In October, after having an individual Aetna health insurance policy, ($5,000 deductable no where near met for this year) that I bought through AARP (for people over 50), for 2.9 years, I had a basil cell carcinoma removed that the doctor billed (before negotiated fee), $2300. Negotiated fee is $1100.This was my first and only incident with basil cell. Aetna flagged the claim, "pending further infiormation." I called repeatedly to Aetna to find out what kind of information and received secretive, evasive, and contradictory information. On Nov 7 I had the doctor's office call Aetna, and as a result, the office sent Aetna my medical records. As of Friday Aetna states that they did not receive anything and continued to pend the claim. After more calls I finally talked to a claims specialist who - after more contradictory information - said, "oh, they're excluding the claim under the preexisting conditions exclusion because you didn't have health insurance when you applied to Aetna in 2008. You'll have to get affadavits and prove prior insurance coverage." After a lengthly discussion this person called my previous insurance company (coverage of which I declared when I applied to Aetna), and received verification that I did have coverage. She said I would hear "something" in 10 days. How can they call it a preexisting condition when:
1) They claim they've never received my medical records;
2) Therefore, they have no such evidence (besides the fact that it doesn't exist).
Has anyone else had this kind of problem with Aetna?
1) They claim they've never received my medical records;
2) Therefore, they have no such evidence (besides the fact that it doesn't exist).
Has anyone else had this kind of problem with Aetna?