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Aetna

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Aetna Ratings

1.7 coverage
2.3 cost
1.3 service
1.2 claims
1.6 overall rating

Based on 210 reviews - 1 is lowest, 5 is highest

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1.5 overall rating
by Anonymous

Foot doctors making cancer care denials

Aetnas history is to Deny Deny Deny first until patient dies OR files enough appeals to prove they will not go away. This should be considered illegal and criminal and prosecuted and punished by huge class action payouts to every subscriber who was caused harm by this mal practice.
0.0 overall rating
by kelly scott

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0.8 overall rating
by Anonymous

COBRA

If you can avoid AETNA and their subsidiary, PAYFLEXDIRECT - do so. They take you money and deliver nothing in return. You call to get answers and they hang up on you. Go somewhere else for your health insurance. Horrible place.
0.0 overall rating
by Anonymous

Why be an nsurance company if you can't cover anything?!

I have to be on my medication, been on it for years now all of a sudden i need a prior authorization in which my dr.s office was on the phone with them for hours. this insurance company is shit! I don't even know why they label themselves an insurance company they don't cover nothing! And their motto on their site is false!!! i wouldn't recommend anyone to Aetna!!!
0.8 overall rating
by Anonymous

AETNA NIGHTMARE

AETNA is by far the most unethical organization on this planet. Due to the fact that they automatically deny all supposedly covered claims, I was forced to write and submit letters of appeal and more than enough supporting documentation from my physicians. AETNA would take up to 3 months to make a decision regarding a claim or appeal. In one incident, this caused me to exhaust my FMLA leave. Because of this, I was forced to take a leave of absence while waiting for AETNA to make a decision. In addition, they gave me and my physicians faulty advice - claiming that if I submitted a new claim using different ICD codes, my claim would be approved. In October 2013, I was employed and to my knowledge insured. Until AETNA retroactively cancelled my benefits in December 2013, and did not offer me COBRA until March 2013, after many requests. For years, I paid for top dollar for either their PPO or POS plans. In hindsight, I don't know what I was paying for because they rarely covered anything! In fact, they just delayed my required medical care and tests, worsening my condition and health. After reviewing the medical record on three separate occasions, I felt that perhaps AETNA was denying my claims due to the high amount of inaccuracies. For example, claiming I was male and not female on some pages, incorrect recording of my age, and procedures I had done. On approximately 81 out of 89 pages there were substantial inaccuracies, the most outrageous - stating I had 3 stomach tumors removed, even documenting their size in cm - I have never had any sort of stomach procedure, tumor or surgery done! When I brought this to their attention and asked that the inaccuracies be corrected, they resent me the exact same report Verbatim- with the exact same inaccuracies. I attempted filing a report with the state board insurance, but AETNA kindly reminded them that they were exempt from such review for they were an ERISA plan, and also hinted that I was violating their "policy" stating that my medical report with my name and employee number on the top of each page in the header received from AETNA no less than 3 separate occasions was potentially someone else's medical report- After numerous attempts and supporting documentation from my physicians to have my medical records corrected, I yet again received the aforementioned report along with a letter stating that after review AETNA found no inaccuracies. Needless to say, this was highly offensive, stressful, and ultimately led me to my resignation from my company. Fast forward to December 2014, I am receiving bills from my medical providers for procedures and tests dating back to October and November of last year. Apparently, AETNA is rescinding payments they made to these medical providers, claiming I was uninsured during that time. How on earth can this be possible?
0.0 overall rating
by Anonymous

Slow to Process Regular Orders

Hands down the worst Specialty Pharmacy I deal with. I work for a busy practice, and coordinate the orders for oral Chemotherapy. They are slow to process regularly lose the faxed order, and their staff is not knowledgeable, and easily aggitated. I only work with them if forced by the patient's insurance. Really bad!
0.8 overall rating
by Anonymous

Every Time There\'s a Screw Up

These bastards are unbelievable - EVERY TIME I need to get a prescription refilled or have a claim filed, Aetna screws up = the DENY legitimate claims and lie to the pharmacy about my copay. I've spent days/weeks/months battling them for even the smallest claims. They're simply EVIL.
0.0 overall rating
by Anonymous

Representatives Have No Clue

Every time I call to ask questions I get conflicting information. They don\'t train their people very well, its very frustrating. I have called about different situations more than 10 times and each time I get a different answers. AH! How hard is it to say they received a fax? How hard is it to tell me if I am covered for a breast pump under my coverage? I guess very hard, I was not trying to be mean, but I hung up on 2 people because they took a long time trying to figure out if I was covered for a breast pump. I called back several times and got different answers. I wished my work did not go through this insurance its just the worst customer service I have ever received from an insurance company.
0.8 overall rating
by Anonymous

Deny Claims Automatically and Wait for Patient to Quit Filing Forms

Over a 2 year period I paid more than $7000 into my healthcare plan and my employer probably paid more than $15,000 on their end. In that span my family (2 adults, 11 year old and toddler ) received care approximately 25 occasions. These were regular check up visits, immunizations, and the occasional sick-visit. Of these visits. 15 were NOT APPROVED. My wife spent hours on the phone with Aetna and the Doctor to get the claims refiled with the correct billing codes. They appear to work together to deny claims so that the patient will pay the doctor\'s office directly instead of dealing with the Aetna. It is a racket. I received a call from a collection agency this week and found out that some doctor\'s office is looking for $200 for a doctor visit 2.5 years ago. Instead of re-filing the claim with Aetna, they come after me. I looked online at the Aetna list of claims to find the dozen \"not approved\" determinations. I attempted to call and to e-mail. No response. The phone line says that they are in training. It is a simple job... Press \"Not Approved\" and then record an out of message about training.
0.0 overall rating
by Anonymous

Hung Up on Me

I had called to get some assistance in some problems I was having in activating insurance. Basically not only did the woman who answered give me conflicting information (telling me that they did have information on me, but then proceeded to tell me that they didn't have any insurance information on me) she also hung up on me right when I was getting ready to ask another question. That was unbelievably rude and unnecessary.
1.0 overall rating
by Grandma

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!!!!
0.0 overall rating
by Anonymous

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.
0.8 overall rating
by Jackie

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.
0.0 overall rating
by Anonymous

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.
0.0 overall rating
by Anonymous

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.
0.8 overall rating
by Never again

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.
1.8 overall rating
by Anonymous

Long Fight

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.
0.0 overall rating
by Anonymous

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.
0.0 overall rating
by Anonymous

PCP Confusion

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!!!
0.8 overall rating
by Anonymous

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.
1.0 overall rating
by John

Aetna is expensive

Damn Aetna is expensive! My largest bill isn't my power bill, my car payment, or anything else it's Aetna! It takes nearly 30% of my total paycheck then all the taxes! Then I still have to pay their high deductible. My company doesn't offer anything else but BOY do I wish they did!
1.3 overall rating
by Sam L

Denied Transplant Meds

My 11-year-old son is a kidney transplant recipient. He requires several medications to stay alive. As is often the case his dosage was changed on one particular medication called Rapamune in April 2013. In speaking with Aetna to arrange for his 60 day refill I learned that our doctor did not relay that change to them. Our doctor's office, upon our request, submitted the change to Aetna. I then followed up with Aetna to confirm that they had received the change when he had about one week of medication remaining. So it was clear to the representative that our need was urgent. We were to receive the med the next day via overnight shipping. No meds arrived, so I called Aetna yet again and elevated my request to a supervisor. The supervisor informed me that it was MY fault for not telling MY doctor to tell Aetna that the order was "stat.". At that time they agreed to transfer the prescription to a local CVS pharmacy. I was made to drive almost 2 hours round-trip out of my way to make up for "MY" mistake. Even worse, when I got the refill I was only allowed to receive 30 days worth. In speaking to Aetna yet again to try to obtain the remaining 30 days of medication I was told that I needed to contact the local CVS pharmacy and tell them to transfer the prescription back to Aetna. Had I not done this the process would have broken down all over again. As an added bonus, I talked to Aetna yesterday and found out that I will not be able to get the next refill until this 30 day supply is consumed. So instead of only having to deal with those idiots every two months, I get to do it again in just one month. Bottom line, Aetna seemingly takes little responsibility for maintaining its own process. And they demonstrated zero interest in customer service, much less compassion, in dealing with a life-or-death situation regarding an 11 year-old boy. Suffice it to say, I am gathering quotes as we speak from other carriers. If the health of your family, especially your children, are important to you, I strongly urge you not to work with Aetna!
0.0 overall rating
by Anonymous

Unwilling to Pay

Aetna does not pay their claims. I went to an in-network doctor and she sent me for some tests. Aetna refused to pay for the tests. I am stuck paying the bill.
1.8 overall rating
by Anonymous

Cherry-Picking Who Gets Coverage

My nephew, who is 23, had a high-deductible policy with Aetna. They cancelled his insurance for non-payment in spite of the fact that they were not sending bills to any of his past or present addresses. I suspect they simply wanted him off their rolls because he has seen doctors a few times. There is no other logic for how he was treated.
0.8 overall rating
by Anonymous

Betrayed

I liked Aetna...I really did...that\'s before I came down with an autoimmune disease, medicines for which are brand only and my pharmacy benefit covers generic only. There are no generic medicines for my condition and I\'m paying for a pharmacy benefit that will do NOTHING for me. They actually approved coverage for this medicine and I got on it through their specialty pharmacy (they even shipped out a 2-months supply of medicine for me), but then they reneged and are now charging me $4800 per month for medicine. They are not willing to do any overwriting/underwriting on my case (at least this has been the case for 1 month now). Maybe that will change. I have been through the wringer with them, and now I have someone from @Aetnahelp who says they\'re looking into my situation but for 2-3 weeks now they have provided me with no feedback as to what they are doing. The only person from Aetna who gave me a glimmer of hope was some girl named Kristen or Christine. I feel like I\'m in a weird policy loophole. They need to change their policies to make sense. THERE ARE NO GENERIC MEDICATIONS FOR WHAT I HAVE.
1.3 overall rating
by Anonymous

Provider POV

As a doctor, I\'m a contracted Aetna provider, and I dread having to call Aetna whenever our patients need pre-determination of benefits, claims assistance, referrals to non-par providers, etc. Their customer service has definitely gone downhill in the last two years. Their representatives used to take the initiative to resolve your problem and were pretty good about getting back to you. Now they just hand the problem off to someone else and nothing gets resolved, let alone paid in a timely fashion due to the errors they make in claims processing. If it weren\'t for those patients I do see who have Aetna as their insurance provider, I would pull my contract and go non-par (and encourage my colleagues to do the same). When my patients who do have Aetna as a health insurance option during open enrollment inquire about this insurer, I try to steer them away.
1.8 overall rating
by Anonymous

What "network?"

When you live in the Bay Area, you live close to the center of the West Coast medical world. World class doctors are everywhere to be found...except in Aetna\'s so-called \"network.\" A few months ago my dermatologist recommended removal of a squamous cell growth on my hand; she gave me the option of conventional surgery or MOHS, an established procedure that has a lower rate of recurrence and less scarring. She referred me to a doctor who specialized in MOHS. Unfortunately, when I called the physician\'s office I was informed they don\'t take Aetna insurance. Checking the website\'s handy doctor locator program, I couldn\'t find anyone within 25 miles of my home, so I called the company. They had exactly two surgeons who perform MOHS covered in-network and neither had fellowship training, which is critical to me. One was 47 miles away and the other was 38 miles away from my home! More recently, I needed a breast surgeon. In Aetna\'s \"network\" just two breast surgeons take Aetna\'s insurance. If I go out of network, the company will pay just 50% of what THEY consider to be \"reasonable and customary.\" On top of that, the dollars I spend out-of-network do not count toward satisfying my deductible!
1.5 overall rating
by L. Shortway

Don\'t Pay Their Claims

Aetna does not pay their claims. I went to an in-network doctor and she sent me for some tests. Aetna refused to pay for the tests. I am stuck paying the bill.
0.8 overall rating
by Cesar

Worst Customer Support

I have been waiting for a claim to get processed for 5 months now. I\'ve called more than 10 times. Every time they said \'wait a week\', but every time nothing has happened. The last time they said there was an error with the claim and that I have to submit it again. Why didn\'t they just said that initially? There are no calls to customers and no emails either. If you want to follow up with your claims, you have to log into their website.
1.3 overall rating
by Michelle M

Denied Claims

I have been in severe lower back pain for 15 years and finally decided to try to do something about it. For the past year and a half have tried chiropractic, massage therapy, medication, acupuncture, hot baths, analgesic pain cream, and epidural steroid injections... of which none have helped at all. My doctor said I have a bulging disc at l4/l5 and spondylothesis along with arthritis in my back and heels. Two years ago he had to replace two ruptured discs in my neck. He submitted my present request for surgery and it was denied as not medically necessary. He re-appealed 10 times and all denied. Now we are trying to get me approved for a spinal simulator and I am guessing that will be denied too. I don't understand what else they want.
1.8 overall rating
by Steven L

Dis-enrolled

I am on my wife's Aetna insurance. It is my secondary insurance. I have my own Medicare policy with AARP United Health Care. Without my authorization, Aetna dis-enrolled me from my AARP policy and enrolled me in their Medicare policy. I found notices from AARP telling me I had no coverage and Aetna telling me I had been enrolled into theirs. I had a doctor's appointment set and had to move it back. I am now out of some of my medications and need a prescription to get them refilled. I tried to get my AARP insurance back only to be told I will have to deal with Medicare directly. I am waiting to hear back from Medicare. I am without insurance and am told it could be a month before anything gets done.
1.3 overall rating
by Anonymous

One Out Of Three Claims Approved

I submitted three medical expenses which are identical other than the names: one is myself, one for wife, and one for my son. Diagnosed with upper respiratory infection, I was given a prescription. One out of the three was paid. The other two were denied. It has been less than six months and each time I call, they just say an item needs clarification and gets resubmitted. It is now getting old. Any suggestions? Maybe someone may know a special number to call for the company that actually get you some real help and action from someone in the company to solve the problem.
1.0 overall rating
by Debbie

Denied Insurance

I currently have medical insurance under my husbands retirement benefits plan. When he got the renewal for 2013, my insurance went up nearly $400/mo. Because of this steep increase, I inquired with several insurance companies for individual medical insurance. Anthem and Cigna denied to even accept an application I applied with Aetna and worked with an Aetna sales rep during the application process. At no time did the Aetna rep give me the impression they would not cover me even though I had pre-existing conditions. After a lengthy application and an interview with underwriting, I was denied coverage. Needless to say I am now without insurance because I did not re-enroll with Aetna under my husbands retirement plan. Their customer service was rude and denied I was led on believing I would get coverage. DO NOT apply with Aetna for individual coverage and get the same runaround as I got.
0.8 overall rating
by Anonymous

won't Provide Adequate Assistance

don't get hit by a car going 80 - 100 MPH and become paralyzed from the waist down. They have moved this patient over 5 times in 3 months. They won't let her get good physical therapy. At one place, they told her she could have an hour PT. Seriously? Now she is somewhere she is really getting help and they want to discontinue it all because she "is not showing progress". How can she when she has skin graphs on the back of her ankles? No one from Aetna has ever even come to see her.
1.0 overall rating
by Anonymous

Worthless

The company has denied bill after bill for tests that are recommended by my doctor.
0.8 overall rating
by Anonymous

Poor Experience

Atena refused to pay for one bill after another - all for basic medical procedures. Customer service and their appeals process were both worthless.
0.8 overall rating
by Anonymous

Cancelling

They did not cover my family like I requested. They claim different prices than what my employer quoted. They also will not answer questions about coverage and price conflicts. Instead they are requesting months of back pay to add family.
1.5 overall rating
by Anonymous

Poor Customer Service

The customer service is terrible. I'm surprised that since Home Depot, since it is so focused on customer service, would want to be associated with this company.
1.3 overall rating
by

I Ended Up Sicker

Aetna is the worst. They deny claims, deny disability, force you into financial ruin. I had Aetna coverage when I had to go on disability. They paid at first, then took it out on me that social security, were slow paying, and dropped me, causing me to lose my home, car, and made my health even worse. They even sent me to their own doctor who blamed Aetna for making me even sicker, and he was surprised I was not in a hospital with a complete breakdown! Aetna didn't care. No attempt to right the wrong, pay me what they caused me to lose in my home and belongings. That was several years ago, and I am still suffering.
1.0 overall rating
by Anonymous

Nothing But Denials

They have all kinds of excuses for not paying your providers' claims. They will show you number of policy bulletins to deny the claim.
0.8 overall rating
by Anonymous

Rude Customer Service

The member services team is absolutely awful and have no idea how to represent the company or offer good service. I was insulted and It's recorded, but no one cares!
1.0 overall rating
by Janet

Denied And Ignored

They sold me a policy they discontinued serving. Then they declined to pay a per-authorized procedure. And of course they have TOTALLY ignored my complaints and a formal grievance.
0.8 overall rating
by Anonymous

Not Surprised

They exist to make a profit. They do not exist to make you happy, or even healthy. If they can make a buck by denying you coverage or making you pay more for coverage, then they will. It's called profitability and they excel at it. They have shareholders and they want to report a profit. And the only way to do that is to charge you more money than they spend on you. When you consider that they have to pay not only covered medical expenses, but also the salaries of all those nice people who answer the phones to tell you that your procedure is either not covered or is going to cost a bizillion dollars, you will begin to understand the flaw in the system.
1.0 overall rating
by Anonymous

Bed Service For Out-Of-Plan Care

They're OK for in-plan, but watch out if you have to go out-of-plan. I had an accident while 3,000 miles away, resulting in an emergency visit to a local doctor. After almost a year, Aetna still has not paid the doctor. They have lied and been rude to the doctor's office staff. They also do these same tricks to avoid paying to my husband when he has been referred to out-of-network specialists by his primary doctor.
0.8 overall rating
by Anonymous

Costly

I have tried 3 times now to find out how much out-of-pocket expense a doctor visit will cost me and after talking to a rep BEFORE going to the doctor they quote me one thing and then when the bill comes in, I have to pay another! They refuse to accept responsibility for the drastic difference in cost from what their rep told me and the only solution they offer is "take it up with your HR rep."
1.3 overall rating
by Anonymous

Clueless And Disorganized

I have been asking these idiots where my payment for an MRI is so it can be placed towards my deductible. They don't have a claim and tell me so I have to file one, but remember if you used an in-network provider, they file the claim. DOH! It was an in network provider, unless It's normal business for them to only charge about $300 for an MRI to anyone. I highly doubt that. Aetna doesn't have other doctor visits on my record either that I paid my horrid high co-pay for. Never have I dealt with such an unorganized screwed up mess as this company.
1.0 overall rating
by Anonymous

Useless

I applied for this insurance as a part time worker to cover wellness visits for my daughter, until my husband's new insurance started. It took them 4 weeks to start it. I never received my cards. Every time I called they said It's on the way. Finally they told me that my file was incomplete and they did not have my address. Even though they'd sent me things in the mail previously. In the meantime, my husband's insurance kicked in so I no longer needed them. When I called to cancel it, they told me it would take one or two pay cycles for it to stop. How is that possible? I didn't know insurance companies send couriers on foot. So ridiculous.
0.8 overall rating
by Anonymous

Cover Nothing

Avoid this company. Their customer service is awful, finding a doctor especially a specialist that even accepts them is a nightmare, and after a visit or two to the doctor, you will wonder what exactly it is that they do cover. Not a single one of my colleagues has had a even remotely pleasant experience with Aetna and as soon I can change providers I will.
1.0 overall rating
by Anonymous

Denies Valid Claims To Save Money

They denied my claim again at a hearing even though 5 doctors have said that I can't work full time. I am now on food stamps. They took my money just fine though...
1.0 overall rating
by Anonymous

Denied Every Single Time

Because of Aetna I'm terrified of going to the doctor or dentist. Every SINGLE appointment I've made has resulted in some screwup from Aetna. My first visit to the dentist resulted in a statement claiming that they weren't covering it because I wasn't covered at the time. I had Aetna through work, so obviously I should have been covered. After being given the runaround, I finally got someone to say I should have been covered, and they must have been updating the system while they processed my claim. If updating the system results in non-coverage confusion, then why did they choose that time to review my claim? They said they'd fix the issue and resubmit. I received no less than NINE further statements from them, each ranging my share of the cost anywhere from $0 to $90. Meanwhile the dentist's office wasn't being reimbursed, and I had to make so many more calls.
1.5 overall rating
by David C.

Cheap Doesn't Cover Anything

If you think for one second that Aetna will pay claims, you are sadly mistaken. Go ahead and pay the cheap premiums. Go ahead and think you're covered when you're not. Aetna will play games with words, exploit fine print and petty excuses to DENY every penny of your rightful claims.
0.8 overall rating
by Anonymous

Covered $1,600 of My $30,000 In Bills

II enrolled in Aetna's, SRC $10,000 Maximum Plan for which I pay $120.00 per month for medical coverage. My enrollment indicated that I would have medical coverage up to $10,000 per calendar year in addition to whatever co pays and deductibles were necessary. I had out patient surgery for a detached retina. Aetna only paid $1,000 for out-patient medical coverage. The bills totaled $20,000. Then I was rushed to the ER with acute kidney pain which turned out to be 6mm kidney stone. The Hospital bill was $8,000 for which Aetna only paid $600. Since my insurance plan only pays up to $1,000 for outpatient surgery I was forced to pass the stone on my own.
0.8 overall rating
by Anonymous

Terrible Dental Insurance

They systematically denied my claims. Their excuse was that COBRA did not update my election although I made a payment. Each time I called, they told me they resend the claim to reprocess.
1.0 overall rating
by Anonymous

What Should Be Covered Is NOT

I recently canceled my Aetna health insurance after experience the worst service. They refused to pay for any of the expenses of my daughters birth (about $11,000) even though I did everything right.
0.8 overall rating
by Cherie

Less Service, Higher Costs

Since 1998, my coverage has been getting worse and my premiums are now higher! I currently pay $1,456/month for a family of 4. They have changed my coverage, so now a flu shot is not even covered! My son was diagnosed with diabetes at age 4. Now they no longer will cover his insulin pump!
1.0 overall rating
by Judy B.

Denied an MRI

I have serious back issues. My doctor has wanted me to get an MRI. I kept putting it off due to the cost of this insurance and my deductible. I have severe pain and was denied an MRI. What the heck do we have insurance for?
0.8 overall rating
by Anonymous

Slow Claim Processing

Their website is slow and EOB's post slow there. The reps are RUDE. Claims are very SLOW to get processed. Prescriptions are expensive. You can't stay in the hospital long.
0.8 overall rating
by Anonymous

Doubled My Premium

They increased my premium almost double stating that I had pre-existing conditions and ones relating to organs that I don't HAVE! When I called them, they told me that it was because I had the potential to develop the conditions. They also said that birth control medication and UTI's are part of the reason that it has increased. Now I have called and checked everywhere and I am pretty sure that they can NOT increase premiums for birth control medication. They are absurd and not helpful one bit. Their customer service reps are rude and not helpful, bouncing you around and placing you on hold for 45 mins!
1.0 overall rating
by Luke

Tests Not Covered By Full Coverage??

Aetna says that we have full coverage for my wife's pregnancy, but now we are being billed for ultrasounds. How is that full coverage? The worst is that you get totally different answers when you call to find out what is going on. This last lady said that ultrasounds are not part of a standard pregnancy. We also keep getting billed by our doctor for random stuff and Aetna won't help at all while we get nickled and dimed to death.
0.8 overall rating
by Anonymous

Sending My Records To My Dad

Get a policy only if you enjoy spending entire afternoons on the phone being juggled from representative to representative trying to correct the problem of why YOUR medical and billing forms are being sent to YOUR DAD. That's not only a huge annoyance but a HUGE breach of confidentiality! And they treated it like no big deal, and something that each representative said "wasn't their department" and transferred me.
0.8 overall rating
by Anonymous

Terrible Customer Service

They lost my FSA paperwork I sent in, so I resent it via delivery confirmation the next time. They won't return my calls nor respond to my email requests for contact. Their website is not intuitive to navigate. Figuring out what paperwork they have processed via their website is difficult. Their online feedback form only allows 3 characters (not words, but letters!) in it.
1.0 overall rating
by Anonymous

Wrong Fees

I used Aetna's Mail Order Pharmacy. They substituted my brand-name drug to generic and charged me the brand-name cost. I am fine with substitution as long as I pay less than brand, but this isn't reasonable. When I called to get an explanation, I was bounced off 5 times, and met with "our pharmacists don't know what your co-pay should be, and there is nothing we can do for you." What a horrible service!
0.8 overall rating
by Anonymous

Terrible Pre-Approval Process

They actually denied a treatment claiming that it was not medically necessary and instead recommended something that was damaging. Apparently, the pre-approval process goes something like this...Board-certified surgeon recommends a course of treatment, recommendation is reviewed by NURSES, who in this case picked a cheaper course that would actually do damage. Reviewed recommendation is then forwarded to a Medical Director who is either not reading them or is under-informed. So now the burden of proof is left on the original physician.
0.8 overall rating
by Winnie

Should Have Paid Out Of Pocket

It's expensive and their services/coverage do not make up for the cost. I paid around $2,000 for an 8 month coverage and my $1,700 medical procedure (and my ONLY medical claim) had limited coverage that the bill stated a "maximum benefit for this period"? Basically, I could have saved more money paying for the procedure myself instead of using insurance. I was also passed back and forth 5 times on the phone with customer service, claim inquiry, and pharmacy inquiry because they weren't sure which department was responsible for addressing my issue, which is frustrating considering I am a college student paying for my own finances.
1.3 overall rating
by Brian

Poor Records Keeping

I'm trying to get these guys to pay a bill for recent hospital treatment. They denied paying the bill because they said I hadn't filled in a form of pre-existing conditions. I called them up and told them I had. After about 15 mins of hanging on the phone they told me "yes, you did indeed. don't worry we will pay the bill." After three more demands from the hospital, the bill still hasn't been paid, so I got back on the phone with Aetna. They told me that they need information about my pr- existing conditions. I thought that we cleared that all up last time?
1.3 overall rating
by Anonymous

Only Mail Order Medications

Aetna used to be a good provider, but now its horrible. They changed how you get some important medication to mail order only and do not cover anything!
1.0 overall rating
by Anonymous

Waited For 3 Years

I was waiting over 3 years for a reimbursement. I called customer service every 3 weeks with no effect.
0.8 overall rating
by Anonymous

Poor Customer Service

Aetna tells me one day I have coverage and the next day I don't. I paid for it. They claim It's a paperwork issue and then never resolve the problem. Then they treat me on the phone like I'm unreasonable when I ask for help resolving the issue so that I can get the coverage I paid for.
0.8 overall rating
by Anonymous

Dropped Our Coverage Leaving Us With $20k In Bills

For 11 months we sent our insurance premium by mail at the same time of the month. Suddenly, when our deductible had been met and they were going to have to cover 100% of treatment, they decided to drop us, claiming that they never got our most recent check and that they weren't covering us for the previous month. They had pre-approved expensive treatments somewhat to the tune of $20,000. Now they claim that since they didn't get the payment they have dropped us and that we are responsible for the past months bills which they had previously agreed to cover, sticking us with this insanely expensive bill.
1.0 overall rating
by Anonymous

Deny Everything

When you call customer service, they just confuse you as to why your service was denied. They deny everything or apply everything to every possible deductible they can come up with.
1.0 overall rating
by Anonymous

Slow Denials

The company's customer service is so bad. I actually have a policy that is managed by one of their subsidiaries. Claims from LAST year are still being declined, even after I provided the appropriate documentation. Now, they are being reviewed again after I sent a rude email.
0.8 overall rating
by Anonymous

Refused Coverage

I have dental insurance. I have been paying my premium for the last 10 months. Now I am in dental pain. I contacted Aetna, they said I can only visit after 12/1. Today is 11/09. How could they take money and not provide coverage? This is what the rep who I spoke with told me: "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. 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 for Diagnostic and Preventative Services, Basic Services and Major Services."
0.8 overall rating
by Anonymous

Would Not Pay

They sent me an explanation of benefits telling me that I was responsible for my out patient hospital visit that was in-network because they hadn't received medical records. I would be responsible for the entire bill without any discount. The provider was eventually paid $3,000 out of the $28,000 billed with no patient responsibility.
1.0 overall rating
by Anonymous

Cost Cutting Measures

Aetna insurance is terrible, as long as they are collecting your premiums you do not hear from them, but when they feel they are spending too much money they send this case manager to talk to you to see how much information that they can get from you to use against you. Aetna had my husband transferred to another facility without my permission just to save money.
1.0 overall rating
by Dave

No One Takes It

First, good luck finding some good medical specialists that are not desperate enough to take Aetna. Also, some specialists, behavioral health specialists, will not accept Aetna because they reimburse so low - $16 on a $165 office visit.
0.8 overall rating
by S. Fox

Useless

I have filed so many claims with them and have gotten so little back. They pay next to nothing. It feels like a totally useless insurance company.
1.0 overall rating
by Anonymous

Drags Out Appeals Process With Denials

My teenage daughter needed inpatient mental health care and I kept calling to get her pre-certified at an inpatient facility that was recommended by her counselor. Aetna said we should try two other places. One of the places they recommended was for adults only. The other didn't treat my daughter's condition. We told Aetna this and that we wanted them to pre-certify. They kept giving us the run around. Lots of phone calls with no commitment or definitive answer. Finally one of their phone agents said we could send our daughter to the place that was recommended, pay directly, and then submit the claim. It has been six months since we submitted the claim and they have been denying it repeatedly. They tell us to keep going through their appeals process. They just keep denying that the treatment was pre-certified and are also starting to question the medical necessity. It feels like they keep putting up hurdles to wear you down.
0.8 overall rating
by Anonymous

Aetna Has Been Awesome!

My family has been on Aetna and we have never had any problems. This year has been an awful for both my husband and myself, requiring numerous forms of testing to reach a diagnosis, and which is resulting in bypass surgery for my husband. Aetna has been very prompt in their payment to medical providers, and has not denied coverage on anything. Of all the medical insurers I have been with over the years, Aetna has been the best one by far!
1.0 overall rating
by Anonymous

Stall Tactics

Every claim is met with what the provider says is a request for additional information. However when talking with Aetna they say it was sent to me, when in fact I never receive anything from them and it is just a stall tactic to delay claim payment.
0.8 overall rating
by Anonymous

Slow Claim Processing

I have had an ongoing problem trying to get Aetna to "rerun" a claim. I call, they say its done, but It's not. I have called at least 10 times! Its ridiculous! The doctors listed on their webpage are sometimes actually NOT really on the plan!
1.0 overall rating
by Anonymous

Doesn't Care What Your Doctor Says

I had a total hysterectomy that required some additional repairs due to scar tissue from previous surgeries. My doctor said I would need 6 weeks off work. Aetna gave me 4 weeks and said they would extend it based on my post-op visit and my doctor's report. The doctor prepared another report and again stated I needed the full 6 weeks. Aetna took 12 days to deny the claim. I wasn't working, so I lost income. I didn't have any more paid time off due to Aetna denying my days off prior to surgery when I was on narcotics and unable to drive (per my doctor's orders). Even though it is ILLEGAL to drive with narcotics in your system and my job requires me to drive an average of 200 miles per day, they still denied the claim. They don't return phone calls, they don't explain in terms you can understand exactly what they need. They simply don't care what your doctor says!
1.0 overall rating
by Michael

Cannot See a Doctor

I called to get a list of doctors I am eligible to see. I then set an appointment with one of the doctors. I was told I was eligible to see him. Then on the day of the appointment, you guessed it, I got a call and was told I wasn't eligible to see said doctor. I calmly tried to contact Aetna. First nobody answers the phone, ever. Then the website acted up in more ways then I can count. I then registered (SORRY TRIED TO REGISTER) to the site, but even after entering the year of my birth, it kept saying "please enter year of birth". I then tried customer support. After technical support told me that I must "register or log in first" about 500 times, I finally got connected with technical support. Can anybody guess what happened next? Technical support told me that it was "currently going through some issues, but we would love to speak with you, please try again later". In the meantime, I haven't been able to see a doctor.
1.0 overall rating
by Anonymous

Terrible Short Term Disability

Terrible short term disability insurance and practices. They treat you as if this has nothing to do with your quality of life, which is further impacted in my case by having no income.
2.5 overall rating
by Mark

No Major Concerns

I've been with Aetna for a long time and haven't had any major concerns. I pay what's my responsibility and they pay theirs, although you do need to keep track. I've had 2 surgeries and only had to call customer service a couple of times. I hated their old phone system, but now they have one that gets you to the right place. I see the complaints on this site, but haven't had anything like that happen to me.
1.3 overall rating
by Kerra

No Coverage

I pay $150/week for health insurance. They don't cover a lot! I paid 100% of my prescription of PRENATAL VITAMINS! Over the counter meds were $12. Aetna had me pay $40!! Had blood work done for my pregnancy. Aetna covered 0%. I had to pay $160. Aetna sucks! When I was unemployed I had better coverage with Blue Cross.
1.5 overall rating
by Anonymous

Complicated Short Term Disability

I too have Aetna thru my job. I went on a leave because of my bad back. They ended up denying my claim so now It's in appeal. The medical examiner at Aetna refuses to speak with the staff at my chiropractor's office and only wanting to speak with with the doctor. The medical staff informs them that the doctor is in surgery on certain days and cannot speak with them. I had to cut my leave short. When I finally received a check, I missed almost a week of pay.
1.5 overall rating
by Anonymous

Difficult

For the cost, the coverage Aetna offers is inadequate. We pay a great deal in premiums and receive mediocre coverage. Additionally, Aetna has made a few billing errors in the past that as customers we are expected to forgive and forget. We recently failed to enroll our newborn within the defined 31 day time period (we were a month late) and they refuse to allow us to add our baby to the policy. Did they think we don't want our child coverage when they know we don't have any other option? They were not understanding at all and wouldn't grant us the exception even though we have worked with them on there errors in the past.
1.0 overall rating
by Anonymous

Paperwork Mix Ups

They can't get anything right and have the nerve to have bad attitudes when THEY ARE WRONG.
1.0 overall rating
by Anonymous

Pre-Approved, but couldn't Get Coverage

Right now, I'm sitting on several bills totaling over 5 thousand dollars because of Aetna. They send you documentation saying that something will be covered and then they don't honor it. Another example is that my baby daughter needs special food to survive. In their coverage details they say that this food is covered. In fact It's one of the major reasons we picked them. However, when the hospital bills come for this special food, they reject the claims. The hospital even told us that Aetna does this all the time.
1.3 overall rating
by Anonymous

Denied Claims

There is a reason the premium is cheaper, Aetna looks for ways to deny legitimate claims.
1.5 overall rating
by Anonymous

No leave coverage

I am on short term disability due to surgery and then a serious staph infection. My employer has approved my leave, but Aetna refuses to send out reimbursement for my lost wages per their contract with my employer. Their customer service called me daily in the hospital to ask if I was going to work that day. Amazing! Calling someone in the hospital to request they go back to work... I was concerned that I was going to have my foot amputated and these idiots want me to go back to work so they can cut their costs. They currently owe me seven weeks pay.
1.3 overall rating
by Carrie

Little Coverage

They hardly cover anything for my son, but immunizations.
1.3 overall rating
by Anonymous

Newborns Require Their Own Deductible?

The second that your child is born, they require their own deductible! Not only does the mother pay a $2,500 deductible, but you also have to pay a $2,500 deductible for the child. Most all other insurance companies don't require a deductible to start until after the first 31 days.
1.8 overall rating
by Anonymous

No Coverage

They won't cover tests because I am young and they don't find it medically necessary. They wont cover prescriptions unless you have tried all the other drugs first. I have never had to go through so many things to get treatments covered. Whats the point of working and paying for an insurance that wont cover anything.
1.3 overall rating
by Anonymous

No Coverage

I have been struggling for this entire year to get even the most common coverage listed in our plan document paid for. Most recently I had an annual vision exam, of which I am allowed 1 per year, with a $20 copay. They have denied every penny and are applying it to my out-of-network deductible. I looked my doctor up again today, and they are listed in the directory of doctor IN-NETWORK. My benefits still show I have 1 of 1 routine vision exams available for my use!
0.8 overall rating
by Mundhenk

won't Pay

They are currently trying to get out of paying my $23,000 claim.
1.3 overall rating
by Jack

Canceled But Paying

I have tried for months to cancel my coverage. They didn't send any of the information to the payroll company for 2 weeks now. They will "see what they can do about reimbursing me my money" it was an extra $400 dollars that were still being deducted from my checks.
1.5 overall rating
by Anonymous

Denied Claims

Aetna either won't pay for things that are routine like a hernia surgery for my son OR they take forever to pay. Unfortunately they are the only insurance provider my spouse's employer offers.
1.5 overall rating
by Anonymous

Denied Claims

I received medical treatment which is covered under the Aetna policy, yet Aetna keeps denying the claims. They also charged the deductible twice! I am truly shocked that Tulane University would choose such cheap and useless insurance to cover their students.
1.5 overall rating
by Anonymous

Little Coverage

I made the mistake of thinking the higher cost and best described coverage would be the best. They challenge everything. I have had to appeal three of six office visits. Their "the doctor used the wrong code" seems to be their favorite.
3.0 overall rating
by Anonymous Company

Great

We have Aetna group insurance for my small business and have not had any complaints. Coverage options are to our liking, cost is reasonable, customer service was great, and so far no complaints from any of my employees.
2.0 overall rating
by Anonymous

Unorganized

I have changed my Aetna coverage due to lack of customer services. Their online service is getting better, but being unable to reach a customer service rep for days is just not adequate. My Aetna plan was very affordable, but did not cover much. They do however, cover preventative vaccines, which was a bonus for the low price of the plan. Just not able to reach them to even cancel my plan for a month.
1.0 overall rating
by Anonymous

Terrible All Around

There is a total lack of transparency. Billing is slow and tedious. The bureaucracy is terrible. Prepare to take a half day of work to talk with them. The online web system is out-dated, slow, poorly designed, and difficult to navigate. They have very high deductibles. I have a history of melanoma skin cancer in my family. This form of cancer is basically un-treatable, except with early detection and surgery. After following the growth of one of my moles for two years, the doctor recommended that I get it removed and sampled. They billed me over $500 total. They will nickle and dime you. They will bill you for several different aspects of a visit and charge you co-pays for all of them. Your $10 copay can quickly turn into a $40-50 bill. Even if you call ahead to find out how much something will cost - what they tell you on the phone, won't be what shows up on the bill. After being very careful and calling ahead multiple times, choosing a professional through their online system, and having the professional provide written proof of my guaranteed coverage, now they are trying to charge me over $600. They claim the only way I can fight it is by going through a snail mail system of sending letters back and forth. We live in the 21st century. By now e-mail or the phone should be standard.
1.3 overall rating
by JoJo

So Many Denials

I have had to fight tooth & nail for all claims in the past few years, the co -pays keep getting higher & higher, deductable is a ridiculous $3000, and as I said they try to get out of paying EVERYTHING!
1.3 overall rating
by Anonymous

Disappointed

They don't wanna pay on my claims.
1.3 overall rating
by Anonymous

Poor Coverage

Our medical bills keep rolling in! Aetna just sent us another bill. The bill states the following: Anesthesia charge $1615. Aetna refuses to cover the full amount. They will only pay $1777 leaving the remainder of $438 for my wife and I to pay.
1.3 overall rating
by Anonymous

No Coverage

We haven't had any problems with just regular doctor visits being covered. However It's been quite a different story concerning coverage for our child born with Cerebral Palsy. He has a g-tube in his stomach thou which we feed him "Pediasure" liquid nutrition. It's what keeps him alive. None of the "in network" pharmacies such as Kmart, Target, Walmart etc. sell that product to consumers with an RX because it can be bought OTC. Pediasure and the tubing supplies is considered "Durable Medical Equipment" according to Aetna and is covered under our plan and yet they cannot find a medical supply/pharmacy that can furnish these necessities to us. One member service rep told us to go ahead and buy Pediasure at the store, keep the receipts, fill out the proper form, (which I insisted she send to me so I knew I'd have the right one) and we'd be reimbursed. It was denied!! Why? Because we used an "out of network" provider. The grocery store. When I stated that THEY told me to do that, they were very unsympathetic and basically said 'oh well, you'll just have to appeal the denial.' We wanted to use the pharmacy we had with our previous insurance but wasn't "in network". Aetna said to have our pediatrician fill out and fax a "transition of care" form to have coverage at that pharmacy for another 90 days. They said they didn't receive the fax from the doctor. So then I faxed it. Two weeks later, I checked and they didn't have a record of the fax. I faxed again. I've waited for 3 months and checked today. That's right, NO RECORD of the fax. We aren't rich. This Pediasure is $14.99 a six pack. Our son consumes 6 cans a day. If we couldn't pay for this ourselves and had to depend on Aetna my son would literally starve to death.
1.3 overall rating
by Tom W.

Canceled But Paying

I had major neck surgery. There were no in-network providers, so my plan says I would have to pay 50% after deductible. Now Aetna is saying that my coverage ended before that surgery even though I am still paying my premiums and they have been paying the smaller claims up to date. They are refusing to pay the larger claims and returning to the service provider claiming they were not pre-approved.
1.3 overall rating
by Anonymous

No Help for Cancer

I have been paying to have health insurance with Aetna for ~ 60 years. I never having a claim during that period. At 86 years old, I was diagnosed with cancer and got the runaround. After talking to ~ 10 customer service reps, I got no help. They did not call me back with the information that I needed to get the medical help and medication I needed.
0.8 overall rating
by Anonymous

Doctor's POV

I work with doctors in situations where patients are hospitalized and have no choice as to which provider is going to see them. In the end Aetna denies all claims.
0.8 overall rating
by Dennis R.

Dissatisfied

I just found out last week that I had not had coverage for my wife and I since August 31, 2007 with Aetna, although they had been paid from my check deductions each month. We have been told by several different ones that it was being corrected. We were told that we would hear from them in 24 to 36 hours, but it still has not been resolved as of yet. They claim that we are covered, but Aetna Mail Order says that we are not. My wife's medicine runs out tomorrow.
1.5 overall rating
by Anonymous

Little Coverage

I have had Aetna for 2 years. I go to the doctor once a year for a check up and both times, they have charged me for testing. They refuse to pay for anything even after appeals from me and my doctor. Their customer service is terrible and quite often have an attitude. Unfortunately I have a preexisting knee injury which limits my options in the search for coverage.
1.3 overall rating
by Meghan

Poor coverage and customer service

They will try to deny your legitimate claim by any means possible. After numerous complaints, Aetna invariably sends a lame apology about how they are wrong.
1.3 overall rating
by Anonymous

Poor Customer Service

They "lost" the fax (despite having the proof). "We never received your mail." Doctor had the wrong "code". couldn't read physio Tax ID. We'll call you back. "Not medically necessary." 800 line gets disconnected.
0.8 overall rating
by Anonymous

Four interviews

After submitting an Aetna application, their doctors and nurses called to interview me four times! I'm withdrawing my application and going elsewhere.
1.3 overall rating
by Anonymous

denied claims

My hubby had an emergency appendectomy surgery. Aetna denied the anesthesiologist bill the first time saying it "wasn't necessary". It took 3 phone calls to get the bill settled. They also denied the ER visit. Once again 3 phone calls. He went back to the ER two days after surgery for pain and was ordered more testing from the surgeon. This claim was denied as he did not see his PCP first. It takes many phone calls just to get simple claims settled. I wish we had another choice for insurance but they are all my hubby employer offers.
1.0 overall rating
by Zachary T.

Never Recommended

Our daughter spent several months in the hospital with a severe illness. We had Aetna Insurance and believed everything was going to be covered. Well, we haven't been denied our claim, but we haven't been approved either, and It's been 10 months since our daughter hospital stay. Repeated calls to Members Services got us absolutely nowhere! In fact, I really think some of the reps don't update their system when we call because sometimes we call and a new rep will answer and say that there are no notations about any previous calls made to the company!
1.3 overall rating
by Anonymous

Poor coverage and customer service

Each time I call member services they tell me something different. Member services tells their members one thing and the physician's offices something different. Aetna tells physician offices that they will cover medical tests and then only cover portions. There are many procedures considered "experimental", including procedures that all other insurance companies consider standard.
1.5 overall rating
by Tyler J.

Less Than Mediocre Service

Aetna's pharmacy via mail order is terrible. For two weeks I have needed a prescription filled and couldn't get it accomplished. I called every single day to find out the status of my prescription only to find out it was never mailed every single time I called. I tried to explain how important this prescription was as I needed it for very serious medical condition and I always got an understanding employee who completely understood everything I was saying why I was so upset, but I never really got anywhere. Finally, I ended up having to go to my doctor just to get samples to hold me over until the whole mess was cleared up. What's really bad is that there's nothing that I can do about it because I get Aetna through my employer and the other alternative health plans that my employer offers aren't really that great either. Unfortunately, I'm stuck with this less than mediocre service.
1.3 overall rating
by Anonymous

Long Term Disability Denied

I had long term disability with Aetna through my employer for 10 years. Five years ago I had a heart attack and then a 5 way bypass. One year later, I had a stint implanted as well. My doctors told me to never work because of my heart surgeries. Aetna, after 1 year, totally denied my claim!
3.5 overall rating
by Rebecca W.

Amazing

I have various health issues and I never got the run around when I called. I believe the Aetna reps are amazingly knowledgeable since whenever I called I may have gotten a different rep, but I still got a person in that knew what they were talking about and what needed to be done. The representatives at Aetna treated me like they really cared about my issues and concerns and I didn't have to keep calling back a hundred times a day to get results. I really liked it when they helped me find a doctor in my local area that accepted their insurance coverage; it made it fast and convenient for me and saved me a lot of travel time of the road. I am truly appreciative of the positive attitudes that the representatives have and the level of professionalism used by Aetna's claim department processors.
1.3 overall rating
by Jeri R.

Poor Pregnancy Coverage

Aetna's maternity benefits cover very little. For example, any pregnancy related blood work or lab work (such as determining HGC levels or the RH factor of blood) is NOT covered under maternity benefits, but instead goes towards your deductible.
1.8 overall rating
by Anonymous

No Prescription Coverage

My wife and I have Aetna with prescription coverage. We had to take Aetna because my wife's former employer went with Aetna and in order to get health insurance at a reasonable enough rate on our retirement, we had to go with them. So far about they only thing that they want to pay for is aspirin and that is a maybe.
1.5 overall rating
by Anonymous

No Coverage

They won't uphold my benefits package. They let a medical group charge me for $30 labs during office visit where I paid the office copay. The booklet says 'no charge' for labs conducted during office visit.
1.5 overall rating
by Anonymous

No Coverage

Had to pay out-of-pocket ($90/each time) several times for prescriptions because AETNA rejected them at the pharmacy and said I had to have them mail ordered. I needed those prescriptions urgently and could not wait for them to be mailed.
0.8 overall rating
by T

Lack of Customer Service

Aetna is the worst at processing supplemental sickness claims. This is unfortunately the second time I've required their service in the past 4 years. I was without pay for 6 weeks before receiving any payment. They are still now one month behind on processing my claim! I attempted to contact my claims rep only to get a voice mail saying to "please allow 48 hrs for a response". Which after 48 hrs I received no response. I was eventually told by a supervisor the checks were to be over-nighted. 3 days later I made a call as to the status of these "over-nighted" checks. I was told they do not over-night, but that the checks had been sent out in the mail. I received the checks 9 days later. The mail can be slow, but not that slow.
0.8 overall rating
by Sarah L.

No Coverage

I paid $200 a month just to pay bills that I would have paid even without giving Aetna the $200 monthly fee. They state in their description of benefits brochure that they would cover certain procedures and immunizations if done at the school health clinic. Well, I went to the school health clinic for those covered procedures and a few weeks later, received some letters from them stating that my routine exams are not covered. I checked their benefits page and called the school and it actually should be covered. So I was asked to call Aetna and the person informs me that the only thing covered are some accidents and emergencies but even then they have to be within guidelines.
1.0 overall rating
by Anonymous

Poor Customer Service

They never receive mailed claims, supporting documentation, faxes, etc.
1.3 overall rating
by Jenn

No Coverage

I had a few medical issues that needed to be resolved and Aetna denied ALL of my claims on the grounds that they had no proof that I was a full time student. After NUMEROUS calls to their representatives, I provided the same proof each time and EACH TIME the rep would tell me "Ok, you should be covered. We'll fix that billing issue now." However that NEVER happened. For MONTHS afterward I was plagued by bills from the doctors offices and the issue: No proof on file that I was a full time student. Again and again I called, provided proof, and was told everything was fine. It is six months after the medical issues, and I have only TWO WEEKS AGO permanently resolved the "full time student" issue. However, now they simply state that I never made the claims in the first place...as if I never even went to the doctor and provided them with my insurance card. So I am responsible for the bills myself even though not one week ago, I talked to an Aetna rep AGAIN and they told me they mailed a check to a doctor's office...Today when I called (after receiving another bill from that doctor's office) they claimed that I had never called and that they are not responsible for the money.
1.0 overall rating
by Anonymous

Run Around

I've been getting the run around with Aetna for one of my claims for almost a year. Different reps from different offices usually 1-put me on hold 2- apologize and say that they will put it on their task list 3- say they will call back but never do 4- make some excuse for the error like it was processed wrong or they need more information. 5- say it will take 7-10 days for it to be process. I have never had so much trouble for a claim. Some reps are nice and some make excuses. The bottom line is that the claim was approved and I still haven't been paid for my out of pocket expense.
1.3 overall rating
by Anonymous

Refuses All claims

I received $19,934.83 of denied claims in one envelope. Every one of them states: "Requested information not received from insured" and "THIS DIAGNOSIS HAS BEEN CONSIDERED ON A PREVIOUSLY SUBMITTED CLAIM, WHICH IS STILL PENDING THE COMPLETION OF THE PRE-EXISTING INVESTIGATION". The first one is untrue, as I have -never- received any request for any information from Aetna SRC. The second makes their intention to disqualify everything as 'pre-existing' quite clear, even though nothing meets their own definition of 'pre-existing'.
1.3 overall rating
by Anonymous

Terrible Coverage

They gave the wrong info to my husband regarding his MRI costs. They told him his deductible would cover it. After the MRI they called and said it didn't cover the cost leaving us to foot the bill. A very large bill.
1.5 overall rating
by Anonymous

Confusing

My son was released from Children's Hospital, Boston on 1/1/07. Since then there have only been 14 days that I have not had to make a phone call regarding medical claims. It took Aetna 3 months to confirm if compounded medications were covered under our policy and we are still trying to get reimbursed for them and other covered expenses that we had to purchase out of pocket! (8 months later) I have been given incomplete, misleading and flat our wrong information by member services. I have had to appeal claims that our policy clearly shows is covered 100%.
1.5 overall rating
by Anonymous

denies every claim outside of my PCP

Aetna's employees at the 800 number are inexperience or unhelpful. I was given the wrong information from Aetna's employee on when I noticed my medical bills had not been paid yet. I have over $10,000 in bills they are refusing to pay.
1.3 overall rating
by Anonymous

Poor Claims Process Practices

I switched to Aetna about a year ago because a friend of mine worked for the company. EVERY claim that we have made has been met with multiple requests for "additional information". They use every lame excuse to ask for more information and they only ask for one piece of information at a time. This draws the claim out for three or four rounds. They send notices that they have "mailed" me requests for more information, but they really didn't send the request. You can't do anything online. You must physically mail the information to them, thus drawing out each request for several days or weeks. Two weeks after I send in the information they usually already had, they ask for another tidbit of information. This is such an obvious stall tactic.
1.0 overall rating
by Anonymous

Denied Claims

The first time that we ever used this insurance was for an emergency and they denied us!
1.0 overall rating
by Anonymous

Rate Increase

In 6 months my family plan premium went up 40%! In the last 6 years it has gone up about 120%. When I called for some advice on a different plan, they were absolutely no help.
1.3 overall rating
by Josh

Poor Appeals Process

Customer service is terrible. If you have a problem all you can do is appeal by mail and then hopefully they will get back to you.
1.3 overall rating
by Anonymous

Poor Customer Service

Awful and impolite customer service. Does not cover what was promised.
1.3 overall rating
by Josh Raymer

poor communication

Their co-pays are ridiculously high and their customer service is terrible. Just yesterday I called to find out how much the co-pay would be on receiving an allergy shot, and my allergist gave me an allergy code to give them. Aetna customer service told me that I would have to just go get the shot and when the office ran my insurance they would be told what my co-pay is. They claimed there was no way for me to find out what the co-pay would be beforehand. I'm sure they'll charge me a full $50 specialist co-pay twice a week, despite it not being an office visit.
1.3 overall rating
by Sue

Everything is Denied

I've been with them for a year. I pay my premiums on time, but they refuse to pay for anything! They won't pay for my physical. They won't pay for flu shots. They tried to deny a doctor's appointment saying I had a pre-existing condition. I didn't have any condition at all! I was going to see the doctor, because I had a runny nose.
1.3 overall rating
by Anonymous

Delaying So They don't Have to Pay

They will delay responding to a claim for medication by a couple of extra days or more just to save those days worth of medication payments on their part. That's just wrong and the world needs to know about it. 10 days prior to me terminating my coverage, one of my pets knocked over one of my bottles of medication landing into his water bowl. The top had come of in the process, destroying what was left of that particular medication. I immediately called to see if I could get a prescription for at least the remaining time I was on the Aetna plan. They said they had to get back to me to see if they could override the prescription refill to allow an earlier refill at least for the remaining of the days I'm still covered. Someone was supposed to get back to me within 24 hours. That was 6 days ago and I've called back twice so far since the medication I need to take is a daily one that builds up in order to work and you can't just go off of it cold-turkey without bad effects. Each time I called to inquire, I was told by the representative that they were surprised at how long it was taking to respond to my inquiry and that It's usually no more than 24 hours for such a simple request to at least be answered with some sort of response. Now three days before the cancellation of my insurance, they're telling me since my insurance plan is ending in three days they aren't able to do anything for me. Even though I called 10 days requesting at least to get 10 days worth of the medication, they waited to respond to my inquiries until the time almost ran out. Even though they said they were going to call back within 24 hours of my original call, they never got back to me nor did they respond to my calls until three days prior to the end of my plan just to tell me that since It's now three days prior to the ending of my plan, they are no longer able to do anything because it would only be three days worth of medication.
1.3 overall rating
by Anonymous

Roadblocks

They find every reason to deny your claim. Customer service reps are not helpful or well informed. Its impossible to speak to an actual member of management.
1.3 overall rating
by Anonymous

often will not pay

They are trying to say that people have pre-existing health conditions, so that they can get out of paying for any claims. The people in the customer service department often cannot even answer your questions. The so-called supervisors are not any better.
1.5 overall rating
by Anonymous

No Answers

My doctor placed me on short term disability for clinical depression and submitted what Aetna required to process the claim. Aetna denied the claim and when I called to asked specifics on why I was denied, I had difficulties getting an answer. After 6 messages I have not received a call back from the claim reviewer. My doctor cannot get them to call him back either. I am being left with the additional stress of not being paid my short term disability.
3.3 overall rating
by Anonymous

Learn Your Plan

I've had Aetna for years and I hated it at first, but that's because I was uneducated about insurance. I've learned a lot and the best thing that you can do is to stay in-network, check out the clinical policy bulletins, and sign up for Aetna navigator so you never have to call member services. You can do everything yourself, even change your address and order an ID card or inquire about a claim. You just have to be pro-active because its your health, not theirs.
1.8 overall rating
by Anonymous

Reject sick people

If you apply to Aetna for individual insurance and take more than 2 prescription drugs, you will be rejected. It's not that they identify medical risks and charge a rate in line with the higher risks. They just send you a letter saying you're declined.
2.8 overall rating
by Angi

i had preemie twins with aetna

It took a few phone calls and a lot of online reviewing, but in the end Aetna paid everything after my $2,500 deductible. They even paid for my twins to stay in the NICU with out another deductible because they were covered under me for the first 30 days. Just the cost of their stay was $79,000 each. They also covered my gallbladder surgery which was a week after I gave birth. I didn't have to pay anything for that surgery. The medication coverage is a little disappointing, but with doctors' letters, I got all of my medications covered.
0.8 overall rating
by Anonymous

No Coverage

Aetna has refused to pay for basic blood tests at a facility that I only went to because their customer service department told me that it was the only covered facility in the area. They also canceled several mail order prescriptions without notifying me even. they charged me a co-pay of MORE than the non-insurance price of a drug and they refused to pay for a orthopedist visit because I didn't have a referral even though I have the open access plan that does not require a referral.
1.0 overall rating
by Tina

Waste Of Money

Good luck trying to get them to pay for anything. I have a moderate-to-severe case of psoriasis and they will not cover anything related to my care. I need strong medications that run upwards of $500 per month.
2.0 overall rating
by Anonymous

Poor Maternity Benefits

I had tried to ask all the right questions before we switched. Understand you pay the specialist copay for each diagnostic test, blood tests, non-stress, etc and for ultrasounds. This was huge for us in a high risk pregnancy and would have changed our decision to switch. It all became clear later. don't be fooled by their Moms to Babies program. It has nothing to do with coverage.
1.5 overall rating
by John A.

No Coverage

I have a large family. Aetna is the only company with the type of payment plan we can afford. I have never ever had to call an insurance company as often as I have had to call Aetna. On a bi-monthly basis, I have to call about a bill that they aren't going to cover for whatever reason they can come up with.
1.8 overall rating
by Anonymous

Technologically behind

They still use paper forms you have to download and then fax. Submitting claims to other insurance companies is a simple online process.
1.0 overall rating
by Anonymous

Poor all around

I paid $5,530 a quarter for the past six years for their insurance. I've gotten: poor service, misleading information, denials written the same day pre-certification app was sent for a covered procedure, appeals never acted upon, lost documentation, and no calls back.
1.8 overall rating
by Anonymous

Terrible Customer Service

If you try to call the toll free number, you get this horrible voice activated answer service that never hears your replies correctly and ultimately just hangs up on you after a bunch of runaround. You can never get to a real person. The drug prices on their website are NOT what you end up getting bilked for at the retail pharmacy.
1.0 overall rating
by Anonymous

No Coverage

Every time a family member or I go to the doctor, we get sent to collections. You could call their customer service every day and get a different answer form the reps on the other end of the phone.
1.5 overall rating
by Anonymous

Expensive Insurance, No Coverage

Aetna offers absolutely no coverage until their huge deductibles are satisfied. This insurance company has raised my rates for deplorable insurance coverage every few months even though I have made no claims and am a healthy individual. They doubled my fees and raised their rates twice over the past three months.
1.3 overall rating
by Allison L.

Poor Record Keeping

I clearly signed up for a full coverage plan (dental, vision & major medical). Money was deducted from my paycheck. When I arrived at the dentist, had my teeth cleaned, went to scheduled a follow up appointment in 6 months, the clerk told me she called my insurance provider, mentioned my place of employment and my name and Aetna had no record of me being in their system. This has forced me to have to pay out-of-pocket for my appointment when money had already been deducted from my paycheck for dental.
1.5 overall rating
by Anonymous

Poor Customer Service

My son was born four months ago, and was in Childrens Hospital NICU for five days in his first week of life. Now, four months later, Aetna has yet to pay more than $25,000 in charges. I am getting phone calls from the CHOP collections dept. wondering what is going on. The whole issue is that Aetna has been trying to find out if my son could have been covered under other insurance during his first 31 days. They sent me a form to verify that my insurance is his only coverage. I filled out the form and sent it back in August. Then Aetna sent me a follow up letter in September saying they need to know my husband's date of birth. I called and emailed customer service 7 times to give them my husband's dob but they are still sending me EOBs saying that my claims are being denied because they are waiting for my husband's DOB. It still has not been resolved despite many, many customer service people telling me that I was all set, and I am at wits end!!
1.3 overall rating
by Anonymous

Nothing is Covered

They don't cover anything. They have all sorts of stupid clauses. I am stuck with a $1,600 bill due to a emergency root canal.
0.8 overall rating
by Rhonda

Double billed

I'm dealing with Aetna's Cobra dept. I lost my job and am paying the premiums on my own. I pay over the phone to avoid any chance of them saying they never received my payment and cancelling me. They took 2 payments instead of one and now I'm getting no customer service in handling this. They say a refund will be mailed, but won't tell me when.
1.8 overall rating
by Chris

No Coverage

They would not pay for anything except $20 of an expensive procedure.
1.5 overall rating
by David

Raised our rates 80% after policy change

I was laid off last year. My wife works for a VA Hospital and added me on her health care plan with Aetna. We received an updated packet from Aetna. Basically they increased our rates 80%.
0.8 overall rating
by Tina B.

Complicated and Disorganized

My daughter received medical treatment that is clearly covered under Aetna's guidelines. Nevertheless, Aetna denied the claim. I filed two appeals with them. The paperwork for the second appeal reached them on December 24th - the second denial letter is dated December 26th. It's obvious the denial was sent out as soon as the paperwork hit the desk. Next I filed an external review with the Department of Insurance. Aetna needed to send me any documentation they had in reference to my claim. This documentation was sent out to me, overnight. Unfortunately Aetna left my apartment number off the address; we are still searching for this package. Then Aetna promised the DOI contact person they would send it to my work. That never happened. Finally they sent the documentation out again. Again addressed incorrectly. This time they left a digit off the street address. UPS is trying to retrieve this package also. Besides that, they are incapable of keeping my address correct in their system, and my EOB's get send - you guessed it - who knows where.
1.3 overall rating
by John B.

No Payments

They did not tell me when a single week's premium payment did not reach them, even when I called and specifically asked if my premiums were paid and the account was OK! Three months after the one-week loss, I find out while I'm at urgent care for stitches that they canceled my coverage for that week and now urgent care will not treat me until I pay the resulting $400 bill! Then my toddler son went to the ER a year ago for an emergency, the insurance checked out fine in the ER. I got a statement from Aetna saying they covered/paid everything, but a small portion of his EKG. I sent a check out for the next day. Today, a year later, I get a massive $3,500 bill from a collection agency for the ER visit! I called the agency and they said that Aetna never paid a thing!
1.3 overall rating
by Ron P.

Overcharges

They overcharge your account and have no records of cashing your check. You email them and fax them documents of them cashing your check, but they still don't fix the problem.
1.0 overall rating
by Anonymous

Poor Customer Service

They refuse to cover anything. They refuse to cover tests that my doctor required and which saved my life. They RAISED THE COST of my birth control when I applied my insurance card. It went from $60, to nearly $80!
1.3 overall rating
by Anonymous

Terrible Health Insurance

Aetna will not follow the provisions of my employer's private PPO agreement, deny everything,and raise premiums and deductibles.
0.8 overall rating
by Anonymous

Paying, but Not Covered

I go to a university where it was required that we have insurance. I paid $800 through my first semester, only to find out that the whole time, I had the wrong insurance card. It wasn't even insurance. It was a discount plan and the medical insurance that I had actually bought was never sent. I talked to a representative. She said that it was my fault for not calling.
1.3 overall rating
by Anonymous

Pharmacy Issues

Their "mail-order pharmacy" is useless. They sent my meds to the wrong address TWICE in a row. So I was out of medicine twice.
1.5 overall rating
by Anonymous

No Coverage

Routine physical, hospital bills, imaging, scans, physical therapy, and lab work is not covered.
0.8 overall rating
by Anonymous

Poor Customer Service

I was told that my plan covers 75 visits of physical therapy per year, yet I noticed that about 20 of my claims have been denied because a progress note from my physical therapist needs to be submitted when it exceed 25 visits. The worst thing is that Aetna does not notify you when claims are being denied. You have to create an account online and check the status of any claims online. My physical therapy office faxed in the progress note and called to confirmed It's been received. I had also called and was told they have received the progress note and will forward it to the proper department. Then I called several time afterward to check on the status of the claims and were told they are still under reviewed and it takes about 3 to 4 weeks to process. After 5 weeks, I called and was told that they need to resent the progress note and have it reprocessed due to an error and it'll take another 14 days or so. I was shocked and tried to ask what's the error. However, the rep was extremely rude and impatient and refused to give me an explanation. She kept telling me that It's due to an error. I asked to speak to a manager and was told all managers were out to lunch. I left the manager a message to call me back. After a few hours of wait, I called back again and was transferred to the manager's voice mail again. Then, I called the third time, the rep said that they would never tell me that managers are out to lunch because the only way to get a hold of the manager is to leave a message in their voice mail and they'll call me back within 24 to 48 hours. It's been a few days now and I still haven't heard back from anyone. Aetna is extremely shady and they don't value their customer at all. I have feeling that my claims won't be approved.
1.8 overall rating
by Anonymous

Aetna will never pay

Aetna simply denies and let 's you spend half of your life fighting them until you give up.
1.3 overall rating
by Anonymous

Bill half paid

Aetna OK-ed my surgery and hospital stay, then I received a $50,000 bill from the hospital. Before this they approved an MRI, and then I had to pay an extra $5,000 out of pocket.
1.3 overall rating
by Anonymous

Treatment Denied

My employer switched to Aetna who denied an on-going treatment for Thoracic Outlet Syndrome that is considered experimental, but is the only treatment option for me. Every health insurance I have had since the diagnosis in 2000 had approved the treatment even with the clause 'experimental not covered' because after review of med records, it was obvious it worked for me and gave me quality of life. My recent appeal was denied even with Aetna admitting the treatment has proven success for me.
0.8 overall rating
by Charlie

Deductible Reset

They had some reps come to our office and explain the benefits of the health savings account (HSA) plan. I specifically asked about the coverage period for the deductible and was told since our enrollment period went from July to June that was also our deductible period. After paying through the nose for services from July through December, we were told in January that our deductible reset and we needed to meet the $4000 deductible again.
1.3 overall rating
by Greg

No Coverage

They were the insurer for my company for approximately two years until my HR Department realized how terrible they were. I had no exclusions, pre-existing conditions, or gaps in creditable coverage, but Aetna denied payment for every visit, lab, test, and prescription during the time they were my provider. It was a different reason every time, including being told "It's too expensive" as the reason they would not cover a medication for which there is no generic equivalent.
3.8 overall rating
by Anonymous

Took Care of My Family

My wife's company pays our premium and when she was diagnosed with cancer Aetna did everything to make it go as well as they could. A nurse with Aetna called and made sure she was getting the treatment she needed, and the $100k+ treatment costs only cost us our $1k deductible. Without Aetna, who paid for everything recommended by her physician, she would not be here today.
0.8 overall rating
by Anonymous

Ridiculous Out-Of-Pocket

We had to prove that our son was a full time university student with an insane deadline that if wasn't met, all coverages on all dependents would be dropped. Then my son had a broken clavicle and it required surgery. First they want to point fingers at anyone or anywhere he was at time of injury. He wasn't in a league, nor did anyone touch him to cause injury, he fell on an older broken clavicle that snapped the bone up by his neck. He wasn't on school grounds, nor in school related activities. No orthopedist would touch him for miles due to Aetna. It took a 150 mile trip to have the surgery. My husband suffered severe angina and was admitted to the hospital for 24-hours observation. Our part of the bill after Insurance payments are in excessive of $2,500. We have the cardio stress test today. They have pre-contacted the insurance company. Our out-of-pocket expenses was in excessive of $1,100.
0.8 overall rating
by James

pays for nothing

I carry Aetna through employer. I have never been to the hospital before, but had to this once for my son who seemed to have disjointed his elbow. After we registered and X-rayed his arm, the problem went away by itself. It should have been covered 100%, but Aetna refused to pay for it and I'm obligated to pay.
1.0 overall rating
by Anonymous

Everything is Denied

They have denied radiological services for a stress test and denied anesthesia for a surgery. I guess that I was supposed to have surgery without it. They also denied physical therapy following surgery. It didn't seem to matter that I could not use my arm.
1.0 overall rating
by Anonymous

no discount

Despite using an in-network-provider, Aetna refused to negotiate a reasonable discount. The bill without insurance was $5,500. The bill with insurance and an in-network-provider was $5500.
0.8 overall rating
by Anonymous

Refused

Aetna has very poor customer service. Their website sucks too. They keep refusing my request to see a specialist.
1.5 overall rating
by Anonymous

Poor Customer Service

I can't believe the substandard customer service Aetna's people deliver. After being ill for an extended period of time and running up quite a few expensive doctor bills, I got several notices in the mail that my bills weren't being approved by Aetna. I couldn't understand why the bills weren't covered because my policy clearly indicated that my doctor visits should have been covered. I had to place five, long, drawn-out, irritating phone calls to the company before I finally got the entire mess rectified. It seems that some computer error was responsible for the inappropriate denial of my claims. Why couldn't Aetna figure that out the first four times I called them? I spent so much time on the phone and aggravated, I am surprised I am not sick just from being so stressed out!
0.8 overall rating
by Christian

No Prescription Coverage

I just tried to pick up 5 prescriptions that I needed. The total cost: $500! I thought it had to be a mistake. I pay for a pretty decent PPO plan from them. I called Aetna SRC's help number and they assured me that there was no mistake. In fact they HAD given me a discount. A discount of $40! I pay you over $150 a month.
1.5 overall rating
by Anonymous

No Coverage

After paying all the bills for my surgery, I got another bill in the mail from the hospital. All my 'Explanations of Benefits' matched and yet another large bill arrived that they wanted paid in 10 days. I called Aetna three times before someone would call the hospital. After they talked to the hospital, Aetna decided that they had overpaid and seemed grateful that the hospital caught the error. So guess who gets stuck with the bill?
1.0 overall rating
by Beth B.

useless

They failed to pay various doctor visit bills, lab tests, etc. My husband got so sick of calling them. He probably spent 20 hours on the phone with them over a few months. We're ending up paying the bills ourselves anyway.
1.8 overall rating
by Michael R.

Little Coverage

I have filed two claims, one of which was only for $56 and they refused to pay either. The other claim was for only $80. Aetna paid out $13.92.
2.5 overall rating
by Anonymous

Cover Nothing

If you call Aetna to ask if they cover tests they will say yes, but when you have a routine test like a mammography they will then deny the claim.
1.8 overall rating
by Anonymous

No Coverage

Our plan clearly states that they are supposed to cover immunizations at 100%, yet they constantly come up with excuses for why they shouldn't have to pay.
1.5 overall rating
by Anonymous

Aetna-"Home of the 5-day fax"

I went out on short term disability and sent Aetna the paperwork. Out of all the millions of pieces of mail going thou the Post Office, mine to Aetna was lost. So I faxed copies of the paperwork to them. Still no check. Now waiting for someone to call me back from Aetna. My employer (who holds this worthless policy) has had no better luck with them than I have.
0.8 overall rating
by Anonymous

Difficult Website

I got a quote for Aetna through Esurance that seemed to be a perfect fit, but when I went to to Aetna's website to compare the quote the website was so hard to navigate that not only could I not get it to give me a quote, but there was no way I could see to contact the company to get help.
1.3 overall rating
by Anonymous

Difficult Customer Service

I took out a health insurance policy for my son when he turned 23 and was released from our family policy. First they doubled the premium without telling us because he has ADHD, even though he never sees the doctor. He just takes medicine during school. Then they denied all of his claims because they said they did not have any information proving that he had prior insurance. Once this information was provided, claims were still getting denied for this same reason. I had to call customer service every time and tell them that they had the information and to please pay the claims. They would pay one claim and then the next would be denied.
2.5 overall rating
by

Unaffordable

we've been very pleased with Aetna HMO's in-network doctors and hospitals. I have not had any major health issues, so I see my primary care doctor only once a year for a checkup. I do not have any prescription medicines. Since 2002, my husband has had 5 surgery / emergency conditions and each event required 3 days in the hospital with many tests and occasionally specialists. We never had a problem with any of our doctors getting paid by Aetna. The hospitals and doctors submitted the info directly to Aetna and we did not have to be involved. But since 2002, our premiums have gone up 540%.
1.5 overall rating
by Anonymous

Aetna Just plain AWFUL

Poor customer service, claims experiences, and website. Absolutely a giant hassle and pain every time a claim goes through. I will venture to guess that about 75% of my claims are not processed correctly, and I have to fight to correct them. 50% of those are never corrected, and I am left paying the difference.
1.3 overall rating
by Paul N.

Beware of Aetna

They seem to play the typical game of denying claims, making you complain to them, and then admitting they made a mistake in denying the claim.
0.8 overall rating
by Cooper M.

Less Coverage. More Payments.

Some of the prescription drugs that we have been on for about 10 years are no longer covered. The cost of this insurance has jumped by $140/month and the deductible has increased. The co-pay has also increased.
1.3 overall rating
by Anonymous

benefits?

They have horrible customer service. They have absolutely NO coverage and make you pay with all these stupid fine prints in their policy.
1.3 overall rating
by Anonymous

No Coverage

In efforts to cuts costs, my employer forced us all into Aetna. It has been an awful switch. They don't cover anything. You continually have to fight with them to get them to pay for legitimate claims. My doctor, pharmacist, pretty much anyone we deal with despises dealing with them. On top of this, they are increasing rates like crazy.
1.3 overall rating
by Anonymous

terrible

Recently, my son was injured at his grandpa's house. Aetna hired a private subrogation company and attempted to sue my dad.
1.3 overall rating
by Anonymous

does not pay items that are covered

Aetna clearly covers 60 physio visits per year. We have X-Rays/MRIs and prescription that they say medically not necessary. However, they refuse to speak with the doctor or respond to his letters reviewing the case.
1.8 overall rating
by Anonymous

Short Term Disability Disaster

My doctor had me off work for a surgical removal of a large lipoma in the palm of my hand. He said at least one month off work. Aetna paid me for two weeks. I had sutures in my hand from the base of my ring finger curving toward my palm and intersecting and running all the way to my wrist. My whole palm was opened up. My sutures were in for three weeks and when they did come out. Some infection was found. I went on antibotics. Aetna admits that they have eleven pages of documentation from my surgeon. When I call Aetna, they always say it is still in review.
1.0 overall rating
by R. Spirelli

Poor Customer Service

They don't pay claims. They pull crap stating that your policy is written in a different state, so the HIPAA is different there. They never return calls and they miraculously never get the faxes you send them.
1.3 overall rating
by Anonymous

Disorganized and slow

I need my medication on the regular basis, so I have to deal with their specialized pharmacy which cannot find my records for 3 months! After going on and on providing proof that I have been with the insurance for almost a year they finally find my file. However, then they need to verify my benefits which takes them 2 more weeks! After I finally I receive my medication, in 3 weeks I have to go through the same process again. Their customer service is unprofessional. They have no clue about what they are doing and have no empathy at all.
1.3 overall rating
by Anonymous

Denied Claims

They typically deny claims as a stalling tactic and it takes numerous telephone calls to straighten things out.
1.0 overall rating
by Kris

No Coverage for Cancer

I have been fighting cancer and Aetna has put me through hell. I had to fight for short term coverage now I'm fighting for my long term coverage. This is for a policy/coverage WE pay for. Terrible company with terrible customer service.
1.5 overall rating
by Anonymous

Flexible Spending = Inflexible

You better give them exactly what they want. They ask for more documentation and then say your to late to submit the receipts.
0.8 overall rating
by Anonymous

No Customer Service

Every time that I have called Aetna, I have reached a person who is hard to understand. They get mad for you not being able to understand them. They tell you a supervisor will call you back, but that never happens. I am writing this while I am still on hold them. This is my third phone call to them. I was just told that a supervisor has 24-48 hours to return my call. I'm getting no where.
1.8 overall rating
by Anonymous

Little Coverage

I recently had a dental issue - a crown cracked. I called my dentist and he fixed the crown within a week. Only after the crown was fixed did I learn that Aetna Dental wouldn't pay for it. Apparently, that crown was put on 5 1/2 month ago and my policy only covered crowns applied <=6 months. After my dental office learned that Aetna wasn't covering the crown, they appealed.
1.5 overall rating
by J.D. Carlton

Going for Broke

Aetna cut off my disability payments when I needed them the most!! I was getting Aetna disability payments when I went out on short term disability. As soon as the short term issue turned into a long term one, Aetna left me hanging out to dry!!! I couldn't believe it, they told me that my disability was no longer covered because it was a Workers compensation issue and that I had to take it up with the company and with compensation. In the meantime I was disabled with absolutely no income coming in. I ended up having to drain all of my saved income, including my 401K plan just to make ends meet! What kind of gig is that? How can an insurance company promise coverage and not deliver? My financial position has been destroyed because of it and I wound up filing for bankruptcy - to anyone who reads this you can't count on Aetna paying you.

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