Aetna insurance/State Insurance Regulator

[Guest guest]

Last May Aetna told me I had maxed out on ST. They said it was 60 LIFETIME

visits when the paperwork they gave my DH at open enrollment says 60 visits per

calender year. Of course I will complain to Aetna but who else can I complain

to? My state insurance regulator? Thank you oh wise group members for any advice

you may offer!

[Guest guest]

In a message dated 11/24/2008 2:55:21 P.M. Eastern Standard Time,

debjward@... writes:

Of course I will complain to Aetna but who else can I complain to?

Insurance Commissioner for the State in which you live. Document everything

and copy your Aetna contact and your HR person (your employer or spouses

employer) who holds the contract with Aetna.

Christy Mattey

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[Guest guest]

We have aetna and our policy covers 60 visits annually NOT lifetime.

someone there has it wrong. I would talk to their manager & the manager's

manager as this company is notorious for making things up as they go along.

My son has been going to Speech Therapy with this coverage for 4 years now.

[Guest guest]

Take this information from " someone on the inside " :

Call the Aetna customer service number and tell them that you want to

make an " Executive Complaint " .

Let me know how things go!

in OH

>

> Last May Aetna told me I had maxed out on ST. They said it was 60

LIFETIME visits when the paperwork they gave my DH at open enrollment

says 60 visits per calender year. Of course I will complain to Aetna but

who else can I complain to? My state insurance regulator? Thank you oh

wise group members for any advice you may offer!

>

[Guest guest]

Ok, help here! We have Aetna, and they have denied all claims for ST

because " no speech was lost " and in your children it is developmental. We

have the diagnosis from a ped. Neurologist.

Any suggestions?

What is an " Executive complaint " b/c I will call and say I want to make one,

and then not know what I am doing :-)

Please .any insurance tips are GREATLY appreciated!!

Another newbie :-)

_____

From:

[mailto: ] On Behalf Of

Sent: Monday, November 24, 2008 5:40 PM

Subject: [ ] Re: Aetna insurance/State Insurance Regulator

Take this information from " someone on the inside " :

Call the Aetna customer service number and tell them that you want to

make an " Executive Complaint " .

Let me know how things go!

in OH

>

> Last May Aetna told me I had maxed out on ST. They said it was 60

LIFETIME visits when the paperwork they gave my DH at open enrollment

says 60 visits per calender year. Of course I will complain to Aetna but

who else can I complain to? My state insurance regulator? Thank you oh

wise group members for any advice you may offer!

>

[Guest guest]

Any documented loss of babble you could throw at them?

Google your state's Insurance Dept. On the website the application

for complaint should be there or instructions on where to get them.

I'd file it. I worked in insurance for 14 years and those complaints

are taken seriously...as seriously as a call to 20/20, at least where

I worked. It was standard procedure that corporate oversaw our

responses to those.

> >

> > Last May Aetna told me I had maxed out on ST. They said it was 60

> LIFETIME visits when the paperwork they gave my DH at open

enrollment

> says 60 visits per calender year. Of course I will complain to

Aetna but

> who else can I complain to? My state insurance regulator? Thank you

oh

> wise group members for any advice you may offer!

> >

>

>

[Guest guest]

If your company " self funds " your insurance plans (as most do), then it is

not Aetna, it is your employer who determines the plan that you have through

Aetna. That can vary from great coverage to no coverage for therapies for

developmentally delayed kids. You need to take it up with your company's HR

department. That is why there are such discrepancies between everyone's

Aetna coverage. This would be for any insurance company, not just Aetna.