Aetna Customer Service

User Reviews, Ratings and Comments

Aetna customer service is ranked #810 out of the 946 companies that have a rating with an overall score of 22.06 out of a possible 200 based upon 442 ratings. This score rates Aetna customer service and customer support as Terrible.


432 Negative Comments out of 442 Total Comments is 97.74%.


10 Positive Comments out of 442 Total Comments is 2.26%.

Issue Resolution




Product Knowledge

Terrible Overall Customer Service Rating

  • Aetna

    Customer Service Scoreboard

    • 22.06 Overall Rating
      (out of 200 possible)
    • 432 negative comments (97.74%)
    • 10 positive comments (2.26%)
    • 10 employee comments
    • Attribute Ratings
      (out of 10 possible)
    • 1.4 Issue Resolution
    • 2.2 Reachability
    • 1.5 Cancellation
    • 2.8 Friendliness
    • 2.0 Product Knowledge

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Posted by Anonymous

This is the worst customer service. I have been working on 2 claims since November. Each time I call I am on the phone for hours. I get different stories from each representative. They say they need more information, which I send, and then they need more. People say they will research your case and call you back- they never do. It's exhausting. I think they want to give you the run around so you just give up.

Posted by Anonymous to

It is my opinion: Years ago, I purchased a long-term and a short term disability policy from Aetna through my employer. Over 2 years ago, I became disabled because age and numerous other health issues, verified by 3 doctors and other insurance companies. Aetna harassed my spouse and I, threatened me with job termination, discontinued my employer pay and benefits, conveniently lost or never received documents my doctors and I sent to them several times, misquoted and distorted facts in medical documents I submitted, forced me to retire because of no pay or benefits, committed fraud, made numerous mistakes always in Aetna's favor, told me verbal lies in phone conversations, made outrageous demands under the threat of being fired "if you don't go to the doctor today and submit these forms you will be terminated from your job", Etc, Etc., Etc. Aetna CEO Mark Bertolini's compensation was valued at $17.3 million last year. He got it by screwing people like you and I. Don't get Aetna insurance for any coverage of any kind. Aetna will not pay claims and will do anything to avoid paying. If you do have Aetna coverage, get rid of them ASAP. If you do have problems with Aetna, keep a log, FAX or send all documents 3 times and file a complaints with your state department of insurance.

Posted by Anonymous

My husband has cancer. We have been on Aetna for several years. We had to convert to Aetna COBRA policy and we're told there would be no break in our coverage. He was supposed to start his chemo drug four days ago and we have gotten nothing but the run-around on getting it filled which as of yet has been filled. I have spent many hours trying to give the information requested only to find more information is needed. Meanwhile, we wait and hope the delay in treatment is not making his cancer worse. How does get his medication expedited?!

Posted by sighhhhhh!!!!

so weird- for the past few months Ive been calling as a provider, and I need help with specific claims. Every time I try to reach a rep they transfer me back to the automated response line!! Terrible customer service!!! They are the worst insurance to deal with, unless they fix their system.
Does anyone else have this issue?

Posted by Hannah

Ever since my employer paid insurance went to Aetna in January 2016, I've had nothing but numerous issues. Almost every EOB is denied before it is eventually paid. Recently, they started denying my claims for 2 reasons: potential medicare coverage and wanting to know if the dependent is covered on another plan. I am single not on medicare and have no dependents! They will do anything to deny/dely a claim.

Posted by Aetna Contract break

I was denied payment for an emergency room visit. Appx 10 days after major back surgery, I had sudden pain and numbness and was highly concerned that something was wrong, such as a blood clot. It was a Saturday and their response to each of 3 appeals was that an average person with common knowledge would believe that going to an emergency was a prudent decision. I don't want to write a long story but want to know if anyone else has experienced this issue. I have contacted an attorney but if there are others out there, a class action suit would harm the company the most. I'm sure that they want me to just go through all of their hoops thinking that the "little guys" will just give up. I'm fighting mad about this anything I can do to discredit the company and prevent other companies from using them for their company health insurance business. I love to hear about anything else I can do to discredit them.

Posted by JTH

Issues Galore w/ Aetna's Log in. Have made numerous attempts to reset my password, Never allowing me to view my "Letters", etc..beyond words to describe! Guess this Fabulous Ins. Company will have to "mail" me my Papers work, in order for my FMLA claim to be completed.
So far, a Horrible experience to say the least.

Posted by Anonymous

I called customer service to find out how much we have paid into the medicare coverage gap and how much more we will need to pay our of pocket before entering catastrophic care. I was diverted to the pharmacy as the resource for answers to my questions. The pharmacy person was less than useless. All she did was keep reading the policy manual, which I had in front of me. My repeated inquiry resulted with her reading the total annual out of pocket costs and for individuals on medicare and at what total (that is total for the individual, insurance, and other sources combined) would bw the annual costs covered and not covered by the plan. This happened five times, even though I re-worded my question to help her understand each of those five times. Why do you call it customer service when all the person is qualified to do is sit and read the manual and is not concerned enough or intelligent enough to actively listen to the question being asked and respond appropriately?

Posted by Shawie

Aetna's customer service representative who are based in the Philippines are ultimately rude, and no manners. A representative named Terri (or might be spelled as Terry) shouted me at least twice since I have called and spoke with her most of the time. My last cal was made today 6-2-16 @ around 9:22am Central Time for the period of 11 minutes and 28 seconds. I was calling from a doctor's office for a claim status. The whole time she sounded very rude and got to the point when she told me "Yeah right, Yeah right as if you knew what you are saying! I am just giving you an FYI because you sound like you do not know what you are doing!" People like her have no business working in call centers because they are not giving customer service at all. I will spread my mouth all over the world regarding this and Aetna will be affected if they do not resolve their customer service issue.

Posted by anonymous credentialing rep

im in a provider office, working on credentialing and contracting. Been on the phone now for 1 hr. with provider service b/c I cant get a hold of credentialing, they only have #s available that I found online!!!! They are located in Philippines and cant even help!!! agggghhh

Posted by MsnaAlfy

Most retarder reason they didn't process payment was because I have medical through the government my kid went to the ER and Aetna stopped they payment first off it's my exes insurance not mine he should get billed second what retards do they not have a computer and Internet to research partnership health plan which is medical from the government and is now secondary medical insurance

Posted by Anonymous

and the worst part is the complaint website they provide is a black hole. There is no way to send a comment I have been on the line over 45 minutes got bounced back to begin the enter plan number 5 times by employees who just don't care I asked for the love of god don't send me to begin again only to go back again!!!!!!!!!!!!!!!!!!!! they just don't care at all...

Posted by Rocketman

Please choose any other provider they automatically enrolled me in a mail order medication scam. Then it took multiple phone calls and departments to opt out. If you want to spend 1/2 a day resolving an issue great. As soon as i can I am changing to another company

Posted by Anonymous

I have so many complaints that there are way to many to list them all.
It has taken over a month and a half to change my mailing address. I have spoken to numerous service reps who after taking my new address just refer me to a different department. Even the supervisor had to refer me to someone else to do the work and it still isn't done.
Due to this my medication was sent to the wrong address causing me to go weeks without my medication.
Today my call was about billing. My credit card was charged twice in Feb. The excuse was because it was a short month. The last time it happened the excuse was it was a new year and the computer system didn't recognize my old plan.
The website is down more than it works.
Thank goodness, I am a relatively healthy person. I pity anyone with real medical issues trying to deal with this crap.

Posted by Anonymous

Fortunately I rarely need medical help, but recently was admitted to a hospital for a brief 1 day stay. I have learned a lot about Medicare, Aetna and HMO v PPO in this past week. Since I am locked in until January of next year, I want to strongly urge anyone reading this to NOT SIGN UP with AETNA! Being locked in to a provider for a year is bad enough, but I find it hard to believe the same provider will not budge on "your plan" once you are signed up. A person should at least be able to switch from HMO to PPO with the same Insurance company. The "customer service" (I say this faciously) people at Aetna with whom I have spoken were cold, brusque, and couldn't care less. Live and learn. In 2017 I will be more than happy to stop giving them MY MONEY.

Posted by Michael J. Rodriguez

Mr. Hayden,

I'm not making much progress getting your company to authorize my medical needs. To a tee each of my doctors offices from Dr. Patrick Leu and Dr. Ralph Hauke in Omaha to my local pharmacy to Dr. Elliott and Dr. Kwon at Mayo all echoed the same sentiment when we turned our health plan over to Aetna. 'Michael for a person in your situation it's the absolute worst health care insurance company out there.' They immediately assume a person with your past medical problems is a huge risk and thus were not going to pay. Period! And yesterday I just threw in the towel. But before I explained another 'denied' lets quickly review this policy which is 'all hat an no cattle.'

1. MIR on the 8th at Mercy of the brain. Aetna is pushing back hard against my doctors to ok it. I wrote a check for a $1000 as feed money. Well after a week they finally ok it.

1a. . MRI on the 15th at Mercy Hospital of my neck area. Denied!! My head is continuing to pound on the left side of my brain. My doctors ordered this and your company said nope. $3500 to Mercy.

2. Mayo visit to have a complete check up Jan 18 & 19 to figure out why my head is pounding. Utilizing the C11 Choline Pet Scan ( FDA Approved) Not experimental practice. Your company denied me that. That procedure has saved my life. You're not about saving lives? Just saving money. Aetna is a business, I get that. But saving lives is a good thing in my opinion. Frankly I have a vested interest in mine. So I get an 18 page letter saying no, sorry, we don't pay.

3. I go to the Ear, Nose and Throat doctor Jan 21. Yes, there is a large inflammation in my sinus cavity. The doctor prescribes a prescription-I go and pick it up-that too denied. So, I write a check for $151. Check mark.

4. I go to the cardio doctor same day. My EKG has two abnormal readings. I must return Jan 28th.

5. I go in for a full stress test with contrast. I never make it to the treadmill. They took a lot of pictures prior to the contrast being injected. Once they started injecting the contrast my body rejected it. Right arm injection--nothing was flowing to my heart valves. Left arm there was 'some' contrast that made it but not nearly enough to get pictures they would counter the non contrast pictures. Blockage??? So the cardiologist immediately orders me to the Nuclear department where they take clear images of the heart valves and surrounding areas. Warren, I'm all hooked up and ready to go and guess what happens? Yep, you guessed it. Your employer said go **** yourself. I'm in the hospital with high potential of blockage and Aetna says---well, not so fast... It goes without saying if I drop from a heart attack my Des Moines law firm will be ordering a fleet of new Mercedes Benz's.

6. So lets cut to the chase. I don't want to be sent another email that reads 'such and such' needs to call this phone number. I've got it down pat. I don't want to be sent another email saying, 'nobody has called Aetna for authorization." Do you have any idea how insulting that is? I've jumped through hoops on my own to get answers and pre-authorizations. Sir, the last thing I want to do is send these useless emails but I have zero advocates. My law firm is my advocate and it's high time they will be used. By denying me coverage at the Mayo Clinic you're clearly violating my federal rights via the Affordable Heath Care Act. They have been treating me since the spring of 2014. The president put that stipulation in if a company changes insurances companies YOU can't pull me out of the 'pile' of employees and say, nope, not going to cover that guy. As soon as I was told back in September we were changing to Aetna I did my homework.

7. So here's what needs to get done and I don't care how you do it. Your team needs to call Mercy Hospital asap and get this Nuclear procedure authorized so they can determine if I indeed have blockage. I would prefer not slumping over at my desk from a massive heart attack. My cardiologist is ......................, Mercy Cardiology. The employee who schedules these procedures and gets authorization is ...................................

Lastly, Mr. Hayden I have no trouble with anyone making an honest living. But if a person schlepps around peddling a product that won't help 'specific' consumers then that's truly sad. And in case it's a clear case of violating my federal & civil rights. Mr. Hayden I'm not some lazy slouch sitting on the couch. ( ok insert from Caddyshack, "Judge Smails, "Ty, I'm no slouch when it comes to golf.". Ty, "Judge don't kid yourself. You're a real slouch." God, I just love that movie. Warren, If you knew me I'm a really funny guy. I always keep my sense of humor no matter what) ---my Mayo doctors have brought me a long ways. A long ways!!!! I've been working out hard each day at the Y for the past nine weeks, heading pounding and all. Lost 15 lbs. so far. A ways to go. I haven't been on the golf course for 4 years due to my health. I will be on my golf course this spring!!!!! It's my passion. I walk when I play and I love it. Don't kill my passion. The last thing I want to do is continue seeing doctors. I hate it!!! But, I have another bump in the road that needs to be addressed. Capiche?

Michael Rodriguez

Sioux City, IA

Posted by Charlotte Pat

I waited on the phone for 62 minutes until I was able to speak to a representative. The woman was absolutely useless. Where does Aetna get its CSRs from? Are these really humans? Theses guys beat AT&T for bad service, any day.

Posted by Anonymous

I agree with most of the comments here that Aetna customer service it terrible. Aetna keeps mailing me with notices about my account based on outdated information. Some of the Aetna customer service reps I spoke with have been clueless and useless. Others tried to be helpful, but Aetna made it difficult for them to provide the information necessary to resolve the problem; and one supervisor of a Situation Resolution Specialist promised to send an e-mail with the information I requested, and never did. Today, I finally spoke with an Aetna customer service rep who found the confirmation of that information posted on my computer records at Aetna, which means I don't have to keep calling them. Based on my experience, Aetna HAS THE WORST CUSTOMER SERVICE OF ANY COMPANY I'VE EVER DEALT WITH.


Two hours today to get a prescription order filled. They have the order on hold until thirty days after I filled the prescription locally since I was out of maintenance medications. NO one can comprehend if they wait thirty days I will be out of medications again before the order arrives AND NO ONE CARES!

Posted by rblack

Aetna purchased my previous health care provider effective January lst, 2016. I have attempted to get a printed copy of my health insurance plan si9nce December 18th 2015. I am referred to the online copy only which is difficult to understand. I have requested a list of doctiors Aetna/Altius will accept and have been told to0 call and see if a doctor is approved. I desire a list of approved doctors so i can research any complaints about the doctor. their location. their qualifications etc. The customer phone service has limited hours and the people are often unable to answer my questions seeking clarification of policies. It took me 5 phone calls to get registered for their mailorder pharmacy and all of my questions have yet to be addressed.Aetna seems to have a take it or leave it practice if you are dissatisfied with their lack of response.

Posted by Pray8083

Aetna changed my benefits from Primary to Secondary without my knowledge. I've been on phone for 6 days trying to get issue resolved. Talked to enrollment, conflict resolution specialist, supervisor, managers, and numerous reps. They have hung up on me, transferred me, and lied to me. Now I'm on hold again to be transferred right back to where I began.

Posted by Anonymous

I called to ask a question about upcoming change to Aetna. The woman I talked with I could nearly hear her and she acted like she was in a hurry to get off the phone and she had no personality and about half rude.

Posted by Maria

The customer service representative Maria was obstructionist. She was only interested in transferring my call. When I asked to speak to her supervisor she claimed that her supervisor "doesn't have a phone". When I told her to go and get her supervisor, she put me on hold for five minutes and then came back and said "she had stepped out for a few minutes and would call me back". She is such a liar.

Posted by SICKINME

Timed my call, 31 minutes, just to get my prescription. Rite Aid had already called several times as well. Have been without my medication for 12 days. Reason????? The cost. This is the second month in a row. You can barely hear the person at Aetna due to muffled voice and background noises not to mention the horrible reception. Spoke with Terry in customer service and Justina in the Pharmacy Department. If my customer service calls at my job took 31 minutes, I'd be fired.

Posted by ES

Customer Service Representative Name, Roshina S Of Aetna Bombardier. (ref Call #: 2468185043. I Usually Don't Take The Time To Complain But For This Call That I Had W/ This Staff Is Just The Worst I've Ever Had. She Has No Phone Etiquete At All. She Speaks So Fast Giving The Fact She Already Has An Accent. Sshe Wasn't Pleasant At All & She Sounded Like She Just Wanted To Finish The Call Immediately.

Maybe She Needs More Training 7 Guidance On How To Work In A Customer Service Related Job. She Gives A Bad Impression To The Aetna Company.

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Posted by Veronica

5/25/2016: I called Aetna with a question regarding pre-natal services. I was helped by a representative called DEJOUR. I have never been so pleased with a call before. It was the best call ever; he literally walked an extra mile to help me and show me that I am appreciated as a customer. He walked me through the various links online that I could use during my pregnancy and postpartum. He was very helpful, courteous and very efficient. I wish there were more aetna representatives like him. I really hope this comment reaches and helps him get appreciated as a very good employee. Thanks.

Posted by Makeeda. Customer service

I have dealt with Aetna customer service for many years. I just talked with makeeda. What a wonderful experience. Was very helpful and followed my question as i am changing from an hmo to a ppo for service. I was very impressed with her.

Posted by redintx

We have had aetna open select for 4 or 5 years now and have never had a problem with the customer service reps or them paying for any dr, emergency, ect.. We changed to them through my husbands company when bcbs went way high on their premiums. I feel so bad that all of ya'll are having such a hard time. Good luck

Posted by Anonymous

I read all of your comments and researched the credentialing dept. myself for the provider I work for. It took me less then 10 mins to get a hold of a live representative and was given a correct phone and fax #.

here's the direct line to Aetna's credentialing department: (800)-999-5698

And next time,doctors, do a little research before you start complaining.

Posted by Anonymous

I am trying to figure out numerous hospital and medical bills for my mother, who has dementia. She was under hospice services for a short time last year, but was discharged in November 2011, and somehow all claims were still being denied. Several phone calls have been made, speaking to various representatives. The hospice involved notified CMS when they discharged, and numerous letters,( of which I have copies) from the hospice involved, have been sent to Aetna. We have continued to receive EOB's stating she is under hospice care. I have made numerous calls, speaking to your representatives. Many told me they " couldn't fix it until I contacte one ever so much as tried to look up the information.
Today I was finally able to speak with Patty at Aetna..This employee deserves to be recognized for her patiece and dilligence in finding and correcting the problem! Please have her teach some of your other "phone problem solvers" how to speak to customers, and how to handle the situation. "Patty" not only found the problem by contacting CMS,but assurred me that everything will be resolved. That is REAL customer sevice! I wish some of the numerous other employees I spoke with could learn from her. She deserves the "customer service award"!

Posted by Anonymous

My Cobra is Up August 31, 2010. I called several numbers for Aetna trying to get the same coverage. I was able to reach a customer service rep each time I called. I finally did get a policy to cover me until I go on Medicare in April 2011. I didn't like the monthly figure quoted, but what can you do. All I can say is that I had a pleasant experience with customer service. even though I had to call about five numbers.

Posted by Anonymous

wow..Aetna happens to be one of the easiest companies to navigate thru. As soon as you get a rep on the line ask that your call be recorded. That usually changes the tone of the phone call, also ask for a call reference number...they do keep track of all calls.

Posted by Anonymous

Horrible customer service! I had to call a few times just to get an issue looked into. They gave me a different number to call and ask for someone by name. When I did, that person didnít exist. Then after a few more calls, the person that was able to answer was not pleasant at all.

Posted by Anonymous

I actually have had Aetna for the past 6 years and never have a problem getting through to someone, and you can mail your payment in or pay over the phone.

Posted by liivbot

I had the pleasure of speaking with Ruby from your customer service dept for providers.She was very knowledgeable and nice. I hope I don't have to collect from Aetna, but if I do, I hope I get Ruby on the phone. :)

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Posted by former employee of aetna

As a former aetna employee just for the record. We are horribly understaffed in call centers, high turn over rate, and the training is not enough for those who have no insurance experience or working in insurance. It really is a horrible place to work. They do not care about employees at all. They have managers there with no back ground in the medical field only on a high school education. Honestly one needs formal training to work in insurance so they give the proper customer service info. Believe me there are those of us who really do care about our members and will bust our humps to try to help. But when an employed does not have a working computer or phone its hard to service the members. Horrible company to work for as I said they do not care about employees I the mean management. I'm so sorry to hear all these bad experiences but know there are good people at Aetna that really do care and do know what they are doing, also that have a formal education in heathcare. It is until I was in the customer side I really found out just how bad some experiences can be with this company. It's no fun I totally understand the frustration.

Posted by Anonymous

I work for the bloody company and am forced to have Aetna insurance. They pre planned their OE 2015 to end before the marketplace is open. So in short I have to elect Aetna or chance the marketplace! Real nice Mr. Bertolini!
I have paid out $1600 just for insulin and test strips alone for my type 1 child. That doesn't include pump supplies which topped another $2000 this year! (And I have 3 other kids with broken arms, cuts, check ups ect.)The coverage is RAPE plain and simple! My premiums are $500 monthly and for what!!!!???

Posted by yours

ok...for the people that just talk their crap about this company. the company YOU work for is the one that CHANGES (MAKES CHANGES) to your plan...everyone in the US and other countries DOES NOT HAVE THE SAME PLAN...every company has their OWN PLAN...SO THEY MAKE THE DECISION in what they want to have their plan cover. everybody always blames Aetna..."They changed this and didn't notify me....I was not told about this..." GO AFTER THE COMPANY THAT YOU WORK FOR....THEY MAKE THE CHANGES...AETNA JUST PUTS IN THE SYSTEM WHAT YOUR COMPANY WANTS TO PAY FOR YOU. STUPID!!! every medication is not covered on most plans. just because a doctor writes a prescription for you doesn't mean that the insurance will pay for it. for example....suboxone must be pre-authorized by a department within the company by a phone call or fax that your doctor must call. that being said...that will not always 'APPROVE' that medication. there are certain criteria and reasons why medications will be approved by the precert dept. if they are not met -- then it will be denied. plan and simple. AND FOR THE person that says they paid $1400 for 1 year for BCBS insurance....that's a FAT paid more than that honey, whether you knew it or not...and did you know...EVEN IF YOU SKIP AROUND TO DIFFERENT DOCTORS to get those controlled medications like for pain, anxiety (hydrocodone, Xanax) -- and go to 3 or 4 different pharmacies....that the insurance company can see all that when they pull up your file....YES they can tell when they are talking to a drug addict on the other end of the phone. STOP BLAMING others for a mistake that most of you made -- YOU DIDN'T READ THE PAPER YOU SIGNED THAT YOUR EMPLOYER GAVE YOU.

Posted by JaneDoeRep

I am a rep. Believe me, we don't like the problems anymore than you do! We are only the voice of the computer, and it mostly says, "no." Those of us who answer the phones are moms just trying to pay our bills and put food on the table. That's not to make you feel sorry for us, just to let you know that we are not pharmacists, we are only on the other end of the phone to serve you (at least I know I am). I could go into a whole list of issues we reps are having to deal with, but the last thing I want to do is add fuel to this obvious fire.

To save you frustration on your next experience 1) call us right away at 1-866-612-3862, the computer and automated service DO NOT work right now, 2) PLEASE have your Aetna ID ready for the rep, 3) realize we are not machines, please read your ID numbers off in a human speed, and 4) have some patience. Those will make your experience at the very least tolerable.

If all else fails, by all means, call your Member Services listed on your Aetna card to file complaints.

Posted by urfatcat1

It is true. Being aprovider for this company sucks. They are rude, never helpful....and i have been trying to sign up to use their online service. Its been about three months now and no one will help me. We should drop them.

Posted by yousuck1

You think this company sucks for members? Try being a provider. You cannot reach anyone in provider services. You get the ivr and then when you request to speak to a real human being it "pretends" to transfer you then hangs up on you. Great Provider Relations right there! Ha! I wish my company would cancel our contract with them. This company is almost as bad as Anthem. At least they give the run around and don't hang up on you.

Posted by RSA

Let me start by saying that Aetna employees have the same crappy coverage that the average joe has. There are no "better" plans for us, no matter how long we have worked for this company!
Second, Aetna has sent a very very large portion of work to India which I believe will result in me losing my job eventually. This includes claim processing, appeals, claims rework, overpayment requests, and probably alot of other things I am not aware of. The people in India have no clue what they are doing, 1) because Aetna thinks a few weeks of training actually prepares someone to do things correctly, and 2) because their country has no companies offering insurance and the like, they have no mental concept of how it works in the first place. EVERYTHING in this company has gone downhill since they outsourced everything, all in the name of higher profits!!
And please don't think our pay and benefits are better than those for someone in another line of work because, believe me, they aren't. Every employee at Aetna is expendable, because we can always be replaced at a much cheaper rate by someone in India.

At Aetna, what it all comes down to is training, or lack thereof. When someone mistakenly denies your claim, or your coverage is wrongly cancelled, etc, it's all because no one trained to do their job properly! No one listens to the complaints of the employees when we say we need more training, and we have such high quality and production rates that we have to make in order to even keep our jobs, many end up with the attitude that "it's a paycheck, and no one cares, so I won't either".

One of Aetna's sayings is "Do the right thing for the right reason." What a joke. More like, "Do whatever will make us more money, but don't give a damn about the people that actually work their butts off trying to do a good job and help people." The upper mgmt does not care about you OR me, only their stock options and bonuses. If you have the choice, go somewhere else. (And fyi, what the other employees have commented on here is all true-I can vouch for that.)

Posted by jacobsteep

All of you people complaining about how "Horrible your coverage" is have to realize one thing. Aetna does not determine your benefits packaged and what is covered and not covered. YOUR EMPLOYER DOES! Your employer builds his insurance compensation package with Aetna and the determining factor is HOW MUCH HE WANTS TO PAY. The more he pays the better YOUR coverage. If you are only allowed 25 Chiro visits a year it is because that is all your employer wants to pay for. Aetna will only give you as good of an insurance policy as what your cheap ass employer will pay for. So before you bellyache about how poor your coverage is have a talk with your employer.....hes the one calling the shots!

Posted by Whistler blower

As a former employee of Aetna Pharmacy Management precrtification depeartment I can tell you this is a horrible company. Thankfully their pharmacy benefits were sold to Caremark starting 1/1/2011.

The call center reps there really do want to help you but there are a few issues.
1) The staff (front line) is given incomplete or incorrect information. This is due to management not allowing information to flow to all staff members. Speak with a supervisor if you question the response.

Aetna does not understand how to make a "situational" determination on drugs that can be covered under part B or Part D of Medicare. They rely on a system called Code Correct, which is for medical procedures not pharmacy. If you have a relative in LTC often times these medications will be processed incorrectly.

3) Before submitting a prior authorization request review the criteria online. Almost every brand drug with Aetna will require authorization. Its easier to have your md submit the request with the information or to try the drugs they are asking. Appeals can be a mess and get lost in their system.

Their faxes to the medical side as well as the mail is handled in India. These people do not speak English very well and do not know where to route the requests. I would see requests get thrown from department to department for a year or more.

Although many of your medications are covered without authorization if you are on a contraceptive make sure your dr tells them its for a medical reason and not contraception. Read their PCB- at because your diagnosis must be on the list.

The staff does not understand how to process your requests. Ask to speak to a supervisor if in doubt.

Beware of any supervisor you speak to as well. You may get Deb Moy- if she is still there. Beware of anything she says. I am not certain who is still there as a supervisor but be wary and ask to speak to Rebecca (Becky)Potts if she is still there.

Posted by csr

As for a rep not giving out their first and last name, Aetna does not allow reps to give out their last names. Which as a customer, I am sure that you do not care, but either way, we are not allowed to give out or last names and do not have to. That is why they give id numbers.

They also encourage us to not get superviors because usually, no supervisor can do what a regular csr cannnot. Now when it comes to knowlegde, that is different, but trying to over ride your plan, such as trying to get 90 days at retail when you plan only allows 30, asking to speak to a supervisor is only going to waste everyones time because we cannot go beyong what the plan allows. A lot of plans are sponsored by the memebrs employers who set the standards of what can be allowed and what cannot, such as, a common complaint is mandatory mail order, that is something put in by your EMPLOYER, not aetna and they provide the exceptions to the plan, not aetna.

Contact numbers are provided on the back of your card. We are not being rude when we tell you to look on the back of your card. There are different divisions within aetna, such as Small Business Accounts, self sponsored accounts, national accounts and there is not just one member services phone number so it would be highly impossible to provide you with the correct mm svs number, we are provided with a general mm svs number, which we can connect you to, but they will probably give you another number to call which will just upset customers more. So it is best to locate the number on the back of your card and call.

If you are complaining that aetna has not updated your cobra coverage, that is because aetna does not updated the cobra coverage. Your EMPLOYER provides effective and term dates. Same goes for over payment or member termination letters, if you receive a bill from aetna stating that you owe them money for a rx that the pharmacy filled after your coverage termed, it is because your employer as not timely in sending in paper work, so aetna continued to pay for your medications because according to aetna, you were active, then when your emloyer turns in paper work and it is processed, aetna will go back and terminate you and the computer generated letter will be sent seeking payment for medications that were paid.

If you are going out of the country and want to contact Aetna, unless you have out of country or out of network coverage, you are wasting your time because it won't be covered anyway. If you are contacting aetna and you do have out of country/network coverage, you will simply need international code and call the same number you would in the states.

As for customer service only being open mon-friday, I am not sure which line you are calling but we do have reps that work weekends and late nights. However, it is healthcare call center... not a 24 hour emergency room. If you need emergency care, seek care first and worry about the cost later. You shouldn't be going to the emergency room unless its an emergency anyway, it if is an emergency, than you won't care about the costs, because you will have to pay them either way.

As for member services, if you want to speak to a live person, keep pressing 0 and it will go ahead and connect you. The only reason that the voicemail prompts you to put your information in, is so that the rep that takes your call doesnt have to waste your time asking for it, if this is an inconvience to you, push 0 and then you can give the information to the rep. If you have questions about your pharmacy benefits call 800-238-6279. Medical member services is tricky, as stated above because there is not just 1 number.

For DMR (direct member reimbursement): the estimated turn around time is 6-8 weeks for dmr processing, as long as all information is submitted in full (detailed phcy receipts with ndc#'s (your pharm can provide them to you) along with quantity and drug name included in this).


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