Aetna
Reviews and Complaints

I tried for many hours to get some information on my existing F’in accounts and was told they were closed. WTF-I hope you understand what that stands for. We are in the middle of the Medicare selection period and not only will I not use Aetna, but I will actively discourage all of my friends and Associates to avoid Aetna. I am not a subtle disappointed client, but I am a very proactive client who will do my best to affect your bottom line.. YOU SUCK!

I had covid in December, before Aetna Medicare, I still have trouble breathing, so my Dr ordered a follow up cat scan. Aetna decided I wasn't worth it and denied authorization. So I guess if I wind up in the hospital they can just pay for that instead. I am actively looking for other insurance providers.

I changed from railroad retirement Aetna Advantage Plan to a new plan with Aetna, Advantage Plan on January 1. My husband died 11/24/2021. I am being charged the full rate each month of $170.10 Plans A & B deducted from my social security. I have called Social Security numerous times and they said that Aetna instructs them on the type of plan I have to initiate the correct deduction. I call Aetna and get the runaround every time. They always blame Social Security. Social Security can only issued checks for the correct amount - depending on the type policy I have. I should be receiving about a $35 discount for having an Advantage Plan but I am being charged the entire $170.10. I would appreciate someone checking into this and advising my next step. My cell is [protected].

Sincerely,

Lynne GErisch

I had a sciatic event the morning of 12/20/22, saw my doctor he prescribed muscle relaxers to add with my NSAIDS, byt the evening it got worse, so I saw him at his urgent care 12/21/22, where I prescribed steroids and Percocet, and he ordered an MRI, since I was also getting tingling down my leg. I saw his ARNP at his urgent care on12/27/22, and she put me on another round of steroids for the now numb parts of my leg and foot, and we were waiting on me getting my MRI, I saw him again in January, when they wanted info from him, and I still had the numbness in my lower leg, foot, and toes. it took almost a month to get my denial, for lack of treatments, but my doctor said we cannot treat if we do not know what we are treating! My doctor has suggested I seek legal help to resolve this, as he feels it is medically necessary for me to have this MRI, and they have no reason to deny it. I am worried since my left side is starting and I do not want numbness in both feet and legs, I walk crooked as it is! I need my MRI!

Ever since silverscripts was bought by Aetna, the customer service is non existent. Beware, and change your plan if you can during open enrollment. Wait on hold forever for someone to answer, then they just hang up on you, happened 4 times this summer, then called them today to see why the yearly prices medicare quotes is 2, 200, and Aetna says I will pay 14, 000, awful huge difference there, 3 people who asked me my name, birthdate, account number before finally transferring me to pharmacy, who never answered, recording said my wait had timed out, but they had time to give me a survey, which I entered as strongly dissatisfied on every question, then it hung up on me. People on medicare don't need to deal with this kind of grief from an insurance company, go elsewhere.

I was talked into getting supplemental insurance to go with my Medicare. I was not told I could get a better policy and pay nothing for it. My wife was upset she told me not to go through with it. I thought the broker would know more, so I did. Than after a month I spoke with a man on the phone that told me the same thing my wife did. I was being set up to pay for what I did not need. It was cancelled but had to keep it 4 more months until January. I noticed even after being cancelled they still were taking money out of my bank account. I called and told them. The lady said it had been cancelled but I still wed a month. Fine yet the next 2 months they took 2 more months out and I found I never did even owe for January. I called my wife called and they persisted on telling us it was never cancelled. They did the same to 3 other people I have spoke to.

For years I have been getting haluronic avid injections for the osteoarthritis in my left knee, but they have ceased too be effective. Aetna declined coverage for the recommended total knee replacement. Their argument was that I had not completed 24 weeks of approved treatment. I have had the approved treatment injections for years. The suggestion that 24 weeks on a walker will allow my knee cartilage to regrow is ignorant, willfully deceptive, late in coming, and the reviewing doctor should have his license revoked for incompetence. There is a peer review. Of the decision is not reversed I will sue the [censored].

Since october 7th i started the claim on my fathers life insurance he passed away in sept. sent in what i needed to claim it always getting the run around been calling every two weeks since then. They do not reach out to update you You have to call them. two weeks ago they stated claim was approved- and a check will be cut. I call due to not receiving two weeks later they tell me it was denied and i have to fill out more paper work to make the claim. This is unacceptable to take 6 months to claim life insurance my father paid for to take care of his family...

On August 12 my husband was admitted to area hospital for a diabetic wound on the back of right leg and bilateral edema.Prior to his discharge it was determined that he was in renal failure and dialysis was needed.After his first or second dialysis treatment both arms became swollen.Also both knees.I was informed by his doctor that dialysis caused his gout to flare up.He was in so much pain that he screamed when you touched him.He was unable to walk or feed himself.I decided to send him to a area nursing and rehabilitation facility to regain some of the mobility in his hands and legs.He was admitted on August 16.It took the rehab facility until August 28th come up with a care plan.On August 29, I was informed that he was being discharged on the 31.Your company decided he wasn't doing enough to qualify for continued treatment. I was told that I could file a appeal. After speaking to your appeals department.I was informed that Peer to Peer conference was required. The facility informed me that Friday at 6pm they unable to contact anyone for a conference.That following Tuesday morning I was informed that the appeal was denied.When called your corporation to find out who they had did the Peer to Peer with
No one could give a valid explanation. That Monday was the Labor Day holiday. So I know there was no conference. While at the facility my husband's condition worsened. He now had a wound on his coccyx and bilateral heel wounds .All of which was seeping.Iwas I told by his dialysis nurse that he his protein levels was too low for him to heal properly. Also he was in so much pain he could not sit due to his coccyx wound.He was sent to another area hospital for wound care.At that time I requested he be evaluated by their emergency room.Since his ability to speak was now mainly yes or no answers.He was admitted .He now has wound vac on his coccyx and his leg wound.The heel wounds are healing but not enough for him to walk yet.And his swelling has decreased in his joints.He is still unable to feed himself .When I requested he be sent to another nursing or rehabilitation center for additional treatment. Your company denied him admission. I spoke to Amy at your corporate office.She informed me he doesn't qualify for rehabilitation due to his condition. Because he is unable to sit without aid.How is he suppose to sit with a machine attached to his coccyx. And regain use of his hands and legs without proper rehabilitation. I was told to apply for Medicaid for him.But since he recieving his pension and social security pay.His income is too high to qualify for it without putting all his income into a Miller Trust account. Prior to applying for Medicaid. Since your company is refusing to pay for any more services .I have no other place for him to get proper treatment while applying for Medicaid. I am unable to care for him at home.We live in a second floor apartment.which was not problem for my husband prior to this. But impossible now.I also work a full time job.And take my handicap son to his part time job. Home health will only cover limit amount of hours.Am I to leave him alone during those times.I also have some health issues that limits my mobility. So bringing my husband home is not a valid option. Since your company refuse anymore nursing facilities. And I can not bring him home without jeopardizing both his health and mine.Personal pay is not a option. I will already lost half of my household income in order to get him qualified for Medicaid. If I have to use my income as well.My son and I would soon be homeless and car repossessed. Neither one could get to work.I
want someone to call me from your headquarters and explain why I am being put in this difficult position. His prior authorization was so short that nothing was done to aid in his recovery before he was cut off.Now you are denying him any additional services. The letter we receive when this plan was activated by Mittal in 2017.Stated we could decline this plan but with cause a potential forfeit of other services from Mittal.It also stated the Aetna had Medicaid plans.What plans and is my husband able to get them in his condition. Is your profit margin so much.That you are willing to bankrupt me allow him to die from lack of proper care.I sure you don't really care.
So I'm sure there will no reply from your company.But please make sure your CEO get a copy of this.I want him to know how his company is making there billion dollar profits.

I filed for Short Term Disability in February.
W0007 23001
Charles M. Michalak

My claim was initially denied stating that Aetna did not receive paperwork from my Doctor. I know that my Doctor completed the paperwork because I viewed it. I also paid $15 for the office to fax it to Aetna.
I was forced into the appeal process. I was told that a third party Doctor determined that my symptoms were not severe enough to keep me from work. Without getting angry, I know what my symptoms are and that they kept me from performing my work. That is why I went to a Doctor for help. Also, my Medical Providers put me out of work and sent letters to Aetna to dispute their findings.
I am now in the middle of the second appeal. I have worked for UPS for 40 years and rarely used my benefits. The only time I really used them was for my mental health due to my divorce. My Doctor has diagnosed me with symptoms that she states keep me from working. At the last visit, she increased my medication because I was increasingly anxious due to this situation. I have insurance through my benefits. They state that if an illness keeps me from being able to perform my job and effectively, I am covered. My Doctor has prescribed that I be out of work from the beginning, yet now I am feeling worse due to the added stress and not being paid for 5 months. Very dissatisfied, if it matters at all.

filed for a Short Term Disability claim. My Doctor's diagnosis and observations support my claim, yet Aetna as denied the claim twice. I get a myriad of excuses; paperwork not received, cannot reach Doctor, Insufficient information, New obtained detailed information not sufficient. It is outrageous. My benefits state that if I have a disability that keeps me from performing my job effectively I am covered. That is the case and it is supported by my Medical Providers. Aetna Representative Charlei Lang informed me that my symptoms are not debilitating enough. Memory loss, sleep disorder, anxiety, difficulty completing tasks, recall issues, poor decision making, overall though process has slowed, etc... All of these contribute to me not being able to perform my work effectively. My coverage does not state that I have to be completely debilitated. It states that if something is keeping me from performing my work effectively I am covered. Because of the tactics executed by Aetna, my Depression and Anxiety is worse than ever. I was making good progress but now I have retreated. I have been led on for 4 months with no pay. The mental anguish that has been caused is unacceptable.

My wife was deined coverage my Aetna. Once I received a bill from the doctor's office in March I reviewed the EOB's and contacted Aetna. I was told I would need a letter of "Medical Necessity" stating this work was in conjunction with the breast lesion removal and biopsy. The doctor's office sent a letter to Aetna stating this on 3-22-18, Aetna received the letter 4-3-18 with their confirmation number [protected].
On 4-6-18 I called Aetna and was told that they had the letter and the claim would be reprocessed based on the information. I did not think to get a confirmation number that day. I was told 5 to 7 days to reprocess.
On 4-16-18 after no response from Aetna I called again. I spent a half hour on the phone while they looked for documentation. I was told the claim had not been sent back for processing but they had all the necessary documents and it would be reprocessed. Aetna CNF #[protected].
On 4-23-18 I called again as I had no response from Aetna. Again I was told the claim had not been sent back for processing. I spent another 45 minutes on the phone while the documentation was found again. I was told it would be sent back. Aetna CNF. #[protected]. Then the representative that I was talking to said " but call back in two days and ask to speak to a supervisor".
So on 4-25-18 I called and spoke to a supervisor for another 45 minutes. The claim still had not been sent for processing and I had to explain the entire narrative again. He spent time to again gather the documentation and he said he was sending it to " Complaint and then Reprocessing" and it would take until May 10th to resolve. The CNF # yesterday was [protected] and he gave me a case ID number [protected].
On May 23rd I called to try and get some resolution or information and at that time I was told that the claim was in Appeals and would be resolved by May 23rd. I said what happened to the 10th. I was told the records they had did not say May 10 anywhere.

After having extreme congestion and a bad cough for over 10 days, I called Teladoc. I paid $40 to be yelled at by a doctor and essentially, to be told I am trying to get medication. When I told him last time I felt this way, I went to the Minute Clinic, they gave me a Zpack and I felt better, he told me they did me a "disservice" and I shouldn't have been giving a presciption. He was rude and insulting and I hung up the phone and cried. I will be telling everyone I can not to use this service. 12/3/17

Trying to see about buying st disability. Was told I had to do that during my enrollment. I should not have said it because that doesn't want to fork out more money but I found out I have to have surgery a bone is literally coming out of my foot I have to stay off of it . Every time I call I get the running around no one takes me seriously I'm sure they make exceptions for people I'm sure there is something that can be done and no one will ever return my calls yesterday August 3, 2017 I wasted a whole day on the telephone and I still have no answers . I have worked in customer service before there is no reason for me to be treated this way .

My employer changed to Aetna from Humana on Jan 1, 2016. Since then, 9 out of 10 claims are denied for various reasons: need more medical records, wrong codes, not a covered benefit (when it is), etc.

One denial for annual blood labs in Feb 2016 was denied as not a covered benefit. When calling in (17 phone conversations in total) I was usually told the charges were added to my deductible. They never were.

By August, I was able to show them the claim was never added to the deductible and that they should reprocess the claims. They did not stating I was beyond the 180 days to appeal. I was left with $700.00 of labls to pay for out of pocket.

It is not a lot of money except that I became permanently disabled in November 2016 with an incurable and untreatable condition in the United States. (Some foreign countries have approved treatment for my neurological progressive disease). Fortunately, I began receiving SSDI a few months ago.

Fast forward to Jan 2017 - Aetna is denying claims to manage my symptoms. They claim they never received my medical records even though my physician sent them with tracking. When I called in today, the representative said the records were not received. When I stated I had proof that they did receive the records, she said they weren't scanned into their system until 5 days later, 1 day after they closed the claim.

Instead of matching up the information and paying the claim, they did NOTHING until I called today 12 days since their receipt of the requested information. Concurrently, they have been reimbursing for my physical therapy (after many delays, denials, requests for more information) at 70% instead of 90%!

After requesting to re-process at least 20 claims at the higher rate, I asked what can be done to make sure the reimbursements going forward are corrected and was told by the member concierge, "I don't handle claims but they should pay it correctly next time." I let her know there is no logical reason to think they'll get it correct "next time" when they've had 20 PT visits to get it right so far.

I am so sick, live alone and resent having to spend hours on the phone each week to beg for services for which I pay (via my former employer as part of long term disability). Though I am dying a slow death, I am sure the emotional frustration and fatigue from Aetna is going to speed up my departure from this world.

Seriously, they are reprehensible!

Since June 2016 I've been having shoulder issues which my doctor believes may be a torn rotator cup. Aetna repeatedly denied the request for MRI in 2016. On January 3, 2017, Aetna approved the MRI. I had met my 2016 out of pocket expenses so the MRI would have cost me around $160. I find it more than a coincidence that Aetna finally approves the MRI once the new year started. The cost of the MRI will now cost me over $1000, which I cannot afford. I've been with Aetna for years and not once have I ever met my out of pocket expenses or been denied coverage until 2016. I feel their denials were deliberate because they didn't want to carry the burden of the MRI cost. Why else would they approve the MRI on the third day of January? I'm interested in filing a class action lawsuit against Aetna.

Aetna is a rip off. I had a previous miscarriage as the baby was missing part p of chromosome 12 (12 p dilution). The next pregnant the dr suggested i do a cvs test which then showed mosaic of chromosome 12 (23 Q mosaic). As it was the same chromosome the dr suggested we do a micro on my husband and I to rule out the possibility that we may have it. Aetna is now refusing to pay for it which costs $10, 000 because their code shows experimental. This is a rip off. For a test this expensive they should have pre authorization at least or maybe use their brain and read the history to know that this was a needed test not experimental...

Aetna is HANDS DOWN the worst company I have ever had the displeasure of dealing with! Not just the worst insurance, the WORST COMPANY! My husband has severe rheumatoid arthritis and Aetna will NOT pay for the prescription my husband has been prescribed by his Doctor! So far they have turned down 2 medications and forced him to go on a different medication than what was prescribed by his DOCTOR! In June, my husbands RHEUMATOLOGIST prescribed Rituximab, Aetna rejected it, so his DOCTOR prescribed it again! Aetna once again turned it down, forcing him to take Orencia, even though biologics have NOT worked before! He's been on Humira, & Enbrel, neither has helped in the least. We are now at the point that my husband is going to have to quit his job & go on disability just so he can get treated for his Rheumatoid arthritis.
I have been prescribed Seroquel. This is a medication that I NEED! I am Bipolar and I NEED the prescription my DOCTOR prescribed me. All of a sudden they won't pay for my full prescription & I have had pay $100 for 1/3 of my prescription. I called Aetna, about 3 weeks ago, and told them that they are REQUIRED by LAW to have a HIPPA compliance/privacy officer & I wanted to speak to this person... They don't have one. And since I called & complained, they have started treating us even worse! They DO NOT care one bit what happens to their patients!

I retired from Owens Corning in 2006 that had provided life insurance while I was working. In 2008, per my employer website, I contacted Aetna to see if I still had some life insurance as a retirement benefit. I told the representative at Aetna I had retired in 2006 and she looked up my information and told me I had a $50, 000 life insurance policy - I asked if she was sure about the amount as I had been an hourly employee not a salaried employee and she stated it didn't matter I still had $50, 000. A letter was sent to me confirming the insurance dated March 20, 2008 and I heard nothing else until April 2015. At that time I received a letter telling me they had found an error and I did not have any life insurance. When I called I was told that my account showed "terminated" and that I needed to contact my employer and get that code changed. Upon contacting my employer, I was told that "termination" is what is updated when I was no longer covered for insurance. I was then told by Aetna an appeal form would be sent - I waited and when form never arrived I called and was told there was no appeal process. Aetna claims that Owens Corning did not notify them of my retirement "termination" however I contacted Owens Corning and they advised they had transmitted my information. In addition, both Owens Corning and Aetna confirmed that payments had also stopped. In contacting Aetna I was told that they had a representative at Owens Corning that would have been contacted once payments stopped to find out the status of the account and why no payments received. Therefore, Aetna either did not contact Owens when payments stopped or they simply missed coding my file timely. Also, I found that when insurance was contracted between Owns Corning and Aetna, the responsibility of insurance verification was delegated and/or assumed by Aetna; therefore, if there was any doubt, Aetna should have contacted Owens Corning before verifying that I had life insurance. I filed complaint through Ohio Department of Insurance since that is where the policy was originally and after a year, I have been told that even though Aetna should have contacted my old employer before verifying insurance I received a letter dated May 14, 2015 stating they had contacted Owens Corning to verify coverage which was after-the fact. After filing a complaint with ODI and waiting a year for them to look at all information, I have been informed there is nothing they can do. I basically lost 7 years of paying on a legitimate policy as result of thinking I had life insurance that never existed. To me this is fraud. I would like to be compensated for the 7 years I thought I had a policy.