2.6
67 reviews
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Aetna

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Aetna
 
2.6

(based on 67 reviews)

Ratings Distribution

  • 5 Stars

     

    (4)

  • 4 Stars

     

    (20)

  • 3 Stars

     

    (11)

  • 2 Stars

     

    (6)

  • 1 Stars

     

    (26)

49%

of respondents would recommend this to a friend.

Pros

No Pros

Cons

No Cons

Best Uses

No Best Uses
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Most Liked Positive Review

 

Got Health Care Issues? Get Aetna

Health insurance is a must in today's world of high hospitalization costs and expensive outpatient care. A simple visit to a family practitioner can cost a couple hundred dollars and this is nothing compared...Read complete review

Health insurance is a must in today's world of high hospitalization costs and expensive outpatient care. A simple visit to a family practitioner can cost a couple hundred dollars and this is nothing compared to the cost of long- term care or major operations, which can run into the tens of thousands of dollars. One company ready to assist with your health care needs is **Aetna Health Insurance**. Let's take a closer look at this insurance business:** **

**Insurance Commentary:**

Aetna is a large, mutual insurance company that offers many different types of insurance. The health insurance is the Aetna product with which I am most familiar and I have been using  Aetna Health Insurance for several years now. I left once, for a short time, but then returned to Aetna because my "experiment" with a less expensive provider didn't work out the way I had hoped.

Aetna Health Insurance is offered at several different levels and these are going to vary from one group plan to the next. The group plan to which I am a member offers about five different plans with a substantial cost difference between them. At the upper end of the cost scale, Aetna will cover just about anything you need and will charge low deductibles. The base cost of this top- level coverage is about $200 per month greater than the lowest level and unless you feel you are prone to illness and excessive doctor's visits, it is best not to select these higher levels of insurance coverage. Most individuals and families will not use the benefits to make this selection cost effective.

My level of coverage with Aetna ranks in the middle of the plans offered. I would likely have selected the least expensive coverage level, given my nearly perfect record with health issues. But since I have a family, it is important to have a plan that is at least a little bit more flexible and that covers more health- related situations. The plan I have selected with Aetna Health Insurance has proven to be pretty good and while I have had to pay some money out of pocket, Aetna Health Insurance has always covered the remaining expense without any problem. They have kept their side of the deal, like they should.

Claims and customer service are the main components to a successful and respected health insurance company and Aetna Health Insurance ranks above average in these areas. One of the greatest irritations is to call a health insurance provider and wind up stuck on hold for a long period of time- especially when you are standing there, in a doctor's office or hospital, needing quick answers to questions. I don't know how many customer service reps Aetna Health Insurance has, but I am impressed at how quickly they answer the phones when I call. I usually hear a live voice in less than one minute, and the rep is quick to answer my questions. I get a little annoyed at the amount of information that has to be provided for verification, before the Aetna Health Insurance representative will assist the customer, but I also realize that they have to be very careful to make sure they are speaking with someone who really is an Aetna customer.  

With claims, I have had few issues with Aetna. I can recall one time when they would not pay for a family member's prescription, but a quick call got everything straightened out. The helpful rep even sent me an e-mail link to the exact place in the Aetna web site that I needed to go, in order to get the form I needed to process a refund for the prescription expenses. It was so quick and simple that I was able to overlook the inconvenience.

**Bottom Line Viewpoint:**

No insurance company is perfect, but Aetna Health Insurance ranks as one of the better insurance providers with which I have done business. Aetna is getting more and more restrictive in what they will cover, but this has been the trend with health insurance providers for a long time now, due to rapidly increasing costs. And when I consider everything, Aetna Health Insurance ranks as a better than average health insurance company. I've had a few issues with them (who hasn't had issues with their health insurance provider?), but they have resolved them quickly and professionally, ensuring that I stick with Aetna for the foreseeable future.

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Most Liked Negative Review

 

deny, deny, deny

 

           In Jan, 2006, my company changed HMO's and I was excited because Cigna had not done a very good...Read complete review

 

           In Jan, 2006, my company changed HMO's and I was excited because Cigna had not done a very good job. Aetna had a pretty good reputation. I had 3 doctor visits in 2006 and had only 1 minor problem with Medco, their prescription handler. Then came 2007. I think they wanted to be stars in the movie "Sicko". I can understand a claim being denied because of different reasons and then when more information is obtained, the claim is paid. What I cannot comprehend however, is when 9 claims are denied and after 11 phones calls, all the claims are paid. It seems obvious to me that a pattern of "denial first, ask questions later" is in place. Having worked in the customer service business for 31 years before retiring, I was quite upset. I hope this situation is unique to me, but somehow, I don't really think so, 

Reviewed by 67 customers

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1.0

Aetna Medicare Open Access HMO

By 

from New York, New York

Comments about Aetna:

Aetna has paid for nothing so far: they approved a CT scan, then disallowed it; they do not pay for my prescription for basic blood pressure medicine; they did not pay my dentist even though I had the additional dental coverage by claiming the dentist was out of network even though they assured me the provider was in-network;they fill me with dread every time I need to see a doctor because even though I double check to be sure I have an in-network provider, I anticipate a fight.

  • Affiliation:
  • I am an employee or otherwise affiliated with the brand

(4 of 4 customers found this review helpful)

 
1.0

DO NOT GET AETNA

By 

from Houston, TX

Comments about Aetna:

No one at Aetna can seem to give us a straight answer in regards to my wife's doctor and her visits. We have been fighting with them for months now to cover my wife's Well Woman Exam which has been legally covered by Executive Order since 2013 and they are refusing to pay. At first it was an "experimental" procedure and they would not cover it; they also stated that my wife's doctor was out of network but when we looked it up the website said she was in network. After a month of phone calls and no consistent answers from anyone, we were able to get the actual exam paid for but they still refused to pay for the doctor visit. Another month of phone calls later, we finally got to someone that "fixed" our problem, an email saying they resolved the issue and that all along Dr. Blackwell was in our network. We thought our problem was fixed but unfortunately my wife is in need of a procedure for her endometriosis and we are now being told once again there was a mistake and Dr. Blackwell is out of network and she needs to find a new doctor. Nevermind the written document we have saying that she is in our network and apologizing for the mistake in the first place. Instead "you must be mis-informed" is what we were told with no offer of help to fix this ongoing problem.

What great customer service!!!

At this moment, we are counting the says until open enrollment begins again and we wont make this mistake again.

(4 of 4 customers found this review helpful)

 
1.0

Disappointing customer experience all around

By 

from Atlanta, GA

Comments about Aetna:

I am a small business owner and purchased individual insurance for myself and my son starting in 2014. It's been a disaster of an experience.

Just the highlights -

I was told that my out of pocked max for by hospital birth was 6500 - ended up being 6500 for me + 6500 for my child who spent 8 days in NICU - grand total of 13,000.

I called and cancelled my son's coverage for 2015 since he was being covered by his father's insurance. They neglected to make the change.

Aetna "accidentally" dropped my service along with my son's service (which, luckily, he did not need) in 2015 because that plan was no longer offered. In such cases they are supposed to auto enroll you in a similar plan. We were both totally dropped - I had no idea until I could not fill a prescription. After 3 attempts with customer service, the first 3 told me I had to wait until the next open enrollment period, I was finally told that the cancellation had been done in error and they re-instated my coverage.

Billing - I am enrolled in autopay - some months I am not charged at all - some months I am charged for 4 months. Seems to be no rhyme or reason.

My son's father recently lost his job and I needed to re-instate coverage, which, legally - I should be able to do - as an exception to open-enrollment. The Aetna agent told me - sorry, you cannot apply for coverage - you have to wait until open enrollment. I explained all the details but the agent was no help.

I called Humana - the agent was informative and said, absolutely, your son qualifies for an exception and can be covered.

Horrible experience, I will get out as soon as I can!

  • Affiliation:
  • I am an employee or otherwise affiliated with the brand

(2 of 2 customers found this review helpful)

 
1.0

Thumbs down

By 

from Bradenton, FL

Comments about Aetna:

My company switched from a self-insured plan to Aetna. I have had Rheumatoid Arthritis for 40 years and have had my ups and downs. A little over three years ago, my doctor prescribed Orencia to me and it is a miracle drug. My insurance covered the cost ($2900/month per the website)and Orencia helped with the co-pay. My monthly cost was $5.00. My doctors is trying very hard to get approval for Orencia from Aetna but it is one obstacle after another. When I called the company (that's another story!!), I was told they did not find the medication "medically necessary." Orencia has changed my life so much and Aetna doesn't care. Not having the Orencia will mean the difference between not having pain and working full-time, to being in a lot of pain and applying for SSDI. Other people are in this situation with drugs that mean life and death. I have not heard one good thing about Aetna from my co-workers. I cannot write here how I really feel about them.

(2 of 2 customers found this review helpful)

 
1.0

Aetna doesn't cover blood - even for emergencies or Red Cross

By 

from USA

Comments about Aetna:

Aetna covers a lot of things for the $14,000 in annual premiums that I pay them since they are the only choice I have - and yet they won't cover blood transfusions, even after accidents or in cases of Cancer. Even Medicare would cover blood. Aetna doesn't even care if the blood was donated to the Red Cross. Now I've paid $5000 for 3 units of blood and a unit of plasma to avoid dying. I hate Aetna.

Customer Service
Even their reps cant explain why they will cover a bypass operation for hundreds of thousands of dollars but yet wont pay for the blood that is needed.

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(1 of 1 customers found this review helpful)

 
1.0

Watch Out For Your Benefit Balance!!

By 

from USA

Comments about Aetna:

In my case, the claim filed by my doctor was not updated on my Aetna account. I ended up paying out-of-pocket for that (around $1000+) because my benefit had been exhausted by the other following treatment 2 months after.

I did check how much I had left prior to getting the other treatment. Since they didn't receive the claim/update my account (which definitely was Aetna's FAULT), I didn't know that I had no more benefits for that year. Had I known that my benefit had been exhausted, I wouldn't have had proceed with the other following treatment.

Bottom line, it's Aetna's incompetency in keeping my benefits up to date had caused me huge sum of money. They blatantly said it's not a matter of whose fault, and regardless, they would still deny the claim anyway!! Also, their customer service is notoriously rude!!

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(5 of 6 customers found this review helpful)

 
1.0

AETNA NIGHTMARE

By 

from USA

Comments about Aetna:

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?

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(4 of 5 customers found this review helpful)

 
1.0

Difficult

By 

from USA

Comments about Aetna:

I have found Aetna to be extremely difficult to work with. They have interfered with Dr.s recommendation with no consultation with the Dr. The website is not easy to navigate. The deductibles are outrageous for the amount of premium I pay. The premium also increased by over $100 after the first year. Further the list of approved lab facilities in my home area is limited to a local hospital which increases the cost for me considerably. Overall it appears that the company creates roadblocks to accessing convenient and affordable care in most areas. I would not recommend Aetna to anyone and am currently searching for another health plan. The Patient Care Department, and they are not employed by Aetna, is the only department that has offered genuine help in navigating this unfriendly and complicated policy.

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(5 of 6 customers found this review helpful)

 
4.0

So Far So Good

By 

from Dallas, TX

Comments about Aetna:

We have recently switched our family over to Aetna coming from Blue Cross Blue Shield as mandated by my husband's job. Premiums and rates are about the same, but I have noticed that the plans seem a bit more customized in terms of variety of options. We have coverage for the primary, which is my husband, as well as the spouse and children. I did notice that adding a coverage option for the spouse made our premium significantly higher, even more so than adding just our two children.
Additionally, the policies seem pretty straightforward. There is no guesswork about exactly what is and is not covered.
The website seems user friendly. I really like the "Find a Doctor" feature that allows me to locate doctors that are in my network according to which specialization I need. The virtual assistant is a helpful feature as well.
Again, I have not had a great deal of time being covered with Aetna, but so far, I think it stacks up pretty comparably to Blue Cross Blue Shield in terms of rates and coverage.

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(2 of 3 customers found this review helpful)

 
3.0

Better then not having any health insurance

By 

from Pittsburgh, PA USA

Comments about Aetna:

I wish I had a choice other then Aetna, but they are the only coverage that my employer offers. The issue is that it is a large national healthcare company and when you live in a market with several strong local options for insurance companies, there are many doctors who won't accept Aetna or are considered Out of Network. I have had some issues with customer service and paperwork with aetna as well. And the billing seems a bit unorganized. There will be times that I get a bill up to six months after a service. Other times I got a bill less then a week that was due immediately. I'm not sure why there seem to be such inconsistencies but it is frustrating.
If I had a choice in the matter, I would not have Aetna for my insurance coverage.

Customer Service
For the most part, my customer service experiences have been mediocre at best. The worst was when I was going through a difficult time and needed paperwork from Aetna for work. I was transferred about five times and had to explain what I needed each time (and it was very tough and emotional to explain it). The first representative I spoke with knew that and I wish they would have had a way to relay that information to each other instead of making me repeat it several times.

Available Plans
This is a tricky question because the available plans are limited to what is available through my employer. Much like most other major corporations, they switched to only offering all high deductible plans. I had the choice of paying more for insurance if I wanted a lower deductible, but there were not a lot of choices between levels of coverage and what was covered. They don't offer the options and plans that some companies do that include things such as a gym membership which is unfortunate because they claim they want you to get healthy and have the resources to do so, but then they don't really offer those resources.

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