed an order on April 1 , Order #[protected]. Never recd. Called and replaced order through representative on 4/26, order #2665949. Recd the #266 order; however, one item was missing … Fungsl Nail Renewal Treatment 25.00. I assumed I would be given credit for the item because it continuously shows it is out of stock. Never recd credit. Contacted your ofc yesterday. Spoke to 3 different representatives. (1) Advised me that I needed to talk to my Aetna Medicare Rep abt the issue. Didn’t sound right to me! Was transferred! (2) Poor Aetna Rep knew right off the bat I had been transferred incorrectly. Returned me to the original team. (3) This gentlemen explained to me you didn’t have a procedure in place for this type of problem and if I could give him another item he would order it for me! I advised I would call back. I know that 25.00 is not a great deal of money but how can something so easy to correct be made so difficult. I just asked for my credit to be returned to my account. Thank you for listening.

Per DMR Dental Benefit, (Direct Member Reimbursement) can see any licensed U.S. dental provider. Have a max of $1,000 per year. Saw dentist 2/23/2023 and 3/22/2023. I paid All in full to dentist, $606.00. Followed and submitted to Aetna all receipts, codes, dates of service, all required information and sent to appropriate Aetna address, TX for reimbursement. Yesterday, per login into Aetna and calling on phone, they are only sending me a check for $303.00 (They stated, "Out of Network" thus paying only 1/2.) They can't have it both ways from "seeing any licensed U.S. dental provider" to "Out of Network" and thus only reimbursing me $303.00. I don't dare deposit the $303 as I don't want this to be construed as "settled".

I had a ten minute virtual visit with the CVS Minute Clinic on 1/11/23 which should have been free. The Claim ID is EMTX3PQ74. The Explanation of benefits statement I was sent shows I saw a specialist for 30-60 minutes and my credit card was charged $40. My plan had $0 Telehealth so I should not have been charged for this visit. CVS Minute clinic says they filed the insurance correctly. I spoke to an agent at Aetna on 1/23/23 when my card was charged & she said my visit should have been free and that my card would be refunded within 30 days. She gave me reference number [protected]. On 1/26/23 another Explanation of benefits statement was sent saying I owed $40. I called Aetna again on 1/27/23 and was told the same thing and another Explanation of benefits statement was sent on 2/2/23 with the same error. I spoke to Roseanne at Aetna on 2/3 Reference #[protected]. She said it should have been a covered service with no copay, co - insurance, or deductible. She promised to rework the claim and call me within 24 hours but she never called back. Every time I call they say the same thing and assure me that my insurance covers telehealth and that it would be corrected but then I get another incorrect Explanation of benefits statement billing me like I saw a specialist. I did not see a specialist, I saw a Nurse practitioner through the CVS minute clinic virtually for less than ten minutes. My credit card was wrongfully charged because this was a covered service that Aetna should have paid for. I want the claim corrected and I want to be refunded the $40 I was charged because of the error. After them filing the claim incorrectly three times I canceled my coverage and decided to file a complaint. Page 12 of my Schedule of benefits says: Telemedicine consultation for non-emergency services 0%, no deductible applies.

I have tried several times to find away to speak to customer service regarding this card not working properly to an avail and no response now I have used up all the minutes on my mobile phone service again attempting to resolve this now I dont have phone service so speaking to someone over the phone is not possible I also used the benefits last year to pay my mobile phone bill I tried getting on the website to resolve the problem but I cant sign in and have made several attempts and I assume now I am locked out which adds to my frustration since I am now limited to using the internet to communicate with anyone I will have to wait to receive my monthly SS benefits in order to pay my phone bill but until the benefits arrive I am without a phone and limits my ability to communicate with anyone including emergency services if needed please tell me what and how can I resolve this problem I have also sent a message to Aetna via the website and am waiting to get a response from them

I had an annual (2022) mammogram as recommended by my primary health care provider. I went to the same imaging center as I had gone to in the past (including 2021-twice). This mammogram was well beyond the 365 days required between mammograms. I received a bill from the imaging company along with an EOB telling me my claim had been denied. The reason? The imaging center was out-of-network and required a referral or precertification. (Remember that the previous year's mammogram at the SAME imaging center had been covered.) I was told by AETNA that I should have verified that the imaging center was covered. Apparently, AETNA arbitrarily reclassifies health care providers and it is up to us to verify each time we see someone to verify they are still considered in-network. On appeal, the claim was again denied.

Both my wife and I are SilverScript PDP customers and have been for several years now. Both our accounts are paid automatically through our bank bill payment services. A recap of the days it takes Aetna to process our payments between November 2020 and December 2023 reveals it took as few as 9 days up to 29 days for Aetna to acknowledge the payments. In 27 months the average days for Aetna to process our payments is 15 days. Between November 2020 and May 2021 the payments were sent on the last day of each month, and payments took between 9 and 17 days to process. We backed the payment schedule to the 25th of the month before the due dates beginning June 2021. In February 2022 we received the first of two nasty letters from Aetna saying if we didn't pay up we were going to be disenrolled. I contacted Aetna and they said they had received the payments although they were received late. Between June 2021 and February 2022 it took between 10 to 29 days for Aetna to acknowledge the receipt of the automated payments. Beginning in March 2022, our payments were further backed up and sent on or before the 23rd of the month before the due dates. Since March 2022 and January 13 2023 it has taken Aetna between 12 and 21 plus days (we are still waiting for Aetna to acknowledge the payment sent on 23 December 2022) to acknowledge our payments. I am writing this complaint in response to the second nasty letter sent by Aetna, dated 13 January 2023, threatening yet again to disenroll both my wife and I from SilverScript Choice PDP insurance. Aetna A further investigation into Aetna's account receivables indicates that when we sent our payments in on the last day of the month it was taking 12.9 days on average for Aetna to acknowledge the payments. When we backed the payments up to the 25th of the month Aetna's accounts receivable took on average 15.6 days to process our payments. And we got a nasty letter for taking action to get the payments in Aetna's hands sooner. Since we have backed up the payments to the 23rd of the month Aetna's accounts receivable are now averaging 16 days and counting to process our payments. It is impossible to comprehend how Aetna's accounts receivable are not held accountable for negligence when it comes to both cash flow and customer service. This needs to change. I am, we are asking Aetna to square this chronic problem away. And please, enough with the nasty, threatening letters.

We have been submitted our claims both via fax and via mail. Due to our patients getting chemotherapy. Most of the claims are billed on multiple HCFA Claims, for only 6 charges can be billed on one HCFA Claim Form at a time but there may be 2 to 3 pages (claims). Each claim number 1 of 2, 2 of 2 or 3 of 3 pages. After Aetna receives our claims, they are being split into multiple claims and then maybe a few charges will process from one of the 2-3 claims, then then the other charges (claims) on the same day will deny: looking for a parent code or will deny looking for medical necessity (medical records). All of our claims over $2000 are billed via paper with the medical records and if applicable with a copy of the primary EOB. When Aetna processes these claims they are again split and denied for additional information needed or need copy of the EOB and now we are seeing denied for "No Authorization" but an auth is already on file. We have even had claims keyed into Aetna's system with the wrong dates of service or wrong billed amounts, then we have to call and request to have our claims reprocessed or do a dispute for Aetna's errors. We have over a million dollars in outstanding claims and are looking for legal action now. We will be getting our patients/ your members involved and they will be getting billed for all services not paid by Aetna. We do not understand why this is happening to or "BIG DOLLAR" amount claims only. On our end its just another stall tactic for Aetna to make more money or to push balances on the members hoping that they will not complain.

The first card was very useful! I shop with Aldi and they accepted the first card with no problems. I could also buy gas with my first card. Great plus! My brother tried his at Walmart and it did not work and the explanation was that "something is wrong in Walmart's system." LOL. I think the glitch was finally worked out. My brother also shops at Publix, and I believe they also accepted the card.

The second card comes out and it does not work at Aldi. My brother who also received the card and his does not work at Publix now. It DOES work at Walmart.
He tried calling to get info and he had to hold forever and got tired and hung up.
I registered my card online today and wanted to see which items were available to me to buy at Walmart. I was willing to go to Walmart, even though I shop at Aldi for the most part.

The agent I spoke to, who was not the nicest, walked me through the process and we tried to search for acceptable items at Walmart and "that feature was being updated" and did not work. LOL. That is the same excuse they gave my brother months ago on the first card. LOL.
My brother used his most recent card at Walmart and $3.89 was declined by the card. He figured out that the Triscuits he bought must be the declined item. He said he did not buy any questionable items, and the Triscuits cost plus tax exactly matched $3.89.

It's a great idea! Please get Aldi on board again, let us buy gas and get all of your website functions working so we can check in advance which items are acceptable at brick and mortar retailers.
Thank you.

One of the reasons I transferred from United Health Care OTC $85 quarterly to Aetna for OTC $165 quarterly. Aetna didn't advertise the very "limited" selection of products, or brands(Colgate toothpaste) for OTC products. Aetna does NOT allow purchase of products I NEED during pandemic tissue, paper towels alcohol, disinfectant spray or bleach. UnitedHealth care DID allow purchase of these items. I rather have less OTC to get the products that I need and that's required to be safe.I'm very disappointed with Aetna. I will leave as soon as enrollment allows me to.

My daughter has seen the same therapist for three years, but this year, Aetna denied coverage. I appealed, and it was denied. Trying to talk to Aetna on the phone takes hours of holds and disconnected phone calls with dogs barking in the background and calls mysteriously ending. Aetna makes it impossible to get appeals accepted due to their incompetent phone staff (possibly, by design?) we are switching insurance plans this year.