Aetna Inc.

Reviews 9

A

A Private User

Aetna is a ripoff they try to deny every claim even for routine physicals My husband and I have been fighting with Aetna to pay the claims to no resolve as they are trying to use the preexisting clause to deny payment and are threating to deny all claims including the disputed claim for an Orthopedic visit. Here are the claims that they are trying to deny payment for. Dr Albilo Munoz(General Practioner) - My husband and I where scheduled for a physical, a few days prior to the physical my husband was walking and he had an accident his ankle rolled and his knee dislocated on his left hand side and went back into place so he was able to walk again. We figured since it was not to the point where he could not walk that since he was seeing the doctor anyway for a physical that we call our primary care doctor and ask him for advice. Our doctor said he would take a look at it during the physical. When he went to the physical we explained to Dr. Abilio Munoz that my husband had never had this happen to him before the 20th when the accident occurred. Dr Munoz subsequently referred us to an Orthopedist (I do not know the name offhand). My husband visited the Orthopedist and was advised to get an MRI. My husband called to schedule an MRI and was told that in order to have the MRI done it would be $500 as the insurance company did not cover it. Much to my surprise, a week later I received a letter in the mail from my insurance company asking if my husband had insurance from 07/10-09/10/10 because of the Orthopedist claim. I immediately called the insurance company explaining to them that while we did not have insurance during that time period, we went to the Orthopedist under the advise of our doctor due to an accident that happened on 01/20/10. We explained that there was no prior injuries or operations to this knee prior to us obtaining coverage. I was advised by the rep that they still needed to check for prior coverage, to me he made it sound like if I did not have insurance coverage from 07/10-09/10 that they were going to deny it and say it was preexisting just because they could. I asked them if they where going to send some kind of medical questionnaire as we can prove that he did not have prior issues but they advised me they would not. I advised them over and over that this was a recent accident and it should be covered but they refused to approve the claim without this preexisting questionnaire. I tried escalating the issue to a supervisor to explain a clearly logical argument that what did July have to do with January. I even offered to let them take a look at our previous medical records but they refused to do so. Even after saying that accidents are covered they still said I needed to fill out the form, mind you they refused to even take a look at our medical records and just only wanted to know if we had preexisting coverage. They kept giving me the run around and also refused to let us speak to a supervisor. When my husband got mad and demanded to know why they even threated to deny all claims including the claims for the routine physical. I feel like they are bullying us and trying to get away with not paying ANYTHING and it is frustrating me because my husband was clearly told by the Orthopedist that he need to get his knee and his ankle fixed and now I am afraid he will never be able to. I am not sure why I pay for health insurance if I am having to fight them to pay each and every claim including the smallest claims for routine physicals.

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Steve Reins

Aetna Zero ethics - Normally BBB does a good job, but some companies must have too much power. Filed complaint against Aetna for classifying out-of-network charges as in-network. Aetna promises to fix and I agreed to close complaint. Aetna lied, fixed by denying charges as unnecessary. I refiled complaint - BBB closed without notifying me. Nice business model Aetna, even your 5 Star ratings mostly look fake.

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Bill Maura

I have been very sick with COPD and many other complications that requires very expensive doctors and hospital stay, they covered/cover everything with no questions asked, trouble free. Everyone has been first class and very polite. The company I had in the past was the very worse in every way.

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DL

DL Langdon

Stopped offering plans in my state, and are dropping everyone with no alternate plans being offered. Doubled my premiums at the beginning of 2016, took my money for a year, and now leaving me in a lurch. Zero stars.

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debra hintz

*******WORST INSURANCE COMPANY EVER*****SENT CLAIM IN 3 TIMES FOR EYEGLASS REIMBURSMENT, THEY STILL SAY THEY NEVER RECEIVED IT.......OPEN ENROLLMENT WILL FIND NEW INSURANCE!!!!!!!!!

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barbara french

They insist claims have been processed and checks mailed, yet no checks are received. Customer service is lacking. Will be looking into moving my dental insurance.

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IR

Iron man #1

It is where my mom works but it stinks

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Livi Steele

My mother works here duh dur

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WI

Will L

the cafeteria

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