Aetna Insurance Company, also known as Aetna Health Insurance, is one of the largest health insurance companies in the United States. According to their website, they offer a wide range of products and services, including medical, dental, pharmacy, behavioral health, group life, and disability plans.
Despite their size and reputation in the industry, Aetna Insurance Company has received its fair share of bad reviews from customers over the years. In this article, we’ll take a closer look at some of the most common complaints and explore whether they’re a reflection of poor service or simply part of the insurance industry’s complex landscape.
One of the most common complaints about Aetna Insurance Company is their customer service. Many customers have reported difficulty getting in touch with a representative, long wait times on hold, and lack of follow-up on claims or questions. One Yelp reviewer writes, “Their customer service stinks. Long hold times, uninformed people, and they don’t seem to be able to answer questions.”
Another complaint frequently cited in reviews is Aetna’s denial of claims or refusal to cover certain medical procedures or treatments. According to a Washington Post article, Aetna denied over 12% of claims submitted in 2017, which is higher than the industry average of approximately 8%. Some customers claim that Aetna’s criteria for denying claims are arbitrary and frustrating to navigate. As one reviewer on Consumer Affairs put it, “The criteria for their denials are so obscure that it seems futile to even try to figure it out.”
Aetna Insurance Company has also been the subject of lawsuits and investigations related to these denials of claims. In 2018, Aetna settled a lawsuit in which they were accused of denying coverage for necessary medical procedures to policyholders with HIV. The company agreed to pay over $17 million in damages and revise their policies to ensure that they covered necessary medical care for those living with HIV.
Another issue that has received criticism in reviews of Aetna Insurance Company is their prescription drug coverage. Some customers have reported that Aetna’s prescription drug benefits are inadequate, with high out-of-pocket costs for necessary medications. According to a 2018 report from the Kaiser Family Foundation, Aetna’s prescription drug costs were higher than average for their plans, with 23% of medications excluding generic drugs requiring prior authorization.
In response to these criticisms, Aetna Insurance Company has made efforts to improve their customer service and claims process. In recent years, they have invested in new technologies for claims processing, including artificial intelligence and machine learning. They have also expanded their telemedicine offerings, giving customers more ways to access medical care remotely.
Aetna has also attempted to address concerns about prescription drug costs by launching a program in 2018 that offers rebates to customers who purchase certain medications. They have also made efforts to improve their prescription drug formulary, or list of covered medications, to include more affordable options for customers.
Despite these efforts, Aetna Insurance Company continues to receive bad reviews from some customers. It’s important to remember that the insurance industry can be complex and frustrating to navigate, regardless of the provider. Health insurance policies often have complicated language and a lot of fine print, which can make it difficult to understand what is covered and what isn’t.
Additionally, the insurance industry is heavily regulated and subject to laws and regulations that can limit the coverage and services offered by insurers. This means that some treatments or procedures that patients believe should be covered by insurance may not meet the criteria required by insurers.
As an article from the Motley Fool notes, “Complaints and lawsuits relating to claims is not an issue unique to Aetna; it is a common issue across the entire health insurance industry.”
Despite the mixed reviews, Aetna Insurance Company remains a popular choice for employers and individuals seeking health insurance coverage. Their wide range of options and long-standing reputation in the industry make them a competitive player in the market.
If you’re considering Aetna Insurance Company as your health insurance provider, it’s important to do your research and read reviews from other customers before making a decision. You should also speak with an insurance agent or representative to get a better understanding of the coverage and services offered by the company.
In conclusion, Aetna Insurance Company has received its fair share of bad reviews over the years, with customers criticizing their customer service, claims process, and prescription drug coverage. While the company has made efforts to address these concerns, it’s important to remember that navigating the complex world of health insurance can be frustrating for anyone. We hope this article has provided some helpful insights into the world of Aetna Insurance Company bad reviews and what they mean for potential customers.