Aetna Health Insurance?

[Octoberbride03]

As we all know its Open Enrollment season for many of us. DH's company started this week. We wound up with good news and bad news. Up till now we have had Anthem PPO which has worked out fine. DH had thought that they were getting rid of the PPO and we would have to switch to HMO. As it turns out his company has switched all the insurance to Aetna.

Does anybody here have it? Just about all my life i have been in 1 Blue Cross/Blue Shield or another. Next year I will need to replace my speech processor for my Cochlear Implant. This is a HUGE cost. With Anthem I knew I was covered. I have no idea what to expect with Aetna.

So just how good is it to make a claim for something through them? I would get the processor now, but I know that the next version should only be months away from being available with my particular implant. Its not ready yet for me, but this had been giving us time to plan and get other things paid down so we could have the co-pay ready when it is.

 

[disneymomjcs]

We've had bcbs forever. My husbands company switched in April 2010 and we haven't had any problems so far and I've had a ton of testing recently.

 

[Squirrel!!!]

We switched from PPO anthem to PPO Aetna last year, and Aetna does not seem to cover as much of any lab testing. I end up paying about another 20% on any lab test, but that is the only thing I have noticed, and my daughter had tons more than usual this year.

 

[DisneyAndRedSox]

We have had Aetna for a while now. I had back surgery over the holidays last year and had some out of pocket expenses, but that is b/c of the type of plan we selected. It is much less per week out of DH's pay, but there is a deductible before they start paying (except well visits). His company put money in a HSA account to cover part of the deductible. When I did get bills from the hospital, they were for the insurance company's discounted amount, not the amount billed. Then my hospital gives a 20% discount if you pay with in 30 days (you need to call for it, they don't take it off automatically!) The only problems I ever had with billing was b/c the doctor or hospital coded it wrong. Once Aetna didn't pay for a test which was part of my annual check-up, since the doctor didn't code it correctly Aetna didn't pay it b/c we hadn't met the dedictible yet. The doctor sent it a new bill and it was paid.

I did have one problem with Aetna recently... but it was with their Rx mail order service. I needed a refill of a Rx, it showed as being 'out of refills' on the website. The website said to verify my doctor's fax and they would get authorization. A week later I went on Aetna's site, it showed my Rx order was 'cancelled' (I never got an email or call which makes me furious), they said they never got authorization from my doctor. My Doctor re-faxed it (yes, we verified the correct fax number), after several days still no new order showing on-line. I finally drove to my doctor's office and stood there as they called it in. Customer service at the mail order service was miserable, they absolutely refused to call my doctor to get the authorization, they just kept faxing them and then saying they didn't get a return fax, but my doctor had a record of sending it. For nearly 5 years I never had a problem with the mail order service until now.

 

[Green Tea]

Aetna doesn't set the policy, the employer does. The human resource office should have information on changes. Most likely they contracted with Aetna for pretty much the same coverage as you had.