Aetna is one of the leaders in health care and dental pharmacy, providing many kinds of long term and care benefits to all the customers. The main aim of the company has always been to provide health and financial benefits to all its clients. Benefits can be provided to all people, with the help of safe and easy access, along with cost effective, high quality health care services to all the customers, in order to protect their finances from the different health related risks. We have a dedicated team of people, who help people in the achievement of health and financial security. There are around 50 states, to which Aetna is said to be providing health related benefits, along with providing them with enough resources so that they are well informed about the health related problems. Our main aim has always been customer satisfaction, with the help of our large number of innovative products, along with health care benefits. Aetna has a rich heritage of 150 years, and will soon be a leader with a large number of doctors, hospitals, patients, and public officials, taking care of the public health system.
Health and dental plans are often placed under the health care facilities, and are usually offered on a risk basis as well as employer-funded basis. In case of risk basis, the company assumes most of the responsibility, of the health and insurance, whereas in case of employer –funded basis, the sponsor is under an administrative services contract, and assumes majority of this risk.
Group Insurance refers to a renewable kind of contract, in which the amount that is required to be paid may be fixed or linked to the wage level of the individuals. There is a special kind of insurance that is referred to as a Group disability insurance that provides employee income replacement benefits, for short term as well as long-term benefits. There are many insurance companies that provide long term and custodial care benefits in a nursing home, adult care homes as well as in home settings.
Large Case Pensions
Large Case Pensions are known to be managing many retirement products that are primarily meant to provide you with benefits, and of contribution plans. There are contracts that provide you with non-guaranteed as well as guaranteed investment options, with separate account products. There are many health care products, that are fully insured and self-funded, that includes HMO, PPO, and Pharmacy, Vision, and all the health plans that provide you with reimbursement programs. On 31st March 2006, there Aetna was able to cover as many as 15.4 million medical members. There is also a dental coverage of 13.3 million members, providing insurance against group life and accidental death and personal loss, along with long term and short-term disability.
Aetna Products and Programs:
There are a large number of products and programs that are offered by Aetna, that is mainly aimed at improving the quality of health care, disease management, patient safety programs, and other kinds of information that is related to disability. We provide all our customers, access to a number of health care tools, that are quite easy to understand, and can also help you in making better decisions relating to all your health care and financial well being. We are the first health insurer who forms a consumer dedicated health plan, and continues to lead the way with the help of a number of products that include HAS, HRA and RRA options. All these benefits are provided to our customers in around 50 states, with the products targeted to small mid sized and large multi site national employers.
More About Aetna
Aetna is a diversified, health benefit Company that is known to be providing a large number of traditional and consumer related health products, along with a large number of medical facilities that includes medical, pharmacy, health, group life and long-term medical health. The company had issued its first medical insurance life policy in the year 1850, after thirty years of coming into business. It was in the year 1996 that Aetna merged with US Healthcare, and became one of the eleven companies to be earning a 100% score on the Human Rights Campaign Corporate Equality Index in 2002.This was also maintained in the following years of 2003 and 2004.
I Discontinued a Policy, They Keep Renewing
I discontinued a policy for grandson\'s health insurance. But every month I receive mailed notice that they\'re adding some other coverage for him that will be automatically deducted from my bank account--I have to call them every time to refuse the insurance. Ridiculous!!!!
The 10% Solution
My wife was transferred to the emergency room of a decent local hospital from urgent care. Urgent care was in network, but the hospital apparently was not. Out of a $40,000 bill, Aetna agreed to pay less than $8000. Aetna says that I owe $32,000, which is more than four times my alleged out-of-pocket maximum. Aetna is despicable.
Poor Expensive Service
We have to use Aetna Specialty Pharmacy for a prescription and you should know that you are required to call them in Florida every month, then take a day off from work to receive delivery. They cannot tell you what time it will come. I checked with 3 local pharmacies and they carry the same medicine at a significantly lower cost. This month I asked for a delivery that requires signature since they will guarantee delivery by 8am, allowing me to get to work. But it did not come and when I informed them, they say it is out of their hands. They cannot explain logically why I am required to use their more expensive service in Florida when I can find the Rx cheaper here at my local NJ pharmacies and I do not have to lose one day of work EVERY month. I can only conclude that this is another money maker for them but it is the most ineffective way to serve the consumers. So far it has caused only great frustration and wasted my family's time , not to mention an entire day (without pay) lost to waiting for delivery each month.
Took Me 9 Months to Get Reimbursed
I was on Cobra Insurance. Aetna did not send me the paperwork to fill out until 4 weeks after I left my job, in the meantime I purchased medications that my former employer told me I would be reimbursed for less my normal deductible. I sent in all the appropriate paperwork and was sent 1/3 of what I should have been reimbursed. I immediately called and started the process to get the rest of my money back. After 9 long months I was denied for not sending in an appeal in the first 160 days (which I did every month!). It was not until I sent a letter to the CEO of the hospital I worked for telling him what happened (9 months later) was I fully reimbursed. After months of calling and spending literally hours on the phone, being told they would resubmit again and again I could not believe they sent a denial letter. Horrible insurance company.
Behavioral Health Nightmare
As a provider I provide one hour sessions for my clients.
Recently, a one hour session with a client co-pay of $40 was paid at the Aetna rate of $10.
Can you imagine?
One hour of therapy and Aetna feels that $50 is appropriate. It is no wonder that the client's previous counselor "went out of business".
The client is paying a large monthly amount to maintain insurance and yet must bear the brunt cost of the therapy. What are my options to stay in business:
1. refuse Aetna clients
2. charge them co-pay plus out of pocket coverage for the sessions
The Aetna rep. told me that I should renegociate. Let's see how that works.
Flexible Spending Issues
All year I have had issues trying to submit for flexible spending. All eligible claims. All denied multiple times. I don\'t know how many hours I have spent refilling out claim forms and resubmitting claims because they denied it. I have had to send in nasty letters to get my $$ back from them.
Two days ago - i checked the account to make sure how much $$ was in there so I could send my daughter to the eye doctor and use up the remaining amount only to have the flexible spending debit card denied for the amount in there and even denied for a lesser amount. I had to call in my debit card!! She was embarassed and I am pissed. Now I have to FIGHT AGAIN on Monday and resubmit the receipt to get my check back from them.
They over charge, they lie, they try to make sure you don\'t read your claims and if you don\'t fight every single claim. If they feel that the \"code\" isn\'t right, they deny.
Dropped Family Members, Blamed Us
They dropped one of my children from coverage 9 months ago. Found out from our dentist. They claim we did it. Why would we do that. He was the only kid who had medical bills the year before how convienient. They also cancelled the mail order pharmacy without notice. Besides a few hundred dollar claims that was the only claims we had so out it goes. Aetna doesn't actually pay for anything. Wouldnt cover an ultra sound for this pregnancy so not hopeful they will cover yhe birth. They didn't cover the last birth either after customer service assured they would. Even little things like a well child visit aren't covered. They set up some company health fund this year so the first few thousand dollars have to be paid by my husbands company then we start on the almost $5000 deductable. And we have the privilege to pay over $500 a month for them to not cover anything. Wish I never left wellmark. They might have cost more but they covered stuff.
My husband's company changed from United to Aetna last September. I called in September to give them our PCP at that time they said he was in network and did accept our plan. We received membership cards with our PCP listed. Well, 10 months later and hours of phone calls later we have now been told he is in network but doesn't accept our plan. The financial person at the PCP office(who has worked there 20 plus years) said this is the first time that she knew that they don't accept an Aetna plan. All the while on Aetna's website navigator still tells me that my PCP is in network and does accept our plan. Call center and their computers, totally useless. Stay away from Aetna!!!
Horrible RX Service
RX home delivery is horrible. I am required to use the their Pharmacy and has gone from okay to horrible over the past year. Simple generic blood pressure medication orders which used to ship in several days now are delayed. The system shows "in process" for two weeks and then, they contact you saying there is some problem which will require a further delay. It seems as if they have made a corporate decision to make sure that all of their customers have at least one to two weeks without medications every three months. Try calling them, and they are just plan rude (that is after you wait for ever to speak to a person.
I guess if you multiply that over millions of customers that adds up to a better bottom line for them, but at what costs? Next open enrollment, I am choosing another company.