Aetna Blows More than Monica Lewinsky

I fucking HATE insurance companies. Today, I think I shall rip Aetna a new asshole in my blog because they so richly deserve it. They probably have plenty ripped assholes already, so one more ought not bother them. Aetna is comprised of incompetent, idiotic assholes. I think they hope I die before they call back so they don’t have to pay anything.

I have an Open Access POS plan through Aetna. No big deal. It’s basically an HMO with an open access option (for which I pay extra). It means you don’t need a referral to see a specialist. You pay a double co-pay, so you don’t save any money. What you do save is time because you don’t have to go see your primary, pay a co-pay, and then go see the specialist.

I’m an adult. I know what part of me is broken, so I if I need an otolaryngologist (ear, nose, throat) because my throat is having troubles, I can go. I pay a double co-pay because he’s a specialist, hence I’ve not saved any money, but I have saved at least a week in time, which is priceless.

They insist I’m on an HMO even though I’m on a POS. The billing computer has it right, my card is right, but the service-provider’s computer (where they check if your coverage is active) doesn’t. So when my doctor calls, it tells them I am on the basic HMO plan. So my doctors all want referrals even though I don’t need one. If I don’t have a referral, I am not covered. That might not sound so bad except when you don’t have a referral the insurance doesn’t cover the visit and you’re looking at $400 instead of $30.

This bit has been ongoing. I have spoken to people at Aetna (as well as my independent insurance agent) all of whom have promised to call me back. Some have asked for faxes, for details, and my contact information.

The people I’ve spoken with all assure me their computer shows I am covered. However, from what the doctors say, I am not covered. One of my doctors even had the information faxed over to me which quite clearly shows I am not covered. I have faxed this to them, my agent, anyone who wants to see it. It matters not to them. I am a human and Aetna cares not one iota for humanity. If I were a dollar bill they would be fawning over me like a lecher over a sixteen-year-old cheerleader.

But wait, there’s more!

But that’s not all. So I’m on these drugs that the otolaryngologist prescribed and I have two days left. Last time I checked my doctor is a licensed professional. The drug (if you care) is Nexium 40 which is to treat my severe acid reflux, the cause still being under investigation. I am supposed to take two per day which is 60 per month. First time I went to get them, Aetna gave me a hard time and said this drug needed pre-certification. I couldn’t get them and had to call the doctor’s office who had to argue with Aetna. The prescription was issued, and the label clearly says “take twice per day” — okay, boys and girls how many pills is that per month? If you got “60” you win. If you got “30” you work for Aetna. So after two weeks with 30 pills, it’s time to renew. I always renew online because it’s easy. I go to pick them up. Apparently Aetna feels they know better than my doctor.

So the pharmacist at Walgreens “a very nice man” let me use his phone so I could call Aetna. I went through dozens of voice-activated automated menus. Everyone around me laughed because none of the menu prompts would recognize my group ID. After much aggravation, I finally got to the part where you say “operator” to get a human and I said “operator.” It hung up on me with no explanation. I started about 4:55pm and got hung up on a little after 5pm. When I called back and went through the same hell again, it said, I had to call back between 8am and 5pm (what happened to 24-hour service for medical issues)? The pharmacist, being the masochist he is, thought he’d give it a try. That failed spectacularly as I found when I called him an hour later.

My pills will run out Saturday. Of course, I can buy them at $188.90 per bottle of 30 and I need two of them. What do you think the chances Aetna will pay are? I’ve had a number of insurance plans, but Aetna is near the bottom — only inHumana was worse.

The worst part is, stress greatly aggravates my acid reflux condition. So Aetna‘s behaviour is actually harming me. I’m sure that’s ironic or something. I wonder if I can sue them for attempted murder?

On Tuesday, I will file a complaint with the State of Florida Insurance Commissioner. It won’t do much good because I have little faith in that office based on what I see of our entire insurance crisis in the state, but if it makes Aetna suffer a little, it’ll make me happy.

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