Masaru S

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Worst regulations and costumer service

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I've had the same prescription for over two years, 40 mg of the same medication daily. Because there are no 40-mg pills for this particular medication, I've been taking either 2 20-mg pills, or a 30 plus a 10-mg pill at the same time. Despite having no issues in the past with this type of prescription, suddenly there is a new regulation that authorizes only one pill a day. They said the authorization process would take up to 72 hours and that my case was likely to be approved because it met the criteria. The process was initiated on Monday night, after business hours, so let's say Tuesday morning. On Friday, I call them and they say they haven't received a response from my doctor, which wasn't true because my doctor had replied to the fax sent by the insurance company on the same day, Tuesday. While I'm on the phone with the representative, they find the form sent by my doctor, but insist that I should reach out to my doctor and tell him to call them, because it's easier that way. I refuse to contact my doctor again and only then they offer to reach out to the doctor's office themselves. They tell me they would call me back, which they never did. I called again on Friday afternoon and I found out that my prescription wasn't authorized and that they don't know how long an appeal would take. They have no idea how certain medications work. My dose was adjusted by my doctor based on my particular body. They won't move a finger unless you call them like a hundred times, and they expect you to be the one going back and forth with the doctor's office. They also don't care if you need the medication urgently.
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Preferred solution: Let the company propose a solution

User's recommendation: Never buy an Aetna insurance plan.

Faith E Rpf

Worst insurance

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I took my daughter just for a wellness visit and got a bill and I explained to them that I paid a copay when I went for the visit and that she wasn't sick. And the lady said I am supposed to pay. I told her even after we paid the premium and did a copay at the hospital, for a kid as small as 2 they are charging me after paying 1500 every quarter then you tell me she is not covered that it's just the premium. It's like throwing my money away. Why pay for something when she is not covered over just a wellness visit. This company is a joke.
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Reason of review:
Not as described/ advertised
Kwan Zue
map-marker Durham, Oregon

Who needs antibiotics when you have Aetna???

I don't think I have ever had a good experience with Aetna. Just another way students this generation are getting screwed. Aside from having to waive in and out every single semester (even though insurance is supposed to be automatic, since it is MANDATORY if you are a registered student), I even pay the extra premiums for extra summer coverage (which are not automatic). Well it was impossible to waive into summer coverage- and you have to wait for someone to actually contact you and fax you the form. When it finally does happen, it ends on Aug. 14- where your fall coverage should theoretically pick up with your semester. Well, in America, the motto is "just don't get sick." I had to go to urgent care. I was hit with the surprise that I didn't have insurance upon checkout? That's $105 out of pocket. When I went home to call the Aetna hotline, they had no idea why I was not covered since I did not waive out and had just come out of extra summer coverage. Not only could they not solve the problem before I had to pick up my Rx, but I was told they had to submit a request just to FIGURE OUT what the *** was wrong with my coverage! I was told someone would call me back. Days later, that NEVER happened- per usual. Not only could I not be covered for insurance that I paid for, but I was told that I should just wait "1-2biz days" to get my antibiotics and healthcare. They couldn't care less it was a time-sensitive health situation. So I also had to pay for my antibiotics out of pocket. This is the state of students and healthcare everyone. Even those that pay for the privatized version.
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Insurance Expert Talks

Exposed: Types of Insurance Scams and Fails

Mar 7, 2021

In this video interview, Charles R. Gallagher, an attorney, explains what sort of insurance fraud happens with consumers. Find out more about insurance fraud, the worst cases discovered, and how to protect yourself from insurance scam.

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Charles R. Gallagher, an attorney and managing partner with Gallagher & Associates. His practice focuses on insurance litigation, foreclosure defense and consumer law.

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