Aetna is despicable. I selected a plan through my employer that theoretically should cover prenatal maternity 100%. That is what they state in their plan design & benefits document, and it’s what they state in promotional documents they provide. On documents they provided later, the only caveat stated is, “We only cover tests and ultrasounds that monitor your baby’s health and development.” Fine. Those have been the only ultrasounds I have had done. Now, they are refusing to pay in full (just a $50 specialist copay) because I had one done at my maternity care clinic, and not at a separate diagnostic center. They never provided me with documents that showed that should be the case. I got a second ultrasound done, per my doctor’s demand (I asked him if I would be charged additional for this, and he said no), at a 2nd level diagnostic center. Aetna states that one is not eligible at all because it was “experimental”. No reason why they are stating that. It will be about $1,500 total. ULTRASOUNDS ARE BASIC PRENATAL CARE. What is more stereotypically ‘prenatal care’ than an ultrasound?
What can I do? I’ve asked what they need me to submit to show it should be covered and they just sent me an appeal form, which seems like utter BS. I’m not sure what other information to provide you with, just let me know.
I just feel constantly cheated and nickle-and-dimed by Aetna. They want to squeeze every last penny out of pregnant women, and the amount of time I’ve already had to spend on this is unreal.
submitted by /u/heroicwhiskey
[link] [comments]
Aetna is despicable. I selected a plan through my employer that theoretically should cover prenatal maternity 100%. That is what they state in their plan design & benefits document, and it’s what they state in promotional documents they provide. On documents they provided later, the only caveat stated is, “We only cover tests and ultrasounds that monitor your baby’s health and development.” Fine. Those have been the only ultrasounds I have had done. Now, they are refusing to pay in full (just a $50 specialist copay) because I had one done at my maternity care clinic, and not at a separate diagnostic center. They never provided me with documents that showed that should be the case. I got a second ultrasound done, per my doctor’s demand (I asked him if I would be charged additional for this, and he said no), at a 2nd level diagnostic center. Aetna states that one is not eligible at all because it was “experimental”. No reason why they are stating that. It will be about $1,500 total. ULTRASOUNDS ARE BASIC PRENATAL CARE. What is more stereotypically ‘prenatal care’ than an ultrasound? What can I do? I’ve asked what they need me to submit to show it should be covered and they just sent me an appeal form, which seems like utter BS. I’m not sure what other information to provide you with, just let me know. I just feel constantly cheated and nickle-and-dimed by Aetna. They want to squeeze every last penny out of pregnant women, and the amount of time I’ve already had to spend on this is unreal.
submitted by /u/heroicwhiskey [link] [comments]Read Morer/HealthInsurance