Aetna, Inc.

Review: In October of 2013 I contacted [redacted] on the Aetna sales phone line. I was in need of new insurance for 2014 and had an out of state doctor I needed to keep. I was told on three separate occasions by [redacted] that my physician, [redacted] was in network with the Aetna [redacted] plan that I was purchasing at full price. I DID NOT purchase this plan through the marketplace, although I qualified for a subsidy, because the physician noted would have been out of network. I am now being told by my physician that Aetna is refusing to cover services stating they are out of network, when as I noted above, I was told repeatedly they should not be out of network. My physician representative stated that Aetna informed them that I had purchased a [redacted] plan, which again, I did not, and I am still currently paying for a full price, [redacted] plan. I am now facing ever increasing medical bills to cover the cost of Stage IV cancer that I did not budget for based on the information sold to me by Aetna prior to purchasing the plan. This is absolutely terrible behavior on the part of Aetna, taking advantage of a young woman sick with cancer, who by all measure, did the right thing and researched for the proper coverage needed prior to the new healthcare implementation. How am I supposed to accurately make a decision when the information given out is not only not honored, but changed?Desired Settlement: I would like Aetna to honor the product they promised me and cover my physician as in network. Logically speaking, why on earth would I have purchased a more expensive plan unless this doctor was covered? If I had known they were going to retract their promise I would have saved myself money on my premium and purchased a subsidized [redacted] plan.

Business

Response:

Thank you for your inquiry received on September 23, 2014 regarding complaint #[redacted] for [redacted]. Our [redacted] Team researched your concerns, and I would like to share the results of the review with you.