Aetna
Reviews and Complaints

they don't care if you get your meds or not on time. been dealing with them since last week of December...still waiting for shipment. For the past year I received a med from them using the regular ordering "line"..when I went to check on delivery was told it was never called in by doc office..checked with them and yes it was called in. Only to find out that it is considered a "specialty med" (after a year of ordering from regular pharmacy?). Well was told finally it would go out next day. I called just to make sure it shipped, and was told it was "computer reversed" and did not ship due to a price increase (in 1 day REALLY). When I asked why I wasn't informed of the non shipment I was told that since it was "computer reversed" I would not have received notification. This med is needed to be taken on a daily basis..life sustaining. When I told the rep this, she said "oh well". Hopefully it will be shipped today and arrive tomorrow. CUSTOMER SERVICE IS ALMOST AS BAD AS VERIZON.

Faxed my claim for my FSA reimbursement four times. Followed up with calls to confirm receipt each time. Each time they said they didn't receive it. I have my fax delivery confirmation from my machine showing it was successfully delivered. They won't accept email and have no way to submit claims online. Their only suggestion is to pay for registered mail and submit the claim that way. TO GET MY OWN MONEY BACK!?

Feels like a tactic to keep the money beyond the filing deadline.

We would like to be included as we deal with this every single year. Today we received a denial letter stating the claim was submitted after the Apr 30 deadline. I know for an absolute fact it was not late because it was in the same envelope as other claims that were paid!
Kristen L

How do I get in on this? They have asked me to substantiate almost all of my purchases when they are sent through Aetna Medical Insurance! Why can they not talk to each other?! Now I am having to do their work for them and send them all this information. I'm sure my whole company would be willing to join in on this lawsuit.

I agree with your comments about Aetna's FSA program. They make it close to impossible to get money back from our account, with $ I set aside from every paycheck. They want double and triple proof for almost every visit to the doctor or procedure.

Contact the drug maker and see if they won't pick up the cost. Sometimes they will and also check to see if your state has a program that might pick up the cost.

Good luck.

Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
You can call your human resources department of the employer the AETNA insurance is through.
Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
they may not want to go with AETNA as an option for the next open benefits registration.

The liason may be able to get some action.
This really freaks out everyone at AETNA because they risk losing the contract ;)

It's 2015 and I'm a 52 year old woman. I was a dancer, a snowboarder and a very active person until I started having back issues in 2011. In 2013 my Husbands new employer gave us Health insurance through Aetna. This employer hired a Benefits Managing company to handle all benefits for employee's and their families. I was seeing a Physical Therapist pretty much every week once a week from Dec 2013 until April 2015 and it was helping. I had to stop because Aetna cut me off. They decided I should not get PT any longer. They decided I'd had enough and that I don't need it any more, or I'm abusing it (like I LOVE having to go to the PT every week to feel good...) that I "Should" be better...I could SCREAM with frustration at this situation! I just want to say, WHAT. THE. FRACK!? We pay a pretty penny for health insurance every month. Am I suppose to feel bad for saying this makes me mad because Aetna IS covering my other issues? AM I suppose to say, "Oh well, It's MY fault I have a ailments and I'm LUCKY...lucky me...they're covering the other ailments, so just buck it up?"
I feel completely dehumanized. I ALMOSt feel like a factory farmed animal. I don't count, I'm just a policy number "bucking up" alright.. as far as THEY're CONcerned, I'm "bucking up" THEIR money! Clearly it's costing Aetna TOO Much to money to keep me healthy and not in pain.
what is there to do? I literally feel like this world is a lost cause and it's Big Pharma and Big Insurance Companies (among others) who are indeed conducting "death panels". it's not a "political thing" at ALL, it's a $$$$$$ MOney Thing.
This is a great venue to vent to, but, honestly, is anyone at Aetna going to see this? DO they even give a crap? ahhh what's worse Aetan or Reality?

AETNA does not pay LTD. They are in the business of denying claims. Please take a look at complain board.

my daugter's health is jepordized because her aetna policy won't cover anymoremental health benefits

Aetna won't even pay for basic coverage of primary care physicians in my plan coverage. That's not anything special, I am talking about just going to the primary care physican, they won't even pay my claim for regular doctor visits.
Aetna SUCKS.

I have been trying to get three claims from 2013 resolved for the past almost two year. The provider is in network but used an out of network TIN. I've been told that all hte information has been corrected and the claims will be reprocessed several times. Now I'm told that the claims are too old to reprocess. I get thet mistakes occur. However, I trust people to fix their mistakes and this one is strictly now an AETNA issue. The reprocessing of the corrected claims is in a loop of rejection - for over 18 months.

I am a 42 year old female who has had insurance since I was 18 years old. I've been covered by varipus plans ranging from Cigna to BCBS and I can say with confidence I have never had a more shoddy, patient/claim unfriendly, unproductive plan as Aetna. Nearly every visit to anywhere resulted in a denial of payment, which resulted in a letter to me from the provider of balance due, which resulted in my having to take time to call the insurance, wait on hold, jot down numbers, make return calls in some instances and basically coordinate payment. In truth, Aetna should have been paying ME for working. This is clearly a tactic to save money, banking on the patients who lack the knowhow, patience and/or determination to go the distance and hold these scheisters accountable for a service that has been paid for, but not received. Seeing the large amounts of complaints on here, I see this review will come as no surprise

http://www.diattorney.com/

I am currently fighting with AETNA ! Ebony Doctor is the 4th person to handle my case. According to her my Dr. has not sent the correct paperwork, but my Dr. said he has never received a request for any xrays, MRI's or cat scans. I think this is their game. They say" we don't have the correct paperwork" but they simply don't asked for it! My Dr. told me they have played this "game" with him and several of his patients for years now. My Dr. spoke to one of "their Doctors" on the phone and he totally discredited him more or less told him in so many words he was wrong about his diagnosis and treatment. I have had two surgery's and a third forthcoming. I have spoke to three managers, but I just found out that two of the "managers" were not they lied, they were just reps. I even had a "manager "named Wanda that gave me some bull story about how a whole panel of people( like a review board) would be making the final decision on whether or not they will continue my pay after May 9th 2011. I again just found out that is a bold face lie as well, a rep just told me it is Ebony Doctors decision alone! Ebony is not a doctor. not a nurse. has no medical degree of any type. I guess it's just up to her weather I loose my home, car everything. I am a single mother of two that has been with Bank of America for 18 years, yes 18years I have paid for LTD just in case something happened to me my children and I could survive. I suffer with great depression and pray many times daily. I pray for all of you as well. Unfortunately it's all about the all mighty dollar, and no they don't give a ###. why would they? It's not them or their wives or mother or child right? I wonder what happens when AETNA employees get hurt? Would they deny their own? I hope they never have to miss a bar b que or a graduation or a wedding because they are laying in bed in pain. I am optimistic though I have sent medical proof of my disability and with another surgry on the calander I'm sure they will continue my 60%. I will update as soon as I hear back . Good luck to all of you .

Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
You can call your human resources department of the employer the AETNA insurance is through.
Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
they may not want to go with AETNA as an option for the next open benefits registration.

The liason may be able to get some action.
This really freaks out everyone at AETNA because they risk losing the contract ;)

You can also keep going to the ER ;)

My Aetna summary plan description clearly states that 60 visits per year are covered for physical therapy. Nowhere does it state that after 25 visits the PT would be subject to medical review. I underwent radial head surgery on New Year's eve and have undergone painful and progressively active-assisted physical therapy since mid Jan. I have not reached my maximum medical improvement nor my max of 60 days. Aetna's online claim tracker shows checks issued to my physical therapy office. However, last Friday I receive a letter that RETROACTIVELY denies payment for my physical therapy after March 8 based on a Clinical Bulletin that is not referenced in my summary plan description nor was ever mentioned when the member services told my PT office that I was covered for 60 visits prior to my even starting physical therapy. Aetna's plan misrepresents its coverage and to my detriment I relied on their written words and issuance of checks. It isn't a new tactic, on Oct 24, 2003, Aetna settled a federal lawsuit with doctors over the same issues. I am appealing as high as I can go, but I can't even reach a case manager cuz they hide behind their automated phnoe system.

According to a report on the lawsuit: The settlement requires changes and commitments in Aetna's business practices to eliminate "the worst of the improper practices involved in managed care." Among the changes, which will affect all doctors treating Aetna patients:

Eliminating downloading and improper bundling and computerized denial practices.
Establishing the standard of a "physician, exercising prudential clinical judgment" for "medically necessary services, and allowing cost to be considered only when an alternative service is at least as likely to produce equivalent results."
Creating a dispute-resolution procedure, using an independent external review of decisions regarding medical necessity.
Providing a facilitator to assist physicians in enforcing the agreement.
Creating a $100 million fund for physicians to recover some of their damages.
Establishing a foundation "dedicated to promoting high-quality health care."
The agreement also requires Aetna to pay lawyers representing the doctors $50 million in attorney's fees, including $6.5 million in expenses.

Fighting with Aetna is a nightmare, but i found out though AETNA is hard to touch, their employees Doctors and Nurses and Behavioral clinicians are easy to touch they are based out of Florida, if you believe they participated in deceptive practices file a personal complaint with the Florida Department of Health, they will review your allegations of neglect, malpractice or deception and these individuals can lose their license to practice in this state! That would make them think twice before screwing someone over, and screw them if they do, keep in mind they don't have jurisdiction over Aetna or any insurance company it's self just the employees, which is good enough for me. Spread the word! They can't operate if they dont have a licensed staff!

I want to file a complaint against Aetna for deducting from my ltd a auto loss of income policy ihave had for years prior.

Aetna is the absolute worst or all insurance companies. I think a class action suit against them is just what is needed. Anyone interested in joining me please contact me by email me at Cody6723@yahoo.com. I have a really good attorney who has taken my case and would welcome a class action suit against them. Power comes in numbers and we should get what we have paid for. We are disabled and they know this, but have been getting away with not paying claims for years and years. Let's do this together. I too have been turned down for LTD though my doctors have sent reports stating that I am disabled. They set me up with one of their doctors who knew nothing about my disease. He recommended they follow the advice of my doctor and of course they didn't. What is this all about? How they get away with what they do is wrong! Write to your congressman about them.

From what I understand about Aetna and long term disability, once you have been approved to disability social security they stop payments. You actually cannot get both. I'm sure it is written in small print somewhere in your policy.

Surprised, Aetna has been sued? But, still has not paid out...
http://www.longtermdisabilityblog.com/2011/05/aetna-south-carolina-claim-denial.html

Aetna LTD is not worth paying for. The company wants to sells the insurance but, when it comes time to pay out they do not want to stand behind the insurance they sold you. They steal your money and run. Once you need to collect on the policy and you receive your payments they bring in THIER own specialist, they pay good money for to say, you no longer need to be drawing the payment and stop payments. Does not matter what YOUR doctor reports says, they do not want to hear anything from your specialist. They are the ones paying out on your policy and they want the payments to stop. Believe me I have been there and I know how they work. Don't call them and expect them to return ANY of your calls! They say they called and no one was home..And all the doctors they tried to contact never returned any of their calls or they never filled out the required paper work...Anyone needing a lawyer to fight Aetna needs to go through a disability lawyer and good luck with that. Most lawyer will not fight a LTD case because there is no big pay out for them. Unless there is a class action law suit filed against Aetna that may be the only way you could get a lawyer to help you. Either way it is all about the big money! I will never recommend LTD to anyone.

i too am having problems getting Aetna to pay my LTD benifits, I was just declared diabled by social security in a hearing and I called about my "open" LTD policy they act like they have no idea what I am talking about, they claim it was closed in July 2007 even after acknowledging to my wife that I did reopen it in September 2007 but it was supposedly closed because I failed to provide some records and I was never told. This is a lie their rep called me in December 2007 saying everything was in order and to just call them when my claim with social security was approved. Aetna is aweful, to treat a disabled person like me who is in constant severe pain like this? They just don't care! Aeta is fake and should be avoided at all costs. I will not drop this but obviously I am going to have to sue them now and that will take years, what if I die in the mean time? I HATE AETNA! If you have a LTD policy with Aetna it is worthless!

I agree totally with everbody here. Please update us all.

I too am having the same problem only mine is with prudential. My degenerative disk disease is well documented; I also have bone spurs in both my shoulders. I tried for a year to continue working but the pain is too much. I was on short term disability 2 different times dealing with this so you would think that I should just be able to roll my last std over into ltd but no! It is coming upon a year and I am still not getting anything but denial after denial from them. Social security is still going through their investigation. In the meantime I am broke. I know these insurance companies hope that people like us will either be discouraged by their denials and go away or go broke and not be able to pursue them further and/or lastly commit suicide. Those are harsh words but it's true. They would rather we kill ourselves just so they would not have to pay. I realize things are this way because so many people in the past have committed fraud and it's a shame that people with real medical conditions are now being treated like this but when you have a mountain of medical evidence it should not take an act of God to get them to pay. Does anyone have an answer to what we can do? Can anyone help? I'm at my wits end and don't know what to do. I'm about to lose my house, my car and everything I've worked hard to get. This isn't fair! Please can someone help?

I do not know if attorney Herbert Hill [protected], in Orlando, Florida would file a class action law suit against Aetna, on our behalf, but maybe if enough of us were to call him he would decide to represent us with such a suit. We have to stand up and fight Aetna. We cannot allow Aetna to get away with money that is owed to us.

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
You can call your human resources department of the employer the AETNA insurance is through.
Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
they may not want to go with AETNA as an option for the next open benefits registration.

The liason may be able to get some action.
This really freaks out everyone at AETNA because they risk losing the contract ;)

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

I think AETNA was blaming underestimating the costs of "cobra" patients for a decline in their profits at one point recently.
Maybe they want you to cancel your cobra coverage?

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

I have never had such terrible customer service in my life! I'm currently on Cobra and had to change my benefit plan due to a HUGE increase in price (over $200), with higher co-pays for doctor visits and prescriptions. I was given 3 other options to choose from but no information on co-pays or rx prices. Simple information right? Wrong! I talked to 3 people at Aetna and they could give me NO information on any of these plans! I kept asking to speak to someone else and same story. I must add that EVERY single rep I spoke with was rude, snarky, and kept me on hold forever! Finally, I asked to speak to a supervisor, and the rep rudely said, "Okay!" I was on hold for 20 minutes and finally hung up. Once my Cobra ends, I will try to locate another insurance company. I will NEVER pay for an Aetna insurance plan.

Aetna sucks. I had surgery on my neck almost 3years ago. Now I am having numbness and tingling in my right arm and fingers. This was a symptom before the surgery. They had to put 2 metal rods in my neck. I am clearly having a problem again. Aetna denied an MRI that my neurosurgeon ordered to see what is going on. Then my rheumatologist ordered one, and they denied it also. This is just 1 thing in a long line of insurance fraud and abuse by them.

We own a sm. business and have AETNA ins. until this year we have had no claims. Of the 7 claims only one was processed correctly. All of these claims fall under the co-pay part of the policy. Every time I call they tell me it should have been paid but due NOTHING about it. To make matters worse it's time to renew our policy and they have inceased the preium ove $200.00 a month

It wouldn't be so bad if you could bypass the inconsiderate reps by asking for a supervisor. WARNING! If "Mike" from Middletown picks up when you call... call back. He's rude and refused to allow a supervisor to speak with me. He told me to "get a pen, I'm waiting, now write Mike, M-I-K-E, #A243977..." and hung up the phone. I'm a teacher and our family purchased our medical benefits through my husband, chosing AETNA. Next time we will pass. I'd rather even pay more money and be treated with respect than ever be in that position again. The way he spoke to me- he had to be alone because he was loud.

they are cheaters they have you paying in but they cut off benefits

When I was a young soldier in Thailand (U.S. Air Force 1972), I was expected to speak their language when "in their country". I did find someone to teach me some reading skill, but writing was a definite challenge. Point is; I did learn to speak most of the proper dialect in a few short months. If I could have stayed another year, I would have been able to almost master it. The more I visited downtown like the markets, theatre, taxi drivers, etc., really helped me learn the local language and customs.
If you want to live in my country, please learn the language. If your country is so bad, then why don't you change it ? You are not entitled to anything here in the USA.
English is what is spoken and written here. My company does not, and will not cater to anyone who does not speak english.

I feel your pain . . .also Grace family with Aetna PPO insurnace which brings sighs of frustration from providers whenever they hear we're covered (or often not!) by Aetna . . .We also ran into the 359 day rule and were denied well visit coverage. Also had to fight for a well visit to be covered because the children rec'd flu shots several months prior! They fight every claimthey possibly can . . .becareful if your chuildren ever need surgery! The coverage is awful even when medically necessary! Aetna is considered the bottom of the barrell in the industry . . .way out in front when it comes to screwing members at any costs . . . I don't know why Grace continues with this coverage ? . . oh I know . .. it such bad ocverage and the cheapest available they can keep paying the execs big bonues while their emplpoyees children do without health coverage and necessary medications . . . Grace refuses to cover my sons asthma medication or even the antibiotics he needed for ear infections as a baby because they were not on the formulary! He is alleregic to the oneon formulary and even with a doctor's note, they refused . . .nice . . .real interested in the well being of their employees and familes . . . the almighty dollar . . Hang in there . . .I'd let HR know how crappy the coverage is . .until we all complain loud enough they will nver listen . .

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
You can call your human resources department of the employer the AETNA insurance is through.
Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
they may not want to go with AETNA as an option for the next open benefits registration.

The liason may be able to get some action.
This really freaks out everyone at AETNA because they risk losing the contract ;)

Aetne has denied payment for the difference of what EDD is not paying for my medical leave, due to Work related injury, back, wrest, and stress on the job injury. Bank Of America. I appealed with full report from Chiro and Phscy and still they deny pymnt stating report does not give details of this being work related and Medical test and analysis indicated in the report stat stress due to back injury and stress at Bank of America. and she will have to fwrd this over to the physical medical department and mental health with not approve it, I received and denial letter. not that sum other dept will review.

They go from not following your written instructions on the reorder form. to charging your credit card for refills you did not request and without your authorization. I think in most states they consider that illegal. When you try to get it corrected -they tell you all kinds of different stories. They did this twice within the past three week period. Do not I repeat to not use these people. The attorny general in Florida should look into their business practices. They have serious problem within their company. Again do not ever use these people

Where is a good lawyer when you need them.

Aetna schedule of benefits shows that there is a no co-pay and deductible is waived for routine physical exams. Did you know that routine doesn't include talking to your doctor about your health concerns? I asked about my weight and she diagnosed me as overweight. So since I have a diagnosis, it is now considered an office visit and I am responsible for the co-pay and the deductible. Since she is concerned that I might have a thyroid problem, she orders lab work. There is a higher co-pay for getting blood drawn. I was curious about my results and was told to schedule another appointment and pay another co-pay to find out that I don't have a thyroid problem. I asked the doctors office and Aetna about paying much more than I expected to pay. I was told I am responsible for knowing how my insurance company works. I was told that a wellness exam is only covered if I am well. If I am sick, or I ask the doctor if I could be sick, then it is not covered. So in the future, when my doctor asks me if I have any concerns or questions, I will answer "I am well." Actually, I am going to stop going to my doctor. Since I can't afford to be un-well, I can't afford to find out if there is anything wrong with me.

If your employer had the type of AETNA insurance that just has AETNA reviewing & paying claims... is it your employer's money used to pay the bills instead of AETNA's money? If it is, then it's very possible your employer is aware of all your health information including labs, diagnoses, vital signs, medications & every chart ever made on you. The employer is the "payor" and possibly has access to all of your information. It's seems wrong to alert employers of high risk / "high dollar" employees. I expressed my concerns about this and didn't get far. They claim the employer doesn't have the name of the actual employee costing them so much $$$.
I wonder though if an employer could figure out which of it's employees has been in the ICU for 20+ days? It doesn't seem too difficult for them to figure it out.

The "COB- coordination of benefits" will happen at least once per year to see if there is possibly another insurance company that should be primary.
It's definitely a pain.

As far as speaking to a supervisor / manager... try calling:
[protected] or [protected]

Whenever there is ANY issue you should 1st call your PLAN SPONSOR'S REPRESENTATIVE.
You can call your human resources department of the employer the AETNA insurance is through.
Ask for the insurance benefits specialist & ask them why your employer chose AETNA - explain how
they may not want to go with AETNA as an option for the next open benefits registration.

The liason may be able to get some action.
This really freaks out everyone at AETNA because they risk losing the contract ;)

My husband and I are paying a lot of money for a policy that is USELESS. I was recently in the ER and they said that they can't bill me because I"m not in their nextwork..even though the people at Aetna say my hospital is in their network.

My doctors are all coming back to me and saying that I'm going to have to pay out of pocket because nothing is covered under them. Only $350 is covered...and I have to make $350 stretch out for a CT scan, blood work, chiropractor, and therapist?

Yeah, right. What am I paying for this insurance for? Do you realize that there is better health care for the uninsured in clinics than people who are insured by Aetna SRC? This insurance is a scam at best!

I have experienced it first hand with SRC. It is truely unbelieveble they can get away with what they do. I have 6 bills for 3 days of service (1 day for blood work, one day for xrays, and one day for a one hour procedure). The 6 billers for the misc services have all been unsuccessful at getting SRC to receive the bills. Even though the billers have fax confirmations, electronic filing confirmations, and sent bills by U.S. mail, they all "disappear" on the SRC end. Amazing. Its been six months and I spend about 4 hours a month on the phone trying to get them to find the bills as we re-fax them. Capitalism an at its finest.

I am so tired of hearing people moan and groan about insurance companies denying them services. What people fail to realize is that the bottom line with services that are not covered or denied for whatever reasons is that 9 times out of ten if a procedure or service is not covered it is the fault of the employer that group insurance policies are obtained through. A perfect case in point is Bariatric surgery I cant even tell you how many times I have talked to someone that is totally outraged over the fact that Aetna or another insurance carrier is denying a medically necessary procedure. I have never heard such a whiney society! First of all, the customer service rep that you call and yell and scream at because you need this surgery because you are morbidly obese cant do a thing to change the fact that this is not covered; Have a conversation with your employer if you are ticked that you cant have this surgery. I am the first to admit that Bariatric surgery is a necessity for some people but for all of you people out there that want to eat whatever you please and gain tons of weight and then have an invasive surgical procedure to fix it don’t expect your insurance to cover this. The deductible and co insurance rates as well as co-pays are no exception to this rule, the employer works with the health insurance carrier to put together a plan that the employer can AFFORD. In reality if they pick the lower co-pay or deductible they are going to pass that expense along to you in your premiums, then everyone will complain about their premiums, which again the health carrier has NOTHING TO DO WITH. We as a society expect that everything be free in life, especially health benefits. NEWSFLASH nothing in life is free and anything pertaining to the health care field is going to be expensive. Don’t expect to get insurance or health care for free because its not going to happen. It is very frustrating to take calls from members who are screaming and yelling at you about things that you cant change and have nothing to do with. So the next time that you get on the phone and are screaming profanities at the customer service rep think twice about where your anger should be directed. Your plan is mostly based on what your employer is willing to pay for and what they want YOUR premiums to be. Think about this, you don’t buy a car without first doing research on the vehicle luxuries and gas mileage you want to get the most for your money. When its time to renew your benefits do some research LIKE YOU WOULD ON ANYTHING ELSE YOU ARE SPENDING MONEY ON!