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    Aetna

    Has anybody else been denied by Aetna? I was on Aetna and my caths were shipped after they terminated me but still told the cath company I was still on their plan. So the cath company goes to bill Aetna and they deny the charges. Now im stuck with $1,000.00 bill. Should I pay it? Aetna told the cath company I was still on.

    #2
    Originally posted by jk jr
    Has anybody else been denied by Aetna? I was on Aetna and my caths were shipped after they terminated me but still told the cath company I was still on their plan. So the cath company goes to bill Aetna and they deny the charges. Now im stuck with $1,000.00 bill. Should I pay it? Aetna told the cath company I was still on.
    Aetna sucks. Better question is have I ever had anything APPROVED by Aetna.

    You are still responsible, even if Aetna made an error. Authorization of services IS NOT verification of policy coverage. In otherwords, NEGOTIATE with the supply company. Most likely, AETNA owns them.
    Every day I wake up is a good one

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      #3
      cant you appeal it a couple times? if you need caths you need caths.
      in the future find your caths on ebay, can you send them back..
      1000 is alot of money for caths
      cauda equina

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        #4
        $1000 is an awful lot of money for caths. How many does that cover? I pay out of pocket for mine at under $1/ea from Sportaid, and use 5-6/wk, so it's not a big deal.

        I'd let the vendor argue w/ Aetna before getting involved myself. If I were in your shoes and still didn't get anywhere, I'd just return what you can and seek a more cost-effective solution if insurance won't cover this stuff... but even then you should be able to get a letter from your doc saying they're medically necessary.

        Sorry to hear this though. Just understand that insurance companies are in business for profit. It's a pain.

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          #5
          Jk Jr,
          You can PM me with a little more info, such as why were you terminated? I lobbied (actually had a "sit-in") for Dan's benefits at Aetna headquarters after MANY denials. I have many phone numbers that I called, fax numbers that I sent 25 pg letters to, and would be happy to share them with you.
          Email me, that would be better if you're interested.
          C

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            #6
            Ask for a case manager, call member services.

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