Customer Review - Aetna

1.8
Overall Rating
by Anonymous
date 11/09/2011

from Somerset

refused coverage

I have dental insurance, I am paying insurance premium since last 10 months. Now I am in dental pain. I contacted Aetna, they said I can only visit after 12/1/2011. today is 11/09. How could they take mony and not provide coverage?

Following is the conversation between me and Aetna rep:

Member: need to set primary care dentist. I want to set following dr. as my provider.
xxxxxxx(name removed)
System: Connection established.
System: Initiating Call, Please Wait.
System: Connecting... An agent will be with you shortly.
System: Welcome to Navigator Chat.
Member: hi
Melissa: Thank you for your question. My name is Melissa. I will be your Aetna One Health Concierge today. May I ask with whom I am chatting?
Member: xxxx xxxx(name removed)
Melissa: Thank you xxxxxx. One moment while I research your question. This may take a few minutes.
Melissa: Thank you for your patience. I have made the selection of Brunswick Dental Care as your primary care dentist. You will be effective on their roster 12/01/2011.
Member: hi
Member: no I need to visit tomorrow
Member: can you change the start date?
Member: I dont have any body registered now
Melissa: Unfortunately, this is how the Dental DMO Policy works. Any changes made before the 15th of the month will be effective the first of the following month. I may contact the dental office and see if they are willing to see you and render services without getting paid for them.
Member: Does that mean I do not have coverage now?
Melissa: With the Dental DMO Policy, you have to elect a Primary Care Dentist (PCD) on file in order to utilize your benefits. The provider gets paid on a monthly basis, based on the names on their roster for that month. You will be able to see the dentist on or after 12/01/2011 for Diagnostic and Preventative Services, Basic Services and Major Services.
Member: Okay in that case as I shall not get coverage before can I get back the premium I paid since start of this plan?
Member: Okay in that case as I shall not get coverage before 12/1/11. can I get back the premium I paid since start of this plan?
Melissa: You would need to contact the Bank of America Global Human Resources Service Center at 1-800-556-6044.
Member: as practically it is disabled for me till 12/1/2011
Member: I will contact them as you could not answer me.
Melissa: Is there anything else I may assist you with today?
Member: for now can you ask "Brunswick Dental Care" if they can provide service to me and render it when the plan is active?
Melissa: You will be effective on their roster 12/01/2011. You are able to contact their office and make an appointment for on or after that date.
Member: okay, can you check this with your higher management that if there is any way you could provide coverage tomorrow?
Melissa: I may contact the dental office and see if they are willing to see you and render services without getting paid for them.
Member: thank you.
Member: Another question: This policy of Aetna I felt unethical. Can I take this conversation as official and publish it in public forum?
Melissa: The dental office is closed for lunch. Unfortunately, this is how the Dental DMO Policy works.
Member: Can I take this conversation as official and publish it in public forum?

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Coverage
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Customer Service
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