Have been extremely infuriated this week with my insurance which already raised my deductible to 1500$ this year, and now my medications aren’t covered until my deductible is hit.
Anyways, to make a long story short I went to get my medicine and was given the retail amount- which I knew was incorrect because I hit my deductible several weeks ago (with a surgery and another procedure). This was stated on my portal and confirmed by my insurance.
I had to get CVS Caremark to communicate with Aetna and we figured out that the information Aetna had regarding my deductible being met was not properly sent to caremark.
I was told it was resolved 3 different times, only for the same issue to keep happening- which was my medicine still applying toward the deductible. An auditor had to get involved, then I was contacted by an Aetna rep. She told me that I was actually under my deductible, because the auditor “inflated my deductible” which reversed s previous 500$ claim that went towards my deductible. Even though I paid that out to the provider.
She seemed super like apologetic and couldn’t give me any further explanation of what that even means.. so now I’m waiting for another supervisor to call me back so I can understand what the fuck is going on.
Does anyone know what this means and how I can fight It.
TLDR- hit my deductible, then auditor went in and inflated my deductible for a previous claim. Putting my underneath my deductible and causing me to pay out of pocket for a meeting that should be covered since I hit my deductible
submitted by /u/Sbe10593
[link] [comments]Have been extremely infuriated this week with my insurance which already raised my deductible to 1500$ this year, and now my medications aren’t covered until my deductible is hit. Anyways, to make a long story short I went to get my medicine and was given the retail amount- which I knew was incorrect because I hit my deductible several weeks ago (with a surgery and another procedure). This was stated on my portal and confirmed by my insurance. I had to get CVS Caremark to communicate with Aetna and we figured out that the information Aetna had regarding my deductible being met was not properly sent to caremark. I was told it was resolved 3 different times, only for the same issue to keep happening- which was my medicine still applying toward the deductible. An auditor had to get involved, then I was contacted by an Aetna rep. She told me that I was actually under my deductible, because the auditor “inflated my deductible” which reversed s previous 500$ claim that went towards my deductible. Even though I paid that out to the provider. She seemed super like apologetic and couldn’t give me any further explanation of what that even means.. so now I’m waiting for another supervisor to call me back so I can understand what the fuck is going on. Does anyone know what this means and how I can fight It. TLDR- hit my deductible, then auditor went in and inflated my deductible for a previous claim. Putting my underneath my deductible and causing me to pay out of pocket for a meeting that should be covered since I hit my deductible submitted by /u/Sbe10593 [link] [comments]Read Morer/HealthInsurance