Showing posts with label AETNA. Show all posts
Showing posts with label AETNA. Show all posts

Sunday, June 07, 2009

Awww... Poor Repubs Upset AGAIN!

  • President Obama speaks
  • Republicans get upset
This time it's healthcare. What's the problem this time? President Obama suggested that the federal government create a healthcare program to compete with the insurance companies - the same companies who will not insure you if you have a pre-existing condition or have a lapse in your health insurance coverage. Republicans don't want the government to compete with the "for profit companies" and provide better coverage than what those companies provide. They don't want Americans to have the kind of coverage that they receive as members of Congress. HYPOCRITES!!! That's all Republicans are anymore. HYPOCRITES! I am sick of their whining about the "destruction of capitalism" while they continue to give subsidies to huge corporations and accept their own perks and benefits from the government while cutting trying to keep everybody else else from receiving the benefit of quality healthcare. These Republicans and their families should be put on basic Aetna policies for a couple of years and see what tune they are whistling then. We have over $20,000 of debt because of Aetna's so-called "coverage."

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Monday, June 25, 2007

Gevity LIES

http://www.gevity.com

Follow-up to "AETNA - Get It Right - Chance 1"

We have heard back from both companies, AETNA and Gevity, and after cornering the Gevity rep with the evidence we have collected, she finally admitted that Gevity was the company who entered the wrong information into the their systems when we signed up for our AETNA PPO insurance plan. Instead, Gevity signed us up for an indemnity plan (basically, a reimbursement plan). Now, Gevity is saying that they will pay our unpaid claims from the time that we were on the wrong plan. Do I believe this? No. Why, because I had surgery during this time and my bills totaled over $10,000. We have requested Gevity's "promise" to pay in writing but have not received it. I believe that we will be battling this out in court shortly, and the evidence is on our side. I'll keep you posted.

Wednesday, June 13, 2007

AETNA - Get It Right - Chance 1

OR - My Own "Sicko" Episode


At this time, I am going to stop short of calling AETNA Insurance a scam. However, if you go to any of the major complaint sites on the Internet (like RipOffReport.com) and do a search on AETNA, you might wonder about my decision to "bite my tongue."

Here is our situation. My wife is the subscriber to our health insurance through her employer (whom I will not name). Her employer uses a company called Gevity to coordinate the company's benefits. I am still not certain how much of our current dilemma with AETNA is the fault of Gevity's handling of the contract with AETNA, but for now, all I know is that AETNA is not paying claims.

Until July of 2006, my wife and I were paying directly for our own health insurance. At that time, my wife's employer decided to begin providing health insurance as a benefit. We looked at the plan, asked lots of questions, and decided that the national PPO plan that was being offered would be worth making the switch, instead of continuing to pay for our own insurance. We are beginning to seriously question that decision.

Apparently, when my wife and her colleagues were entered into the AETNA system, they were put under an "indemnity plan" instead of the national PPO to which they were to have been subscribed. For those of you who do not know, an indemnity plan basically reimburses the subscriber for a portion of the medical bills which the subscriber must first pay "out of pocket." Needless to say, when we found this out, we began complaining rather loudly to my wife's employer, to Gevity and to AETNA. In November of 2006, Gevity and/or AETNA issued the correct policy telling us that the bills from the previous 4 months would need to be resubmitted, and they would be paid under the PPO. After almost a year of complaining, questioning, proposed solutions, etc., we are no closer to having these claims paid than when this fiasco began.

We have jumped through every hoop that has been placed before us by AETNA and Gevity. We have remained very patient, giving both companies ample time to sort this out. We have exercised restraint and have not filed complaints with the Insurance Commissions of Pennsylvania (our home state), California (the headquarters of my wife's employer), Florida (the headquarters of Gevity) nor Kentucky (the headquarters of AETNA). That is about to change. We have contacted Gevity and AETNA and notified them that they have until this Friday, June 15, 2007 to have this resolved to our satisfaction, or we will be filing formal complaints in all of the aforementioned states with both their insurance regulating bodies and their Attorneys General. After reading many of the complaints on RipOffReport.com, I am beginning to believe that this is the only way that action ever takes place at AETNA. They have a terrible record of creating mountains of red tape to avoid paying claims in a timely manner, if at all.

By the way, this is "chance number 1" for AETNA to get it right. Chance number 2 will be when the Insurance Commissions and Attorneys General come after them. Chance number 3 will be when take them to court.