ED Magedson – Founder
Aetna, Select State/Province USA
Aetna Consistent denials despite benefit coverage Nationwide
I ensured that all of my prenatal testing would be covered undered the Aetna Individual plan I had purchased before making the decision to stick with this plan rather than switching to my employer-based plan, which appeared to have been more costly. I even had my OB billing dept. speak to customer service at Aetna to confirm and was given an estimate as to what my OOP costs would be with the plan I had. All seemed copacetic.
Since I have begun having testing in late-summer 2013, I have been getting bill after bill from service providers citing denial of payment by Aetna. Each time I have contacted the company, I get a different explanation as to why X service was not covered and an assurance that a future service WILL be covered as long as it does not fall under some arbitrary code. For example, I was told that my standard prenatal bloodwork would not be covered but my glucose test would be covered. Sure enough, I just received a bill for this testing and was told by a CS rep that NO testing beyond standard appointments are covered. Meaning, no utlrasounds, no labwork, no stress testing, NOTHING. This is a complete turnaround from what I was told when I made the decision to stick with the plan or else I NEVER would have done so. My benefits package states that ALL prenatal testing is covered and maternity is not, which is why I have changed to a new plan effective January 1, 2014.
I now have several thousand dollars in medical bills to account for and despite my plans to make payment arrangements as best I can, I am told that even WITH a payment agreement, the hospital cannot promise that my account will not be sent to collections at some point upon future review. I have great credit and I cannot believe that I will have to contend with the lingering fear that it will be ruined by this until I have paid off the balance, which will not be before at least 18 months have gone by. I specifically went through each service that my OB stated I would need during this pregnancy and was given the green light by Aetna. I have no recourse now at all.
This report was posted on Ripoff Report on 01/12/2014 08:35 AM and is a permanent record located here: http://www.ripoffreport.com/r/Aetna-/Select-StateProvince/Aetna-Consistent-denials-despite-benefit-coverage-Nationwide-1114937. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
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