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Insurance Companies

Aetna Inc.

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Complaints

This profile includes complaints for Aetna Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

1,334 total complaints in the last 3 years.
467 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:05/27/2025
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Subject: Ongoing Health Insurance Claim Mishandling – Unresolved for 11 Months

I am filing a complaint against Aetna CVS Health for its failure to properly reprocess a medical billing claim submitted by ****** ****** for a procedure I received on June 27, 2024 (Claim ID: *********). The billed amount of $486.06 should have been covered under CPT codes ***** and *****, as in every prior visit.

Despite acknowledging the claim was billed incorrectly, Aetna has:

Denied the claim multiple times without resolution

Promised to reprocess it and follow up, then failed to do so

Repeatedly required me to re-explain my case from scratch in each call

Failed to keep consistent notes, track escalations, or provide callback follow-through

I've spent nearly a year on the phone with dozens of different agents (I have 10 full pages of names, dates and times of day that I've spoken with all of them). None of whom resolved the issue. Most recently, I escalated to a specialist (Maria) on May 15, 2025, who acknowledged a discrepancy — yet nothing has changed.

Due to Aetna’s delays and errors, the claim was sent to collections, even though it should have been corrected long ago. I’ve now missed four time-sensitive migraine treatments out of fear of incurring further bills and I'm terrified of my credit taking a hit.

I am requesting that Aetna:

Immediately reprocess the claim using the correct codes

Remove the claim from collections

Provide a written resolution and apology for the mishandling

This is not a minor billing issue — this is a disruption of medical care caused by a broken system. And now my credit is in jeopardy.

Sincerely,
******** ******
****** Account: **********
Aetna Member ID: ************
**********************
###-###-####
Business Response
Date: 06/06/2025
**** *** ******* **********

Please see our response
to complaint #******** for ******** ****** that was received by us on May 27, 2025. Our Executive Resolution Team
researched your concerns, and I would like to share the results of the review
with you.

Upon
receipt of your request, we immediately reached out internally to have Ms. ******’s
concerns reviewed. Based on the review it has been confirmed that the claim from
the date of service June 27, 2024, was processed correctly based on the way it
was submitted by the office of *** ****** ****** with ****** ******* *****. The
claim was submitted as an in-office surgery visit with procedure codes ******
and *****. The member’s responsibility for this claim is $486.06 which applied
to the coinsurance.

Since
the member stated that claim was not billed correctly, we made outreach to the ****** ******* ***** billing department and asked to have the claim reviewed
to determine if any errors were made. ****** ******* ***** billing department advised that claim will be sent to their review team. It was advised by the ******
******* ***** billing department that this can take up to 30 calendar days
for the claim to be reviewed and resubmitted to Aetna. Follow up will be made to
****** ******* ***** billing department weekly until the corrected claim is received.

We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address Ms.
******’s concerns. If there are any additional questions regarding
this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 06/09/2025
Hello and thank you for this follow up.
I have been to this exact place (waiting on ****** Billing) many many times before. They drop the ball every time, which results in me having to call Aetna back and go thru this entire issue from the start.
****** Billing is the problem but the fact that Aetna never has my back when I have to make that call back again, making me restate a years worth of phone calls and problems and then no one has ever followed up with me until I sent this letter to you. Then I got the call from Shirley from Aetna Resolution 9:02 am on 5-29-25 introducing herself as the one would would be helping me and actually gave me her number (I've never once in this past years nightmare had the same person twice (and there have been about 25 people involved from Aetna).
So it took your intervention to get me a contact at Aetna. But I'm still having the issue with with ****** Billing (who I also filed a complaint against) and until I can get them to reprocess this bill correctly (which it has been in the past) I will not be done with this mess.

Business Response
Date: 06/12/2025
**** ******* **********
Please see our response
to complaint # ******** for ******** ****** that was
received by us on June 9, 2025. Our Executive Resolution Team researched your
concerns, and I would like to share the results of the review with you.
Upon receipt of the complaint, we immediately
reached out internally to further research the member’s concerns. We confirmed
that the member’s point of contact, Shirley, has been monitoring her account
daily to see if the provider has sent in an updated bill. Unfortunately, to
date, they have not. Shirley made another outreach to the provider’s billing
office on June 10, 2025, and they advised this matter is still pending with
their review department. The staff member also advised they sent another expedited
follow up email to their team and reiterated that their turnaround time is 30
days. Ms. ****** must wait the entire 30 days for the provider’s review process
to be completed. Please know, Shirley will contact the member directly as
soon as she receives an update on the claim.
We take customer complaints very
seriously and appreciate you taking the time to contact us and giving us the
opportunity to address Ms. ******’s concerns. If
there are any additional questions regarding this particular matter, please
contact the Executive Resolution Team at *******************************.
Sincerely,

Shay
G.
Analyst,
Executive Resolution
Executive
Resolution Team
Customer Answer
Date: 06/12/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

******** ******
Initial Complaint
Date:05/23/2025
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I had heart surgery and I have critical illness insurance with Aetna. I submitted all paperwork EKGs hospital information date of surgery. Everything that was needed and they still kept denying me when my insurance covers they still keep denying me saying that they’re missing information. I keep on saying everything they’re requesting and they’re still denying.
Business Response
Date: 06/02/2025
**** *** **********

Please
see our response to complaint #******** for ****** ******* that was received by
us on May 23, 2025. Our Executive Resolution Team researched the member’s
concerns, and I would like to share the results of the review with you.
Upon
receipt of the complaint, we immediately reached out internally to address the
member’s concerns. We confirmed that Ms. *******’s claim was denied appropriately
because the documents we received did not support her diagnosis per clinical
review. We also confirmed that Ms. ******* called and advised member services that
she had a procedure, which caused her to meet the clinical criteria. Thus, the member’s claim was processed on May 30, 2025, and she can expect the
funds to be deposited via direct deposit within a couple of days. Should Ms. *******
have any questions regarding her claim or the paid amount, she may contact
member services by dialing the phone number on the back of her member identification
card.
We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address Ms. *******’s concerns. If
there are any additional questions regarding this particular matter, please
contact the Executive Resolution Team at: *******************************.

Sincerely,

Shay
G.
Analyst,
Executive Resolution
Executive
Resolution Team
Initial Complaint
Date:05/23/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I cancelled my Medicare Supplement, * **** online in November, to be effective 12/1/2024 as the renewal premium increased by over $40 per month. This cancellation was ignored and the new premium of $221.74 was deducted from my checking account. I called in December and was told I'd receive a refund within 2-3 weeks. As of May 23, 2025 I have not received a refund.

Each month I have called and each month a customer service representative has lied to me saying I'd receive a refund within 2-3 weeks. They have also played dumb asking for my address repeatedly. On April 25, 2025 I sent a certified letter to Aetna's corporate office stating I would report this issue to the BBB, and the ** ***** ** ********* if I did not receive a refund by May 15. On May 14, I received a voice message from Aetna, Stacey C****** (###-###-####) asking me to return her call. I've tried several times only to be sent to voice mail.

Aetna has been unethical and dishonest in how this situation has been handled. I want the refund of $221.74. Thank you for your help.

Policy Number *** *******
Customer Answer
Date: 05/23/2025
Today, 5/23/2025 I received the refund from Aetna. The check was dated. 5/15/2025.
Initial Complaint
Date:05/23/2025
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Dear Aetna Claims Department,

I am writing to appeal the denial of my claim for my annual check-up performed on March 25, 2025 by ****** * **** (In-Network) under Claim ID ***********, received by Aetna on 3/26/25. According to the Explanation of Benefits (EOB), the claim was denied because the service was provided less than 365 days after my previous check-up.
While I understand and respect the 365-day policy, I respectfully request a review of my claim for the following reasons:
Preventive Care Importance: As you know, annual check-ups are crucial for preventative care and early detection of potential health issues. Delaying or skipping these appointments can have negative consequences for my health and potentially lead to more significant and costly healthcare needs in the future.
Physician Recommendation and Travel Plans: My physician, ****** * ****, and I determined that scheduling my annual check-up for March 25th was the most appropriate course of action primarily because I will be traveling overseas for an extended period and will be unavailable for an appointment until well into next year. Rescheduling after my return would significantly delay this essential preventative care. I trusted my doctor's professional judgment regarding the optimal timing of this visit, especially considering my travel constraints.

I am a loyal Aetna member and I value the comprehensive coverage your plans provide. I am confident that upon further review, you will recognize the importance of preventative care and consider the circumstances surrounding the scheduling of this particular check-up, especially given my extended overseas travel plans.

I have attached a copy of my EOB for your reference.

Thank you for your time and consideration in this matter. I look forward to a positive resolution.

Sincerely,
******** ***
**********
Business Response
Date: 05/29/2025
**** *** ******* **********

Please
see our response to complaint #******** for ******** *** that was received
by us on May 23, 2025. Our Executive
Resolution Team researched your concerns, and I would like to share the results
of the review with you.

Upon
receipt of your request, we immediately reached out internally to have *** *****
concerns reviewed. It has been confirmed that the claim from the date of
service March 25, 2024, denied correctly per the plan’s benefits. The previous routine visit was completed on May 28, 2024, by *** ****** ****. Per *** ***** routine exam benefits, there is one routine (preventable) exam allowed
per twelve months.

We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address ***
***’s concerns. If there are any additional questions regarding this
particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell
H.
Analyst,
Executive Resolution
Executive Resolution Team
Initial Complaint
Date:05/22/2025
Type:Delivery Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On 1/21/25, I contacted Aetna @###-###-#### after receiving a letter from medicare that I was enrolled during open enrollment. I assumed I was calling Aetna directly but spoke to ***** ***** at ********* who took my information. I gave *** ***** my mailing address asking that ALL mail be sent to my mailing address, however to date Aetna continues to send mail to my permanent address. By sending mail to the incorrect address, I missed out on funds due me for February and March, 2025.
When I did receive my plan information from Aetna there was no information regarding Part D Plan or I would have addressed it immediately.
*** ***** never mentioned a Part D plan and I did not agree to be enrolled into a Part D plan, however, Aetna is billing me for a Part D Plan from January, that I am not using and have never used. The bill fromAetna is the first I have heard about the Part D plan. I have asked that these charges be removed, however, I am still being billed.
Business Response
Date: 05/28/2025
**** *** ******* **********

Please see our response to
follow-up on complaint # ******** *** ******** ****** which was received by us
on May 22, 2025. After receiving the complaint, we promptly conducted internal
research.
Our Executive
Resolution Team has finalized the research, and I would like to share the
results of the review with you.

We have confirmed in the
member’s account that she is enrolled in Aetna Medicare Premier HMO -POS
with an effective date of February 1, 2025.

We conducted a thorough review of the call involving the
member and the sales agent and have determined that there was no
misrepresentation in the marketing.

The agent inquired whether or not the member had a specific
plan in mind, to which the member responded that she preferred the plan,
*********. However, the member decided not to proceed with that plan due to the
need to qualify for Medicaid. The agent then presented an alternative plan,
*********, which also offers drug coverage. The member agreed to this new plan
and requested that the agent verify her medication list to ensure that her
prescriptions are covered.

Regarding the LEP, the Centers for Medicare and Medicaid
Services (CMS) may assess a penalty for members who did not have
creditable prescription drug coverage. CMS determines the final amount
of the penalty for which remains applicable as long as they are enrolled in
Part D coverage.

According to CMS guidelines, the plan collects
the monthly LEP if the member has gone 63 days or more without a
Medicare Prescription Drug Plan, or creditable prescription drug coverage while
they are eligible, and does not receive Extra Help.

Not all insurance programs report to
**** Therefore, the LEP Attestation Letter that is sent to members provides the
date range of when they may not have had prescription coverage. They can use
the LEP Attestation Letter to report any creditable coverage for the time in
question.

The plan sent the member an
attestation letter dated January 28, 2025, indicating that she may be subject
to a LEP due to a gap in her prescription drug coverage from August 1, 2022, to
January 31, 2025. The letter noted that the necessary information should be
submitted by February 27, 2025.

During the member’s conversation with
an Aetna Member Services representative on February 11, 2025, she inquired
about why she received the attestation letter. The representative explained
that the plan required proof of credible drug coverage, and they made an effort
to obtain the attestation from the member during that call. However, they chose
not to provide any further information at that time.

Additionally, the plan provided information
dated March 15, 2025, outlining the member’s right to appeal the LEP with ***,
along with the necessary instructions should they wish to contest it.

Please note that the member has the
option to change plans or discontinue your Part D coverage during the Annual
Enrollment Period, which runs from October 15 to December 7.

The
member will receive our detailed Medicare response in the mail within seven to
ten business days. It will also include the appeal form and instructions about
how to file an appeal with ***.

We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address *** ******* concern.

Sincerely,
Jennifer
Analyst
Medicare Executive
Resolutions

Customer Answer
Date: 05/29/2025

Complaint: ********

I am rejecting this response because: Aetna must have me mixed up with another one of their clients. Signing up for/with AETNA has been one problem after another adding stress.
1. AETNA is misrepresentating the information given to clients. This falls under the guidelines of fradualent activity.
2. I have never been on Medicaid ever in my life and do not plan to be on Medicaid, nor did I mention this to their CSR. I have always worked and received health insurance through my employer.
3. Now I know why the CSR loved the AI recoding so it can be changed/deleted.
4. I let the CSR know that I had health insurance through my employer.
5. I researched the plan that I initially asked for but the CSR mentioned she had a plan for me after she looked up my medications and I trusted her.
6. Currently, AETNA, does not pay for my medications. I pay any extras after my discount through medicare.
I do not need or intent to use AETNA, Plan D and would like any monies they say I owe be written off bringing my balance owed to $0 and no further billing.
I would like this bill to be removed from my credit report.
Also AETNA has been blowing up my phone with text messages since I went to BBB. I want it stopped immediately.
Sincerely,

******** ******
Business Response
Date: 06/04/2025
**** *** ******* **********

Please see our response to complaint # ********, for *** ******** ******, which was received by us on May 29, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.

Upon receipt of the concern, we immediately reviewed the member’s account. We confirmed Aetna has not misrepresented or has been fraudulent with the member.

Aetna confirmed, the member is correct per our documentation and per the Medicare system, no Medicaid account was found in the member’s profile. Also, Aetna nor our customer service representatives, will alter any call documentation as stated by the member and required by law.

On January 21, 2025, on the call with the Agent Tammy, the member stated the plan that was initially requested was not processed. This is correct. Aetna has confirmed that the member does not have coverage with Medicaid and currently enrolled with our Aetna Medicare Premier (HMO-POS) plan, effective February 1, 2025.

The member was advised on the call with the Agent Tammy, that the plan the member elected, requires the member to be currently enrolled with Medicaid in place, therefore the member and the Agent Tammy selected another plan that was the best fit and did not require the Medicaid eligibility requirement.

The member’s plan for the Aetna Medicare Premier (HMO-POS) does have prescription drug coverage embedded within the plan. We have confirmed that the member has utilized the prescription drug plan on March 18, 2025, at *********.

Due to the member having access to the plan and had coverage, Aetna will not refund any premiums the member has previously paid. Also, Aetna does not report to any Credit Bureau’s. No information from Aetna was placed on the member’s credit report.

On January 28, 2025 - The LEP attestation letter sent to the member, per the notice stating:

Prior to enrolling in the Aetna Medicare Premier (HMO-POS), it appears that you had a break in prescription drug coverage from August 1, 2022, to January 31, 2025.
If the member did not have prescription drug coverage during this time period that met Medicare's minimum standards, the member will owe a penalty on your monthly premiu*** If the member did have prescription drug coverage during this time period, the member may be able to avoid the penalty by returning the enclosed form.

Please complete the enclosed form and return it immediately to: Aetna Medicare Premier (HMO-POS) ** *** **** ******* ** ***** or call us Monday through Friday 8:00 a.m. to 5:00 p.m. local time at ###-###-#### or TTY ***, to provide us with the information by February 27, 2025.

If the member didn't contact Aetna Medicare Premier (HMO-POS) by February 27, 2025, we will assume the above information is correct and the member will owe a late enrollment penalty.

The member had until February 27, 2025, to file attestation, but not received.

On March 15, 2025 – The Late Enrollment Penalty (LEP) was assessed and option to appeal to *** letter was sent stating:

The member premium will now include a late enrollment penalty. Starting February 1, 2025, the member will have to pay a late enrollment penalty. It will be $11.00 per month. This means the member’s new 2025 monthly premium will be $11.00.

On April 28, 2025, this was the 90-day timeframe to attest with the plan to avoid Late Enrollment Penalty.

Here's what this means for the member:

Medicare told the member; you didn't have creditable coverage for 30 months. This happened between August 1, 2022, to January 31, 2025.

The member may have had multiple gaps in coverage since the member was first eligible to sign up for Medicare prescription drug coverage. These dates show only the member’s most recent gap.

The member’s late enrollment penalty dates back to the day the member became a member of our current plan. This means the member owed a lump-sum amount of $33.00. After this one-time lump-sum payment, the member will owe $11.00 per month.

The member has requested to have Aetna no longer text member’s phone line. Per our abilities to stop the texts, this request only applies to automated calls (Robocalls/IVR), telemarketing calls, and texts. This does not apply to wellness and health-related live manual calls.” Therefore, we did not submit the request to stop the texts as it will remove other call outreaches to member.

If member still wants to have this completed, please call our customer service number on the back of the member ID card and request to be added to the Do Not Call List.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ****** concerns.

Sincerely,

Melissa R.

Analyst, Medicare Executive Resolution
Medicare Complaint Team
Customer Answer
Date: 06/09/2025

Complaint: ********

I am rejecting this response because: Aetna is contributing to my high blood pressure. They are also engaging in fradualent activity by not mentioning that I would have to pay them to use their prescription plan. If I knew I would have to pay them for their plan, I would not have enrolled in it. Tammy explained what I would pay out of my pocket for my prescriptions and I did so in March, 2025
I enrolled in Medicare January, 2022 because of my age and continued to work and use my emplyer's health care until recently. I pay for my medicare out of pocket and do not plan on ever using medicaid and should not have to pay Aetna a monthly fee.
Plan D is for individuals whose precriptions amount to $2,000 or more per year--Mine do not even come close to $1,000 per year. I will pay Aetna because:1. I do not want them to continue to harass me causing stress and escalating my BP. 2. I do not want them telling other agencies that I owe them money and I did not have insurance from 2022 to 2025--a statement they cannot prove or that I plan on enrolling in Medicaid.
Aetna, need to stop engaging in fradualent activities.
Thanks

Sincerely,

******** ******
Business Response
Date: 06/11/2025
Dear Mr. Stewart Henderson:

Please see our response to follow-up on the rejection of complaint #******** for *** ******** ****** that was received by us on June 9, 2025. Please know, we understand how overwhelming it can be aging-in to Medicare and we take *** ****** concerns very seriously.

Within our previous response, we have confirmed *** ****** is enrolled into an Aetna Medicare Premier (HMO-POS) plan, effective February 1, 2025. As Aetna is a Medicare Advantage plan insurer, in order to stay within Medicare Compliance, we must follow all Medicare guidelines.

According to Medicare guidelines, once a member is eligible for Part A & B, they must have creditable prescription drug coverage (Part D) to avoid paying a Part D Late Enrollment Penalty. If they decide not to get Part D when they are first eligible, and they don’t have other creditable prescription drug coverage (like drug coverage from an employer or union) or get Extra Help, they will likely pay a late enrollment penalty if they join a plan later. Generally, they will pay this penalty for as long as they have Medicare drug coverage. This information can be found in the 2025 Medicare & You Handbook or on the website Medicare.gov.

The Part D Late Enrollment Penalty is an amount that’s permanently added by original Medicare to the member’s Medicare drug coverage (Part D) premium. Member’s may have to pay a Part D Late Enrollment Penalty if they enroll at any time after their Initial Enrollment Period is over and there’s a period of 63 or more days in a row when they don’t have Medicare drug coverage or other creditable prescription drug coverage. Members generally have to pay the penalty for as long as they have Medicare drug coverage no matter which plan they choose to enroll into.

The cost of the Part D Late Enrollment Penalty depends on how long the member didn’t have creditable prescription drug coverage. Currently, the late enrollment penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($36.78 in 2025) by the number of full, uncovered months that the member was eligible but didn’t have Medicare drug coverage (Part D) and went without other creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and added to their monthly premium. The “national base beneficiary premium” may increase or decrease each year. If that happens, the penalty amount the member pays may increase or decrease. After a member gets Medicare drug coverage, the plan will tell them if they owe a penalty and what their premium will be. In *** ****** case, Medicare currently shows she went without prescription drug coverage (Part D) for 30 months, if you take the 2025 national base beneficiary premium of $36.78 multiplied by 1% equals 0.3678, multiply that by 30 uncovered months, and it equals her $11.00 per month Part D Late Enrollment Penalty amount.

As *** ****** clearly still disagrees with her Part D Late Enrollment Penalty, she can request a review (generally within 60 days from the date on the letter she received from the plan). We encourage her to fill out the “reconsideration request form”. She can provide proof that supports her case, like information about previous creditable prescription drug coverage, proving to original Medicare that she had creditable prescription drug coverage between August 1, 2022, through January 31, 2025. We have attached the Part D Late Enrollment Penalty (LEP) Reconsideration Request Form if *** ****** decides to ask Medicare to reconsider or review its decision, if certain circumstances apply to her. For example, she might disagree with the penalty if she got Extra Help from Medicare to pay for her prescription drug coverage. Or she might disagree with the penalty if she didn't get a notice that clearly explained whether she had creditable coverage from her previous employer. If she disagrees and wants to dispute the monthly late enrollment penalty, she must complete, sign and mail the request to the address at the end of the form, or fax it to the number listed on the form within 60 days from the date on the letter, which was dated March 15, 2025. Keep in mind, if it has been more than 60 days, which now it has been, *** ****** needs to explain her reason for delay on a separate sheet and send it with the form.

Keep in mind, if a member gets Extra Help, they don’t pay a late enrollment penalty. Please know, people with limited incomes may qualify for the Medicare Extra Help Program to pay for their prescription drug costs. Many people qualify for these savings and don’t even know it. If they qualify, Medicare could help them pay for their drug costs including monthly prescription drug plan premiums, annual deductibles, and coinsurance. Additionally, those who qualify won’t have a Part D Late Enrollment Penalty. For more information about this Extra Help Program, our members can contact their local Social Security office, or call Social Security at 1-800-772-1213, 8 AM to 7 PM, Monday through Friday. Our members can also apply for Extra Help online at www.ssa.gov/medicare/part-d-extra-help.

*** ****** will receive our formal detailed Medicare Resolution Letter within 7-10 business days with this response, as well.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******** ****** concerns. We do apologize for the inconvenience and any stress this may have caused to her as our valued member.

Sincerely,
Marilyn
Analyst, Medicare Executive Resolution
Initial Complaint
Date:05/20/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Recently I applied for a loan from my Whole Life Ins, Aetna Ins. I was told everything had to be by mail. I recd the for** and mailed them back on the 7th of May. As of yet I have not recd the check. I asked for a special reason. I am having 2 different Surgeries in the near future. 1 on the 23rd, the other on June 4th.
The wait time is unacceptable. Several years ago I borrowed funds to give to a daughter so she could move back home from ******, it took a week and they deposited the funds into my bank account. I am now unsure that if I died my kids wouldn't need to wait a month before they could bury me. This is totally unacceptable.
Business Response
Date: 05/28/2025
Dear ******* *********:
Please see our
response to complaint # ******** for ***** **** that was received by us on May 20,
2025. Our Executive Resolution Team researched the concerns, and I would like
to share the results of the review with you.
Upon
receipt of your request, we immediately reached out internally to further
research the concerns. After
further review it
was determined that the member initially requested the loan via the telephone
on April 28, 2025, the loan form was sent to the member on April 29, 2025, we
received the loan request form back on May 13, 2025, the loan was processed on
the same date. The check for $1,100.00 was mailed to the member on May 15,
2025, outreach was made to the member and she confirmed she received the check
on May 20, 2025. Attached to this complaint is a copy of the check that was
mailed to the member.
We take customer
complaints very seriously and appreciate you taking the time to contact us and
giving us the opportunity to address **. ****’s concerns. If there are any
additional questions regarding this particular matter, please contact the
Executive Resolution Team at *******************************.
Sincerely,
ShaCarra B.
Executive Analyst,
Executive Resolution Team

Business Response
Date: 05/28/2025
Dear ******* *********:
Please see our
response to complaint # ******** for ***** **** that was received by us on May 20,
2025. Our Executive Resolution Team researched the concerns, and I would like
to share the results of the review with you.
Upon
receipt of your request, we immediately reached out internally to further
research the concerns. After
further review it
was determined that the member initially requested the loan via the telephone
on April 28, 2025, the loan form was sent to the member on April 29, 2025, we
received the loan request form back on May 13, 2025, the loan was processed on
the same date. The check for $1,100.00 was mailed to the member on May 15,
2025, outreach was made to the member and she confirmed she received the check
on May 20, 2025. Attached to this complaint is a copy of the check that was
mailed to the member.
We take customer
complaints very seriously and appreciate you taking the time to contact us and
giving us the opportunity to address **. ****’s concerns. If there are any
additional questions regarding this particular matter, please contact the
Executive Resolution Team at *******************************.
Sincerely,
ShaCarra B.
Executive Analyst,
Executive Resolution Team

Customer Answer
Date: 05/28/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. My only concern would be the procedure and time involved to receive the funds for my Burial. That information I would like to have in writing for my children. But there response and call to me, I truly appreciated.

Sincerely,

***** ****
Customer Answer
Date: 05/28/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. My only concern would be the procedure and time involved to receive the funds for my Burial. That information I would like to have in writing for my children. But there response and call to me, I truly appreciated.

Sincerely,

***** ****
Initial Complaint
Date:05/20/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I requested insurance which never follow through (health and dental) I requested to cancel before policy started. I contacted these people twice about my refund which they stated both times a check for health and dental would be issue and here we are 5 months later with no refund. This company need to refund as this is considered theft and fraud.

Note: no one ever provided welcome kit not provided policy information. Information gets retrieved via my personal information.

Previous address:
*** ******** *** ******** ** ***** ******* ******* ****** ***** ****** ** ******** *** ******** ******** ** *****
$38.20 (dental)
$53.12 (health)
Business Response
Date: 05/23/2025
**** *** ******* **********

Please
see our response to complaint #******** for
****** ******* that was received by us on May 20, 2025. Our Executive Resolution Team
researched your concerns, and I would like to share the results of the review
with you.

Upon receipt of
your request, we immediately reached out internally to have Mr. *******’s
concerns reviewed. Based on the review it has been confirmed that On February 10, 2025, Mr. ******* was
issued two policies. The Cancer Heart Attack or Stroke (****) policy with a
$75,000 recurrence benefit with a monthly premium of $53.12, and a Dental,
Vision, Hearing (DVH) plan, with a monthly premium of $34.20. Both of the polices
went into effective on February 19, 2025. The address given at the time of the
application was *** ******** ******* ********* ************* *****. The
policies are underwritten by *********** **** ********* ******* of *********,
*********. Mr. ******* contacted us on February 26, 2025, to request to cancel
both of his policies. The policy was canceled on March 3, 2025, to the
effective date and the refund of $53.12 was mailed to the address on file. The
cancellation notice was mailed on March 6, 2025. Mr. ******* also requested to
cancel his DVH policy on February 26, 2025, due to not wanting the coverage.
The policy was canceled to the effective date, and we issued a refund of $38.20
the next day to the address on file. The cancellation notice was mailed on
February 27, 2025.

We spoke to Mr. ******* on May 20, 2025, it was discovered that
Mr. ******* had moved to *** ******** ******** ************* *****. The ****
policy check number ********** was reissued for $53.12. The DVH policy check
number 0076891587 was reissued for $38.20. We mailed both of the checks to the
new address. We contacted the policyholder on May 22, 2025, he confirmed that
both checks were received.

We take customer complaints very
seriously and appreciate you taking the time to contact us and giving us the
opportunity to address Mr. *******’s
concerns. If there are any additional questions regarding this particular
matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive
Resolution Team
Customer Answer
Date: 05/23/2025

Complaint: ********

I am rejecting this response because: from my knowledge, I have yet to see them on my account as cash. Please provide proof that this check was received by Me and cash. I could have not confirmed. I received them if it was not deposit so please provide copies of the cash checks from the institution.

Sincerely,

****** *******
Business Response
Date: 05/28/2025
**** *** **********

Please see our response to complaint #******** for ****** ******* that was received by us on May 23, 2025. Our Executive Resolution Team
researched the complainant’s concerns, and I would like to share the results of
the review with you.

Upon
receipt of the complaint, we reached out internally to have the complainant’s
concerns reviewed. We confirmed that two refund checks
were printed on May 20, 2025, in the amounts of $53.12, and $38.20. However,
the checks were not mailed to Mr. *******’s updated address until May 22, 2025. We
also confirmed that Mr. ******* did not speak to an Aetna representative on May
22, 2025, to advise that he received the two refunds.
We apologize for any miscommunication received on this matter and the necessary
coaching has been provided. Please allow 5-7 business days from May 22, 2025,
for the refund checks to arrive to the ******** ************ address. If the
checks are not received by June 4, 2025, we ask that Mr. ******* contact customer
service at ###-###-####.

We take customer complaints very seriously and appreciate
you taking the time to contact us and giving us the opportunity to address Mr. *******’s
concerns. If there are any additional questions regarding this particular
matter, please contact the Executive Resolution Team at: *******************************.

Sincerely,

Herman M
Analyst – Executive Resolution
Executive Resolution Team
Customer Answer
Date: 05/28/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

I received the payments to my new address which was just issue right after the complain was made (remember that mail has post dates) the letter was not a forward mail as it would indicate on envelope. Thanks to this complain it force them to issue my refund. No further actions required..

Sincerely,

****** *******
Initial Complaint
Date:05/16/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I pay into supplemental insurance through ******* ****** ******* with Aetna Supplemental. I had a baby on 11/28/2024 and have tried multiple times to get the monies within my plan. Specifically, I am filing a complaint to hopefully acquire the $100 for newborn care I am owed according to my plan. I called Aetna multiple times in December, getting different answers from different people I spoke with, giving different advice (upload different documents, submit a different claim). I tried these solutions and am still denied the monies. I filed another claim today and emailed them. Last time I emailed them (as the customer service rep recommended), I never received a response. It is frustrating to pay into a supplemental insurance and not be able to use the coverage when it is applicable to your situation and you are owed money.
Business Response
Date: 05/21/2025
Dear ******* *********:
Please see our response
to complaint # ******** for ******* ***** that was received by us on May 16, 2025. Our Executive Resolution Team
researched your concerns, and I would like to share the results of the review
with you.
Upon receipt of the complaint, we immediately
reached out internally to further research the member’s concerns. We confirmed
that claim number *********887 was processed on May 20, 2025, for $100. Since
Ms. ***** has direct deposit, she should see the funds within two to three business
days.
In reading *** ******* complaint, we can certainly
understand her frustration. Our goal is to provide exceptional service to our
customers, and immediately resolve issues when they do occur. We sincerely
apologize for the difficulties Ms. ***** experienced and that we did not
provide the level of service that she rightfully expects and deserves. These
actions are not consistent with Aetna’s service standards, and we appreciate Ms.
***** notifying us of her experience.
We take customer complaints very
seriously and appreciate you taking the time to contact us and giving us the
opportunity to address *** ******* concerns. If there are any additional questions regarding
this particular matter, please contact the Executive Resolution Team at *******************************.
Sincerely,

Brittany
F.
Analyst,
Executive Resolution
Executive
Resolution Team
Customer Answer
Date: 05/22/2025
Aetna Supplemental said the claim was processed 5.20 but I submitted my claim 5.16 on their website, emailed the support team and filed a complain with BBB- with no response in email. I did not submit the claim 5.21, yet it was processed and made to seem as if I submitted it and it was resolved immediately. I am very thankful for BBB intervening as I do not think the claim would have been paid out had you not. It is frustrating to pay into a service and go through so much trouble to claim your benefits. I wanted the lack of communication documented as well as it feels Aetna Supplemental is trying to rewrite the narrative. It look multiple calls that resulted in getting nowhere and multiple times filing the same claim based on advice and feedback from various customer service reps- one phone call lasted over an hour in December and the agent told me that they could see all the necessary documents were uploaded, only to ask for my consent to view my file documents an hour into the call. When I asked what they had told me they were looking at, there was no answer. It frustrates me their customer service reps do not provide accurate information and make it difficult to claim benefits. I would not recommend this business to anyone especially when the benefits are needed in such a crucial time like early postpartum and maternity leave. They payment has hit my bank account as of 5.22.24. Thank you BBB for helping me resolve this issue in 6 days instead of 6 months.
Initial Complaint
Date:05/16/2025
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Date of service 9/25/24 +10/17/24+10/31/24+11/14/24

I Was asked to pay a bill because I didn't have a reference, I have a HMO plan . After I talked to several agents, before I went to see a Psychiatrist for mental health I was told I don't need a reference. There is record of all the call which is 5 calls . I have also file a complaint with another place on this matter. I am not Satisfied aetna. I don have documented. I feel it aetna error that all there Agents give me the wrong information they need to pay the bill.
Business Response
Date: 05/23/2025
**** *** ******* **********

Please
see our response to complaint #******** for
**** ****** that was received by us on May 16, 2025. Our Executive Resolution Team
researched your concerns, and I would like to share the results of the review
with you.

Upon receipt of
your request, we immediately reached out internally to have Ms. ******’s
concerns reviewed. Based on the review it has been confirmed during the call from September 18, 2024, with our behavioral service center, Ms. ****** was told by the representative
a referral is not required for mental health services, only medical. Due to the
inaccurate information given to the member, we will now allow the claims from
*** **** ********.
The claims from
the dates of service September 25, 2024, October 17, 2024, October 31, 2024,
and November 14, 2024, have been processed with a $40.00 copayment. The member
and the provider will receive an updated Explanation of Benefits (EOB) within 7-10 business
days.
We take customer complaints very
seriously and appreciate you taking the time to contact us and giving us the
opportunity to address Ms. ******’s
concerns. If there are any additional questions regarding this particular
matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive
Resolution Team
Customer Answer
Date: 06/03/2025
Hello , I just wanted to say thank you for your service. This complaint helped. They're actually processing the claims, Because there was an error on their part. I am so happy you guys are around to help with problems like this . thank you
Initial Complaint
Date:05/15/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
My dental office
** *****
****** ******
******** ** *****
Submitted a claim for services
I had done in December of 2024.
I had the services done by a previous dentist who put a claim in.
The services were not satisfactory ( dentures did not fit)

That dentist refunded to Aetna what was paid to them.
Aetna has not paid the claim.
Aetna ticket # for this claim
is *******
Member ID is ************

I have called Aetna on this several times with no satisfaction.
I received a letter from
Aetna when I first tried to resolve this.
Still not resolved.
** *** ***** ************ ***** Kelly
Complaint Analyst
Medicare Complaint Team
###-###-####
Business Response
Date: 05/23/2025
**** ** *** *********** *** ******* **********

Please see our response to complaint #******** for *** ****** ****** that was received by us on May 15, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.

Upon receipt of the complaint, we reached out internally to view the member’s concerns. The previous dentist returned the funds on February 28, 2025, which was after the previous grievance was closed out. No errors found. We contacted the Claims’ Department and had them reprocess the claim for *** ******. A payment of $952 was made on May 22, 2025. The member has a $328 responsibility.

Per further review, the original claim sent by *** ****** was submitted before the first dentist returned the funds, which is why the claim was originally denied. The member will receive a detailed Medicare Resolution Letter within 7-10 business days.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******’s concerns.
Sincerely,
Cindi D
Analyst
Medicare Executive Resolutions

Customer Answer
Date: 05/30/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

****** ******

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