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AETNA!?

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    AETNA!?


    holy ****,
    has anyone tried to get your HRT meds covered by submitting a perscription drug claim form to Aetna? ****! althought test cyp is covered by them, since its an injectable, they wont cover it, unless its from their own aetna pharm. so, although its a DRUG, i cant get it covered because its an injectable...ohhh so scary!

    **** them. why do i ****in pay them a cent if i cant get my meds covered. whats the point of having insurance?!

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    nope havent tried
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    is this thru a job or did you buy your own?

    Usually, blue cross will be adequate. It, in my opinion, is by far better than most.

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    I have Aetna. No I haven't tried getting mine covered. I pay full price for mine so I order from the EU. They are a piece of crap insurance company and I am switching soon =)
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    I work in the medical field and Aetna is one of the worst insurances along with United Healthcare. Both are complete crap and what most people don't realize is both of those insurance companies have the worst reimbursement rates (to docs, med equipment companies, ect..) known to man. In a nutshell that means you get less care, less quality service, less quality med equipment if you need it, drive further to see a good doc, ect... I could go on for days. Unfortunately they are the low bidder when trying to get your company to pick them as the insurance provider, hence your company goes for the lowball price which means you get screwed. Kicker is you pay just as much if not more then you would for a quality health plan. I used to have aetna and quickly swithced, you would be amazed at what others with quality health insurance get that you don't.
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    I had good experience in general with United (their PPO though, not the HMO).
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    I have Aetna HMO, it's pretty bad
  8. DT5
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    yep my aetna is thru work. ****ing weak. i dont think i can opt out and buy my own, but i will look into it. maybe i could just use another insurance company, and pay like 100 bucks a month out of pocket
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    Yeah that's what I'm going to try doing. Cancel my plan and use the money my company pays to get a better plan somewhere else for slightly more $
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    Quote Originally Posted by jminis View Post
    I work in the medical field and Aetna is one of the worst insurances along with United Healthcare. Both are complete crap and what most people don't realize is both of those insurance companies have the worst reimbursement rates (to docs, med equipment companies, ect..) known to man. In a nutshell that means you get less care, less quality service, less quality med equipment if you need it, drive further to see a good doc, ect... I could go on for days. Unfortunately they are the low bidder when trying to get your company to pick them as the insurance provider, hence your company goes for the lowball price which means you get screwed. Kicker is you pay just as much if not more then you would for a quality health plan. I used to have aetna and quickly swithced, you would be amazed at what others with quality health insurance get that you don't.
    I have Aetna through, or HAD Aetna through an employer once before. Great employer, but terrible insurance. I had a procedure done and also had a medical expense account taken out through them, they actually denied my claim for reimbursement...and it was MY MONEY that I have contributed to the account...wtf?

    First, they didnt pay even most of the cost of the procedure, then they denied my OWN MONEY from my reimbursement account through my company....The other day, I got a bill in the mail, it seems that Aetna did not even PAY FOR ANY OF IT...lol. This was done last freaking summer and I am just NOW GETTING THE BILL.
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    Isn't there a such thing as a reasonable amount of time for billing? There is another company which billed me last month for a procedure I had done in January 2007. I have since switched jobs and no longer have that insurance, but isn't 24 months later a bit over the top to be billing the insurance company of which I no longer belong too?

    I could understand 6-12 months, but 24-25 months later? wtf?? Of course they expect me to pay because they insurance co denied the claim. I told them that YEAH they denied the claim because it is 25 months old and I no longer have that insurance!
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    That happened to me before. I got a bill from a hospital for an emergency visit...they sent it about 1 year later so I couldn't claim it anymore because I had new insurance. Also, then sent it to collections without even calling me with a bill first. The American Health care system is a P.O.S. and more scandalous than anywhere I've been. I'm from Canada and heard about it down here, but I wasn't expecting it to be this bad.
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    so did any of you come up with a TRT doctor who will write a scrip for test-e for me?
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    hardknock unfortunately they can even 2 years later. To sum it up these insurances suck ass and if you can avoid them do it. Trust me I'm with docs everyday, dme companies every day and both sides of the fence hate them. I know some docs who are starting to not except united because of the poor reimbursement. Aside from reimbursement the main reason they are doing this is because united will keep denying claims, which means your doc has to appeal like 5 times before they pay and by that time it's been 12 months.
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    I had Aetna "coverage THRU US Healthcare. I was on my ex-wife's insurance plan (she's a dental hygienist), and I paid $629 per month. Specialists such as endocrinologists were only covered if *prescribed* by your PCP; lab tests were not covered at all. Basically what I got for my $629 was a rarely-used co-pay for visits to the PCP (so-called, as it was a local clinic, no particular doctor was "my" doctor) - and an even-more-rarely-used prescription benefit.

    This is exactly why I'm not on any formal HRT: I would have had to pay for it out-of-pocket, over and above the 600/mo for Aetna.

    I terminated the insurance, started putting $400 aside every month for medical expenses. Frankly, it takes me a while to use up $400 worth of medical services, even when I'm sick.
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    Quote Originally Posted by EasyEJL View Post
    so did any of you come up with a TRT doctor who will write a scrip for test-e for me?

    PM me
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    Quote Originally Posted by jminis View Post
    hardknock unfortunately they can even 2 years later. To sum it up these insurances suck ass and if you can avoid them do it. Trust me I'm with docs everyday, dme companies every day and both sides of the fence hate them. I know some docs who are starting to not except united because of the poor reimbursement. Aside from reimbursement the main reason they are doing this is because united will keep denying claims, which means your doc has to appeal like 5 times before they pay and by that time it's been 12 months.
    Yeah, I found that out. lol, damn!

    I don't know though, I am not sure if the pri-med did not bill the insurance until 2 years later, or if they tried to bill them and they kept denying it until so many months passed. It would be odd as the insurance I had then, BCBS, always came through on their part of the payments.

    Well, anyway, they just told me to pay any amount reasonable since it was a "mix up". I said, ok, i'll send you guys 5 bucks a month, she was like "OK". I said, whaaatttt?
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    Did someone say that they were paying 600 bucks a month for insurance? 600 dollars out of pocket?????

    I couldn't even imagine that.
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    yeah, that was me: $629/mo, just for coverage; and as I may not have mentioned, getting the consultations and tests required for HRT (don't *know* that I need(ed) it - but wanted to have it checked) would not have been covered...because it would all be "elective"....

    Hate them almost as much as my ex.
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    Bodywizard you have the right idea but most people don't have the will power to put that money aside and not touch it. Insurance companies are the devil.
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    Quote Originally Posted by jminis View Post
    Bodywizard you have the right idea but most people don't have the will power to put that money aside and not touch it. Insurance companies are the devil.
    But... look at what health insurance covered 40 years ago vs today. 40 years ago health insurance was for catastrophic only, no prescription coverage, and dirt ass cheap. today we expect it to cover bandaids with neosporin in it, and whatever a given doctor decides to charge partially because he has to cover the $100k a year in malpractice insurance somehow. $50 an hour of the doctors 2000 hours a year has to cover just that due to our sue happy country....
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    Quote Originally Posted by DT5 View Post
    holy ****,
    has anyone tried to get your HRT meds covered by submitting a perscription drug claim form to Aetna? ****! althought test cyp is covered by them, since its an injectable, they wont cover it, unless its from their own aetna pharm. so, although its a DRUG, i cant get it covered because its an injectable...ohhh so scary!

    **** them. why do i ****in pay them a cent if i cant get my meds covered. whats the point of having insurance?!
    Caremark is their pharmacy, I think you can also use Wallgreens. At least that is they way it goes here in Texas. I have Aetna too. Just get the paperwork off their web site and send in the prescription to Caremark. They will get it back to you very quicly (>week). The next time you can order it ahead of time on line. Did you know they also cover HGH?
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    Quote Originally Posted by hardknock View Post
    Did someone say that they were paying 600 bucks a month for insurance? 600 dollars out of pocket?????

    I couldn't even imagine that.
    Not surprising.....I pay $550 a month for my Aetna policy for my wife, child and I through my job. Needless to say my job doesn't put out very much money since I have the cheapest policy they offer.
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    Quote Originally Posted by ILiftBig View Post
    Caremark is their pharmacy, I think you can also use Wallgreens. At least that is they way it goes here in Texas. I have Aetna too. Just get the paperwork off their web site and send in the prescription to Caremark. They will get it back to you very quicly (>week). The next time you can order it ahead of time on line. Did you know they also cover HGH?
    please explain. my clinic works with their own pharmacy so i dont think that would work. does yours need a doctor to fill the stuff out?
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    Quote Originally Posted by EasyEJL View Post
    But... look at what health insurance covered 40 years ago vs today. 40 years ago health insurance was for catastrophic only, no prescription coverage, and dirt ass cheap.
    But...look at what health-care *COST* 40 years ago: office visits $20 or less; prescriptions $20 or less...and otherwise "dirt ass cheap".
    Quote Originally Posted by EasyEJL View Post
    today we expect it to cover bandaids with neosporin in it, and whatever a given doctor decides to charge partially because he has to cover the $100k a year in malpractice insurance somehow. $50 an hour of the doctors 2000 hours a year has to cover just that due to our sue happy country....
    Are you suggesting that malpractice doesn't exist? Or just that real malpractice is so rare that "malpractice" amounts to no more than a 'malicious deep-pockets gouge' by the greedy poor?
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    Quote Originally Posted by BodyWizard View Post
    But...look at what health-care *COST* 40 years ago: office visits $20 or less; prescriptions $20 or less...and otherwise "dirt ass cheap".
    The point is that regardless of what it cost then, it wasn't covered. As we expect more and more to be covered, the amount of money spent has to go up, and so the insurance companies have to charge more. Again, if you had to pay for it out of pocket, you'd likely educate yourself more about things to figure out "do I go to catscan place A for $800 or catscan place b for $700" instead of going to whichever one is closest. Pricing for medical services becomes competitive then, and that is in the consumer's best interest. As well, doctors prices go up partially because they have to have more and more technology and administrative staff to attempt to deal with the insurance companies so that raises their rates as well.


    Quote Originally Posted by BodyWizard View Post
    Are you suggesting that malpractice doesn't exist? Or just that real malpractice is so rare that "malpractice" amounts to no more than a 'malicious deep-pockets gouge' by the greedy poor?
    I don't say that it doesn't exist, however multimillion dollar settlements where attorneys eat up 1/3 or more in fees (not including the defense fees) are totally ludicrous when the person's income for the rest of their life wouldn't be that many dollars. Doesn't it seem ridiculous that somewhere in the area of $50/hr has to go just to malpractice insurance?

    Although not malpractice, the 60something year old woman who scorched her privates with mcdonalds coffee got over 2 million dollars. Her net earnings for her entire life weren't 1/4 of that, and although I have sympathy for her pain give me a break.
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    Quote Originally Posted by DT5 View Post
    please explain. my clinic works with their own pharmacy so i dont think that would work. does yours need a doctor to fill the stuff out?
    I figured this out with my BP medication. My work suddenly changed to Aetna and all of the sudden my pharmacy could no longer refill my prescription. I was completely out and needed th stuff. So after hours of phone calls to Aetna I was given 15 days of the BP medication and told that I had to go back to my doctor and get another prescription for at least 90 days and send it to Caremark. They will not allow me to fill any medication that is for more than 30 days at the pharmacy of my choice. it has to go through Caremark. So yes, my doctor give me the script and I mail it to Caremark on their form and about a week later it comes in the mail. For the next year I just order it using their internet service. Caremark and Wallgreens seem to be the same company now so I can also go to Walgreens.
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    my doc wont do that. i think the clinic doc and pharm all take a cut from what i pay them, so if i went to a diff pharm, they wouildnt make money so it would be pointless for them. most clinics work this way.
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