Has anyone else had a bad experience with Aetna insurance
What’s your story?
I’m going to go out on a limb and guess the answer to your question is “Yes”.
Good guess USCDiver
Yeah we are suppose to be reimbursed 80$ as we pay full price for scripts. They had us fax paper work 3 times and then the pharmacy 2 times (same paperwork), Then we called and they couldn’t find us in the system, and we called again and this person said they saw the previous people in our account. All in all it took 6 weeks when it should have taken 7-10 days. One person told us we sent it to the wrong address, although I use the same one for 9 years. Then I applied my scripts and was told denied, because I was suppose to put it thru medical not pharmacy. First I dont put it thru anything but mail the paper work, so i don’t know where they are coming from. Past 2 years has been crazy with them and they are suppose to be buying Humana and Cigna, HEH right
Good guess USCDiver
Yeah we are suppose to be reimbursed 80$ as we pay full price for scripts. They had us fax paper work 3 times and then the pharmacy 2 times (same paperwork), Then we called and they couldn’t find us in the system, and we called again and this person said they saw the previous people in our account. All in all it took 6 weeks when it should have taken 7-10 days. One person told us we sent it to the wrong address, although I use the same one for 9 years. Then I applied my scripts and was told denied, because I was suppose to put it thru medical not pharmacy. First I dont put it thru anything but mail the paper work, so i don’t know where they are coming from. Past 2 years has been crazy with them and they are suppose to be buying Humana and Cigna, HEH right
I now see what the problem is…
Anyone else pronounce it as two syllables: A-Etna?
I haven’t had a bad experience, but my company just switched to them a month ago and I haven’t gone to the doctor under them yet. Have refilled a prescription though. Can’t say I saw much difference.
I work in insurance (not major medical though). As far as I can tell there is no such thing as a good insurance company, just different degrees of bad. They all do their best to find ways not to pay for stuff. My professional experiences with Aetna (again outside of their major medical coverage) have been pretty positive on the whole. But I hear negative stories all the time from disgruntled clients. Then again, I hear those same stories about every company so I don’t pay much attention.
I’m going to move this over to IMHO for people’s opinions.
No.
I’ve had Aetna since March and so far it’s fine. I had a small payment I had to supplement Aetna’s coverage of the lab work, but I don’t think I can really complain about $25 out of $600. First copay to the new doctor was a freebie, prescriptions covered fine.
Prior to this, I had BCBSIL for 14 years. Zero complaints there, either. When I had my gallbladder out in 2013, hospitalized with a complication for 4 days, I didn’t pay a dime out of pocket.
A big-picture view:
I have seen the stats that our local physician-hospital organization keeps on health insurers. They track how reliably/quickly the different health insurers insurers pay on claims. Aetna isn’t the best of commercial insurers, nor are they the worst. The trends I saw indicate that the best insurer for paying claims in a timely fashion does so only about 89% of the time–and the percentage of claims paid in a timely fashion is falling for all private health insurers. Our local PHO members report that Blue Cross is the best at timeliness. The commercial insurers (Aetna, Cigna, Humana, UnitedHealthcare) are worse. The worst private health insurance company’s timely pay rate is in the 60-something percent range.
The bottom line is, no health insurance company out there is ever going to pay every single one of your claims in a timely fashion. If they’re getting it done 80-90% of the time, your health insurer is probably one of the better ones out there.
jjjthird, depending on what the prescription is, it might be reimbursed under medical instead of prescription. I don’t know why, but some companies reimburse certainprescriptions under medical.
This. When I first had to have my Botox (for migraines) covered at my then-new job under the then-new-to-me insurance, it took a few weeks of work by me, my boss (Chief Medical Officer of the company), and my neurologist. Since we’re self-insured, my boss getting involved ***really ***got things moving.
If by “problem” you mean “it took 3 years, about 50 overseas phone calls, and reports to the insurance commissioner to get them to pay for well-documented and relatively inexpensive medical bills in Mexico” I would have to say “yes.”