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AETNA!?

  1.  02-06-2009  02:12 PM
    DT5
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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?!



  2.  02-06-2009  02:20 PM
    Registered User PhysiqueFreak's Avatar
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    nope havent tried

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  3.  02-06-2009  03:49 PM
    Registered User hardknock's Avatar
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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.


  4.  02-06-2009  04:28 PM
    Registered User Gutterpump's Avatar
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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 =)

  5.  02-06-2009  04:34 PM
    Gate Keeper jminis's Avatar
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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.

  6.  02-06-2009  04:37 PM
    Never enough EasyEJL's Avatar
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    I had good experience in general with United (their PPO though, not the HMO).
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  7.  02-06-2009  04:46 PM
    Registered User Gutterpump's Avatar
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    I have Aetna HMO, it's pretty bad

  8.  02-06-2009  04:52 PM
    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

  9.  02-06-2009  04:59 PM
    Registered User Gutterpump's Avatar
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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 $

  10.  02-06-2009  11:47 PM
    Registered User hardknock's Avatar
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    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.

  11.  02-06-2009  11:50 PM
    Registered User hardknock's Avatar
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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!

  12.  02-07-2009  12:50 AM
    Registered User Gutterpump's Avatar
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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.

  13.  02-07-2009  08:50 AM
    Never enough EasyEJL's Avatar
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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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  14.  02-07-2009  08:52 AM
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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.

  15.  02-07-2009  09:26 AM
    Gold Member BodyWizard's Avatar
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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.

  16.  02-07-2009  10:02 AM
    DT5
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    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

  17.  02-11-2009  09:15 PM
    Registered User hardknock's Avatar
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    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?

  18.  02-11-2009  09:17 PM
    Registered User hardknock's Avatar
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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.

  19.  02-12-2009  06:40 AM
    Gold Member BodyWizard's Avatar
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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.

  20.  02-12-2009  09:27 AM
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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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