Does anyone have Aetna Health Insurance?

[Smurfysmiles]

They''ve been taking payments out of my paycheck for 2 weeks now and we haven''t received anything in the mail, no cards, no documents, nothing. Does anyone have any ideas on what to do? I contacted them a week ago and never heard anything so I sent another complaint in today...

 

[Shoopy]

It can take up to 4 weeks to get it.

You can log on to Aetna''s website and get all the documents you need from there as well as temporary ID cards (if you need the cards now).

 

[Smurfysmiles]

Oh really? I did not know that Thanks so much fiery. Hopefully it will let me do that because I tried to log in earlier today and it said my information was not on file??

 

[Smurfysmiles]

dh thinks he has a hernia

that''s why we are so anxious to get him checked out, poor guy

 

[aprilcait]

Ditto to Fiery''s coment.
Sorry you''re having problems with them! I''ve had Aetna insurance for four year now and haven''t experienced any issues. **knock on wood** I hope it clears up for you soon!

 

[Shoopy]

Oh no to the hernia!

I would call and ask to confirm that you are in the system and then try to get on their website again. I had Aetna pre-baby (have AvMed now) and never had problems with them either. I often use the temp cards since I always misplace my ID cards.

 

[Smurfysmiles]

omigosh I really do not have my brain turned to full power today lol
Of COURSE I forgot to actually register for online service, doh

 

[packrat]

Date: 1/14/2010 4:31:02 PM
Author: Smurfyimproved
omigosh I really do not have my brain turned to full power today lol

Of COURSE I forgot to actually register for online service, doh

haha, I was going to ask if you''d signed up for the online stuff!

 

[Smurfysmiles]

Seems I can''t get a temporary id card for DH though and it only offers dental and pharmacy id cards? That can''t be right can it if we are both on the plan?

 

[Shoopy]

Date: 1/14/2010 4:33:56 PM
Author: Smurfyimproved
Seems I can''t get a temporary id card for DH though and it only offers dental and pharmacy id cards? That can''t be right can it if we are both on the plan?

Hmm that''s strange. Maybe your DH has to set up an online account for him using his data? I only had insurance for myself so I''m not sure.

 

[Smurfysmiles]

oh i bet that is what it could be!

 

[Smurfysmiles]

turns out he should be listed under my plan as well, what a hassle

 

[Smurfysmiles]

Nevermind, I filled out the form backwards, oi
You would think as a web tester I could figure it out lol

 

[diamondringlover]

I actually work for Aetna and this is the busiest time of the year for all insurance companies and it will take a little longer then usual to get your cards, alot of companies renew there insurance the 1st of January that is why it takes so long..hang in there.

 

[Smurfysmiles]

oh

that''s good to know
so i filled everything out correctly and the stupid form still isn''t adding him
is there an emoticon for pulling your hair out?

 

[Smurfysmiles]

at least i got an email back saying it was mailed 3 days ago, hopefully there is a card for my husband in there

 

[swimmer]

Just checking here, but if you have his account number (which you have to pay the bills and see his online stuff), you don''t physically need the card. As long as you have a pcp listed, just call their office, make an appt with the account number, and perhaps the card will be in by the time the appt rolls around. If you don''t have a pcp, then find one covered on their website. I had Aetna last year and loved it. The cards did take some time to come in, but all you need is your account number for visits or prescriptions if you are on a script included plan.

 

[Smurfysmiles]

Hey swimmer, I don''t know if you had any subscribers on your plan, but if you did- do you remember if you both had different account numbers?

 

[Shoopy]

Date: 1/14/2010 5:05:35 PM
Author: Smurfyimproved
Hey swimmer, I don''t know if you had any subscribers on your plan, but if you did- do you remember if you both had different account numbers?

From what I''ve seen, now that I have DD on my plan with Avmed, they just add a 1 to the end of the account #. Don''t know if that''s how it is with Aetna.

 

[diamondringlover]

Date: 1/14/2010 5:07:12 PM
Author: fiery

Date: 1/14/2010 5:05:35 PM

Author: Smurfyimproved

Hey swimmer, I don''t know if you had any subscribers on your plan, but if you did- do you remember if you both had different account numbers?

From what I''ve seen, now that I have DD on my plan with Avmed, they just add a 1 to the end of the account #. Don''t know if that''s how it is with Aetna.

Depending on the type of plan you have it will just add a number on the end, like 00 and then 01 for a dependent

 

[Smurfysmiles]

Date: 1/14/2010 5:07:12 PM
Author: fiery

Date: 1/14/2010 5:05:35 PM

Author: Smurfyimproved

Hey swimmer, I don''t know if you had any subscribers on your plan, but if you did- do you remember if you both had different account numbers?

From what I''ve seen, now that I have DD on my plan with Avmed, they just add a 1 to the end of the account #. Don''t know if that''s how it is with Aetna.

Hmmm well it''s worth a shot

Thank you for all the helpful info guys! I''m still new to this whole health insurance game (I was covered under my parents til I turned 25, they had such good benefits it was hard to not do that) so one more space in the game of life

 

[diamondringlover]

Let me give you a little advice, there is alot of different insurance coverage's out there and if you dont know your coverage it can really hurt you financially, make sure you read what your insurance covers and most important is to see if you need referral or not, that is a hugh thing, if you arent sure make sure you call Aetna and they can explain it to you, or you can always check with your human resource department.

 

[Smurfysmiles]

I''m not sure what you mean by a referral?
However, I asked my parents advice, especially my dad as he is a litigator and really good at reading the fine print and he said we were getting a really good deal so that''s why we chose it Basically we are gettin full dental, full medical, full vision, life insurance, 10 dollar co pays for walk in visits, 15 for doctors visits, plus all the pharmacy cards and that jazz. the medical includes maternity leave and all the bills associated with pregnancy (with co pays of course) and it is something like 300 a month. from what i''m told that''s about normal for full coverage?

 

[diamondringlover]

Some insurance plans require you to get a referal from your primary care physician before you can go to another doctor, it just all depends on the type of insurance policy you have, your parents are a good place to go for advice [

what you are paying sounds about right and it sounds like you got pretty good coverage...I guess since I work in insurance I see all kinds of problems and I just wanted to make sure you I always try to help steer people in the right directions so that hopefully you wont have any issues. Good luck and feel free to ask me any questions

 

[swimmer]

Smurfy,
I don''t remember how the numbers went, but it would be a good idea to read up on your policy, as DRL said, every company and every policy is vastly different so it is hard for any of us to speak to your situation. I did find with Aetna that all sorts of strange things were covered, but I had to have my designated primary care physician refer me in order to get anything to be covered.

But having said that, wow, my insurance costs $75 a month with the same coverage/co-pays you listed. Then again, my mom has to pay over $1k a month for hers, so there are just so many variables out there, it is hard to say what a "good" policy, whatever that means these days, is going for these days.

 

[Smurfysmiles]

I believe when they gave us the information at work it said no referral was needed which may also be why it costs a little more than what you had swimmer, just a thought? But at least I can keep it through the year when I don''t have my job anymore so really it''s better than nothing! My dad mentioned at his office that some people pay up to 900 dollars for their health care

I wonder if they have large families though!

 

[elrohwen]

I just got my card from them earlier this week - so they are a bit slow. You can call them and ask for your ID number and use that at a doctor''s office even without the card.

 

[Loves Vintage]

I used to work for Aetna, so I must chime in here too!

Regarding insurance rates and costs to members - The cost per member depends only partially on the richness of the benefits offered. Insurance rates are also based on the experience of the plan members in the past (i.e., how much a group/employer plan's members actually spent on their healthcare in prior years that they were insured through the same group/employer plan, even if insurance was through another insurancy company), spread out across the group. This is why it is always less expensive to pay for insurance received through an employer than to purchase a plan individually. Individual plans are more expensive due to the increased risk that results from being unable to predict future insurance use for the individual because of a lack of past experience. Group plans spread this risk across the entire plan - some members will have a need for expensive medical care, some members will refuse to visit a doctor.

The actual cost of the plan per member, however, is usually not the amount paid by employees/members. The cost to each of us as individuals depends upon how much the employer contributes to the plan cost. The employer could pay for 100% of plan costs, in which case members would have no deduction taken from their paycheck on a monthly basis for insurance. They could pay 50% or 80% or anywhere in between, so this explains why we would all pay different amounts for substantially similar insurance plans.

diamondrnglover - Are you in CT, by chance? If you don't want to say, you don't have to, but just curious. I worked at the main office, years ago, along with approximately 5,000 other people, lol. It was my first job out of college, and I stayed for 7 years! I was able to stay there, working full-time, during the four years that I went to law school at night. Aetna was very, very good to me. I miss many of the people that I used to work with. They were like family to me. I've always said that I sort of "grew up" professionally during my time there. I hope your experience is just as good as mine was!

ID Cards - Just wanted to mention that the timeliness of ID cards depends greatly on the timeliness of each employer in submitting member information to the insurance company. November and December are the busiest months for insurance companies because this is when most employers change insurance carriers and submit their information. I promise you that the folks at Aetna work very hard to get ID cards out to members before January 1 (you wouldn't believe what goes into it, really), but there is only so much that can be done if the information is not submitted timely to the insurance carrier.

Smurfy - You mentioned that you are covered until the end of the year. I just wanted to mention that most plan coverage ceases at the end of the month in which employment ceases. (I am so sorry for bringing this up in this thread, but this is important, and I want you to know what to plan for.) After employment ends, the employee is offered COBRA coverage, so the same benefits apply; however, you have to pay 102% of the actual plan cost. Assuming your employer now pays $300, and you pay $300, then you would have to pay $612 per month to retain your coverage. This is something you would want to discuss with HR. I only mention this because you mentioned that you are covered until the end of the year and just wanted to be sure your undertanding is correct. ETA: Your company may be offering something entirely different, in which case, please disregard.

 

[Smurfysmiles]

Date: 1/15/2010 11:11:35 AM
Author: Loves Vintage
Smurfy - You mentioned that you are covered until the end of the year. I just wanted to mention that most plan coverage ceases at the end of the month in which employment ceases. (I am so sorry for bringing this up in this thread, but this is important, and I want you to know what to plan for.) After employment ends, the employee is offered COBRA coverage, so the same benefits apply; however, you have to pay 102% of the actual plan cost. Assuming your employer now pays $300, and you pay $300, then you would have to pay $612 per month to retain your coverage. This is something you would want to discuss with HR. I only mention this because you mentioned that you are covered until the end of the year and just wanted to be sure your undertanding is correct.

Thanks for the concern

I actually did my research on this. I am on a plan specifically tailored towards contract workers and hourly workers. Since contract work can be iffy, that is why they allow you to be covered til the end of the year. It just is not deducted from your paycheck and you have to send your payments into the company

At least that is my understanding from the representative that I spoke with. While my company I physically work at will be closed, I technically will still be able to gain more employment through the contract company I work with if that makes sense?

 

[ts44]

Second the folks who are saying to get your ID number from online and use that in lieu of a card. I don''t know what state you live in Smurfy, and benefits do vary by state a good deal. First, verify if you have a HMO (health maintenance organization) or a PPO (preffered provider organization)-style plan. HMO''s generally require referrals from your primary care provider (PCP) to go see a different doctor. PPO plans do not. If you have a HMO plan, 99% sure you will have no out-of-network benefits, meaning you cannot see a provider outside of the Aetna network. PPO plans you can, but you generally have a reduced benefit compared to in-network. Some Aetna plans are a POS (point of service) and POS plans combine characteristics of HMO''s and PPO''s. POS plans will have out of network benefits like a PPO, at a reduced benefit from in-network, but also use referrals for the most part. One keyword to look for regarding referrals is if the plan is "gatekeepered." Gatekeeper plans require referrals. Aetna customer service can explain all of this to you as well.

You should call customer service to verify that your husband has made it onto your plan before seeking service however, because if he hasn''t and he sees a provider, you may have to file a manual claim form to get benefits covered once he gets into the system and that''s a pain in the tuchus.

One thing which I always tell my clients is to never let a provider turn you away because "they can''t verify coverage." If you know you have coverage, and you have your member ID number or even just your SSN, you make them call the carrier (in this case Aetna) and verify your coverage while you''re there. Providers get lazy about that all the time and it drives me nuts. If your husband goes to the doctor about his hernia once he''s in the system and doesn''t have a card yet, make sure he pulls the Aetna customer service number from the website and brings it in with him along with his SSN.