Business Profile

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

1,331 total complaints in the last 3 years.
465 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:04/03/2025
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 paid $44.90 on 12/29/24 for Aetna Silverscript. I changed insurance carriers before 12/31/24. I called in January to request a refund. They told me Jan 8, 2025 that they would issue a refund and to call back if I didn't receive it. I didn't. I called again and they said they mailed it to an address from 2 years prior. I don't know why as the invoices I receive come to my ** *** ***. So they said they would reissue a check and mail it to me. I called back on March 21, 2025 and they said I should receive it anytime, although they did not reissue anything I saw. I called again April 3, 2025 and they said there was a request on 3/21/25 for the check but still no check issued.
Business Response
Date: 04/14/2025
**** *** ******* **********

Please see our response to complaint # ******** for *** ******* ****, which we received on April 3, 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 premium history. We found that the member made a premium payment of $44.90 on, December 30, 2024. This premium payment was applied to the January 2025 premium. However, the member’s plan terminated on, December 31, 2024. The member was issued a premium refund for $44.90 on, January 10, 2025. Refund payments can take up to 21 days to be received by mail. We found that the refund check was sent by mail to a previous address in error.

We understand that the contacted us on, March 21, 2025. We updated the member’s address to the PO Box requested. We initiated the request to void the previous refund check and reissue a new check. On, March 27, 2025, a new check was sent to the member for $44.90. Our records indicate that the check was cashed on, April 4, 2025.

The member will receive a written resolution letter within 7-10 business days. My contact information will be included in the letter. The member can feel free to contact the plan if you need any further documentation.

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

Sincerely,
Jasmine W.
Analyst
Medicare Enterprise Resolution

Customer Answer
Date: 04/15/2025

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:04/02/2025
Type:Billing 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.
Aetna CVS Health incorrectly denied two of my claims to the same in-network provider on the basis of not receiving a referral. This is false, because the referral was submitted with the claim by my provider. I resubmitted the referral via fax after I received the initial denial, within the eligible time window. I called customer service to have the claims reprocessed. The claims were denied again for not having a referral. I called early March to report this incorrect processing based on false information (that there was no referral, when it was submitted twice). I was told that the reason the claims were denied is because they hadn't received the fax by the time they reprocessed the claims, even though it was nearly a week after the date I faxed it. I was told on that call that the the claims would be reprocessed since they showed in their system they did, in fact, receive the faxed referral within the eligible time window.

I received another bill from my doctor late March, which indicated the claims were not reprocessed. I called April 2 to inquire about the reprocessed claims, and I was told the last determination was at the end of January, so there was no action actually taken (contrary to what I was told) based on my call early March. The claims were not reprocessed.

I now have to wait 30 days to confirm that the claims are properly processed through their internal appeals system. I have spent hours on the phone trying to rectify this, which is entirely their mistake. I am frustrated, I am stressed due to the potential of my doctor bringing my account to collections, and I am deeply disappointed at the incompetence of Aetna's internal processing communications to rectify this in any reasonable length of time.
Business Response
Date: 04/09/2025
**** ******* **********
Please see our
response to complaint # ******** for **** ****** that was received by us on April
2, 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
and outreach to the provider, the proper referrals were added to the member’s
profile. The impacted claims were sent back for reprocessing on April 9, 2025,
the claims can take 7-10 days to process and finalize. Outreach was made to the
member directly and she was advised of the resolution. Once the claims have
processed and finalized another follow up call will be made to the member to
inform her that the claims have finalized. New Explanation of Benefits (EOB)
will be sent to the member after the claims have processed and finalized.
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,
ShaCarra B.
Executive Analyst,
Executive Resolution Team
Initial Complaint
Date:04/02/2025
Type:Order 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.
Aetna denied a medical necessity procedure ( *************** ) plus a peer to peer was done and also was denied stating surgery it is not a necessity and stating that I did not finished the required physical therapy time. Physical therapy was done for two section and was canceled after that due to worsening my symptoms taking me to the Emergency room. Aetna is ignoring the fact that what they are requiying for approving my much need it surgery is worsening my condition and goes agains the well of my health. Im currently at home rest due to bad pain an difficult to do my daily routine even in job leave with possible job lost if Aetna keep deniying my procedure plus my condition is worsening by day and Aetna seems to be ignoring this health conditions. My neurosurgeon did an explanation of my condition and advised that this is a medical necessity but again Aetna seem to ignore a medical advise keep insisting of denial over a physical therapy that is worsening my condition
Business Response
Date: 04/03/2025
**** *** ******* **********

Please see our response
to complaint #******** for ****** ******** that was received by us on April 02, 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.
********** concerns reviewed. Based on the review it has been confirmed that
the procedure code ***** was denied by our clinical team, as there is no documentation of a least six weeks of formal physical therapy in the last twelve months. A
peer to peer was completed, and the member’s physician indicated they would submit
additional the physical therapy records. However, no additional physical therapy records
were submitted.

Mr.
******** has the right to appeal, the member has 180 days from the date of the
denial letter to submit an appeal. Mr. ******** may call customer service at ###-###-####
or send a letter to the following address with the additional physical therapy
records:

Aetna

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

We
take customer complaints very seriously and appreciate you taking the time to
contact us and giving us the opportunity to address Mr.
********** 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: 04/04/2025
Good day, document’s requested has been sent to them by the surgeon side surgery coordinator *** *****. As stated before effort was made to complete PT but it was canceled due to worsening my health condition to the point i was in need to go to the Emergency room almost unable to walk and high levels of pain currently at home rest w/o been enable to perform my daily activities in need of this procedure!!. Please see files attached of documentation Aetna is requesting as proof of the Physical Therapy efforts and the letter explaining therapy could not be completed
thank you
Business Response
Date: 04/14/2025
Dear Stewart Henderson:
Please see our
response to complaint # ******** for ****** ******** that was received by us on
April 4, 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
has been determined that the member submitted new information that was not
previously received or reviewed. Since the member submitted new documentation, a
new appeal has been opened for the member. I will respond directly to the
member going forward regarding the resolution to the new appeal.
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,
ShaCarra B.
Executive Analyst,
Executive Resolution Team
Customer Answer
Date: 04/15/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ******** and will wait and hope for a positive outcome from this matter

Sincerely,

****** ********
Initial Complaint
Date:04/02/2025
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.
In October of 2024 I was sold what was described as an insurance policy but is in fact a "discount" plan. I was told by the agent (Jordan Tucker) that in-network providers were not required and that the "plan" was accepted widely. This is not the case. Providers in my area are unable to verify any type of coverage, and as a result I have had to cancel any health care appointments I have made. Attempting to reach customer service at any of the numbers provided on my policy information card has been futile. ###-###-####, ###-###-####, and ###-###-#### all result in such long hold times that the calls are disconnected, or the language barrier of agents is so significant that neither party understands the issue. Emails are not answered for weeks if at all. I have been attempting to get information for almost 3 months. Meanwhile I am paying over $400/month for useless coverage. I have also filed a complaint against ******* ****** *********, the broker who handled this, and they are passing blame onto me and advising I cancel the policy by calling ###-###-####. I have called this number multiple times and been unable to reach anyone who can assist with questions.
Business Response
Date: 04/03/2025
**** ******* **********
Please see our
response to complaint # ******** for ***** ****** that was received by us on
April 2, 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 complainant does not have any active coverage through Aetna. The numbers
the complainant stated she called are not Aetna telephone numbers. The complainant
would need to make outreach directly to ******* ****** ********* or the Broker
in which she enrolled in the health plan with. The complainant can try other
telephone numbers for ******* ****** ********* such as ###-###-####, or ###-###-####.
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,
ShaCarra B.
Executive Analyst,
Executive Resolution Team
Customer Answer
Date: 04/03/2025
I have contacted PHS and the agent I spoke with told me to contact Aetna. If Aetna is also denying responsibility then I probably have no further recourse. Please communicate to Aetna that passing the buck between themselves & PHS means I am not satisfied with their response. Poor communication between providers should not result in an experience as frustrating, stressful, & time consuming as mine.
Initial Complaint
Date:04/02/2025
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.
Have been with Aetna advantage for a number of years. Have also used their online OTC benefits program each quarter. The last two quarters I have received no shipment. When I called I was rudely told that I basically don't know how to do online orders. Since I run a business online, I disagree.
I am out only the cost of the last two quarters, but I can't help but wonder how many others are having this type of problem.
Business Response
Date: 04/04/2025
*** *********
**** *** ******* **********

Please see our response to complaint # ******** for *** ***** **** that was received by us on April 2, 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. We contacted the OTC Department to inquire why the member did not receive his orders and to review the calls from the representatives the member spoke to. The OTC Department advised that there are no transactions for 2025. The member activated the card on December 11, 2024. There are no call notes since December 2024. The member may access his 2025 OTC benefits online at *************************.

We did review a call that the member made to Aetna on April 2, 2025. The representative advised that the OTC allowance is now $30 per quarter and gave the correct phone number to OTC which is ###-###-####. The representative was very respectful and helpful when the member advised her of the issue. No errors were found.
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
Initial Complaint
Date:04/01/2025
Type:Customer Service 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.
Since January of this year I have recieved two text messages from Aetna between the hours of 1 am and 4am, I do not need to be awakened in the middle of the night to recieve a message regarding refilling presciptions!
Business Response
Date: 04/02/2025
**** *** ******* **********

Please
see our response to follow-up on complaint #******** for
*** **** **** that was received by us on April 1, 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 immediately member’s account. We confirmed the
member’s account that he is not set-up to receive any type of communications
regarding his prescriptions. If the member could supply a screenshot of the type of text message that he is receiving we would be happy to look into this further.

After furher review, we show the member has his prescriptions filled at his local retail
******* ********, located at **** ******** ***** ******** ** *****. Their contact
phone number is ###-###-####, their pharmacy website is ********************.
According to *******’s website: Customer notifications will be received through
email (if they have a connected pharmacy account), app push notifications (if they
have them turned on), and text messages (if they have signed up for pharmacy
texts). Customers can sign into their pharmacy page at ******************** and
select how they would like to receive notifications about their prescriptions.

The
member will receive a detailed Medicare Resolution Letter within 7-10 business
days with this response.

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,
Marilyn G.
Analyst,
Medicare Executive Resolution
Initial Complaint
Date:03/31/2025
Type:Delivery 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 name is ***** *****. My son's name is ****** *****. And he has Aetna Better Health of ********. Seven months ago I called in the change his doctor as his doctor was no longer sufficient for him anymore. Unfortunately for myself and my son, I called in multiple times for the last 7 months and have YET to receive his medical card! I've filed a complaint with the company and STILL have not received his medical card and downloading it online is NOT AN OPTION FOR ME!!! I shouldn't have to go through this much! JUST MAIL ME HIS MEDICAL CARD! ITS BEEN 7 MONTHS!!
Business Response
Date: 04/07/2025
**** *** ******* **********

Please see our response to complaint #******** for ***** *****
that was received by us on March 31, 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. It has been confirmed that the member ID card for ****** *****
was sent to the verified address 7*** * ***** ** *** ** ****** ***** ** ***** on three separate occasions. The ID card was sent to the verified
address on January 10, 2025, February 19th, 2025, and March 19th,
2025. Each ID card was printed with the Primary Care Provider (PCP) *** ***** * *******.

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: 04/07/2025

Complaint: ********

I am rejecting this response because:

I don't care if you say you sent the cards I NEVER GOT THEM. So you obviously did not send them. I don't care what your system says I NEVER GOT HIS ID CARD! NOT ONE! So maybe send the his ID card certified Mail so someone has to sign for it, or send it ***** or ***. I don't know. But I have NEVER received ANY of the ID cards I've asked for. And I've called **** and they have no way of tracking anything without a tracking number. They have no record of any ID cards from Aetna coming here or even being sent back. It's been almost 7 months and I CANNOT GET HIS ID CARD! UNACCEPTABLE!!!

Sincerely,

***** *****
Business Response
Date: 04/18/2025
**** *** *********:

Please see our response to complaint #******** for ***** ***** that was received by us on April 7, 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 the member ID card
was mailed to the verified address on file (which included “West” in front of
the member’s street name) on January 15, 2025, February 19, 2025, March 19,
2025, and April 9, 2025. In addition, we mailed another member ID card on April
16, 2025, to the address verified with the ****** ****** ****** ******* (****),
which does not include “West” in front of the member’s street name. Ms. *****
should allow 7-10 days for receipt. Please know, using the verified address was
a one-time courtesy. To change the address permanently (to not include “West”
in the address), Ms. ***** must contact member services at ###-###-####. Furthermore, we
confirmed that the only method of mailing the member ID card is through the ****.

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,

Herman M
Analyst – Executive Resolution
Executive Resolution Team
Customer Answer
Date: 04/21/2025

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:03/31/2025
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.
I have had several communications with *** AETNA CVS HEALTH since December, 2024. I have been trying to cancel my health insurance policy that I was auto-enrolled in (without my consent per ******* ******). ******* ****** is a State-based Exchange on the ******* ********** **** *** Platform and they have acknowledged cancellation of the policy in their system, but Aetna has not. I requested termination of my policy to be effective 11:59pm on 12/31/2024 as I gained other health coverage through my employer effective 1/1/2025. To date, my policy is still active on Aetna's website (see attachment).

Additionally, I have requested multiple times to be taken off autopay and to get refunds for 2 charges they made against my credit card without my authorization and a refund of those charges plus a refund for an additional overpayment they acknowledged. Each autopay charge was for $728.48 and the overpayment amount was $82.92 for a total of $1,539.88. Aetna refuses to acknowledge the autopay status or the 2, $728.48 charges despite me providing credit card evidence (see attachments). I have since disputed both of those charges with my credit card company.
Business Response
Date: 04/08/2025
**** ******* **********
Please see our
response to complaint # ******** for **** ***** that was received by us on
March 31, 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 was previously enrolled in an *********** Silver S plan
partially subsidized through the State of ******* effective February 1, 2024,
through December 31, 2024. The member’s plan was auto enrolled but has since
been terminated effective December 31, 2024. There were two auto payments processed
for February 2025, and March 2025 in the amount of $728.48 each due to auto pay
not being cancelled. The member’s billing portal currently reflects a credit
for $728.48, there was a chargeback issued for payment processed on March 25,
2025, due to the member’s request. A refund was processed on April 3, 2025, in
the amount of $728.48 back to the member’s **** credit card on file. The auto
pay has been removed from the member’s billing portal. Calls and chats were
reviewed, missed opportunities were identified and the coaching has been
provided.
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,
ShaCarra B.
Executive
Analyst, Executive Resolution Team
Customer Answer
Date: 04/09/2025

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. Thank you for your help!

Sincerely,

**** *****
Initial Complaint
Date:03/27/2025
Type:Billing 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.
Subject: Urgent Fraudulent Account Dispute – Immediate Action Required

Dear Aetna Health,

I am writing to formally dispute an account fraudulently opened in my name. Yesterday, I received an email stating that I owe $125.01 under Account ID: **********, which led me to call the ****** ********* ***********. I never applied for or signed up for an Aetna insurance plan.

I have always been on my father’s ******* **** ***** *** **** ****** insurance due to my cognitive disabilities, and he ensured my continued coverage. It makes no sense for me to have any other insurance. Also, every time *** attempted to run my prescriptions through Aetna, I told them I had no knowledge of any Aetna policy.

An Aetna representative informed me that the person who fraudulently signed me up used the false name “**** *****” and a fake phone number, ###-###-####, which links back to Aetna. The fraudulent application listed *** * **** *** ********* ** *****, while my actual residence was *** * **** **. This raised suspicions that my ex-girlfriend, ****** ***** (birth name ******* ******* *************), or my former roommate, ******* *****, both of whom have legal issues, may have done this.

I have reported this fraud to:
• ***** ****** ********* ****** **** – Case # **********
• *** ******** ***** ********* ****** ***** – Report # ********************************
• ******* ***** ********** ***** – Report #***-***-**** • Better Business Bureau (BBB)
• ***** ******** ******** ********* ******
• Aetna Executive Team

I also learned that three fraudulent applications were submitted in my name. If I had signed up, I wouldn’t have reported it.

I demand Aetna cancel this fraudulent policy, remove all records from your system, and confirm I am not responsible for any charges. If this is not resolved, I will take legal action.

Sincerely,
******* * ******
###-###-####
********************
**** **** *** ************ ** *****
Business Response
Date: 04/01/2025
**** *** ******* **********

Please see our
response to complaint #******** for ***
******* ******that was received
us on March 27, 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 immediately reached out internally to further
research the consumer’s concerns. We confirmed that an
application was received on December 07, 2023, and coverage was active for the
entirety of 2024 with a $0.00 premium. Another application was received on
October 16, 2024, for 2025 coverage with a monthly premium of $41.67, which
resulted in a past due balance and notification to you via email.

The
*********** handles all concerns related to unauthorized enrollments. They
have created a case to escalate the concerns and will contact you directly
with the resolution. If the *********** deems the case to be an unauthorized
enrollment, your providers and pharmacies will need to rescind their claims
and rebill to the correct insurance. If the *********** declines the case as a
valid enrollment, you may appeal their decision directly with the ***********.
Any further questions or concerns regarding this enrollment should be directed
to the ***********.

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,

Phalyn C. |Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 04/02/2025

Complaint: ********

I am rejecting this response because:

It isn’t my responsibilities to take care of this matter. If I have to I will hire an attorney I didn’t sign up for this fraudulent insurance you guys and market place should be talking not me! Or talk to agent **** ***** this is illegal what you and market place and agent **** ***** did all 3 of you guys should be sued in court! Talk to my dad about this ###-###-#### I am not filing anything out or doing anything else! I may even get the media involved if I have to!

Sincerely,

******* ******
Initial Complaint
Date:03/25/2025
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.
I went to a physical therapy appointment in early Jan 2025. Aetna denied my claim. I called CS and was assured that it would be covered. Once I filled out a manual
form with the supper bill. I did as I was told and had to call back numerous times before I could confirm it was received and being processed. This continued into February where I had to call, speak to a supervisor and was told my claim was denied. I explained that I was told by multiple reps it would be covered. The supervisor said he could see in the notes this was true. He told me physical therapy isn’t covered using the code submitted on the form and that there is no way of knowing in advanced if a medical service is covered or not. Darryl (supv) said he would submit a special claim that takes 12 days.
It’s now late March. I’ve called at least 6 times to be told the same thing. Darryl is the only person at the entire company who can assist with my claim. Each agent told me they left Darryl messages but he had never attempted to contact me.
I can not get treated by my doctor due to the outstanding balance and they are sending me to collections.
After months Darryl still can’t get reached. They had the audacity to tell me, in late March to resubmit the super bill and form again.
I literally feel sick every time I call because they have me going in circles. They are preventing me from continuing my treatment and my credit score is at risk.
This is the most incompetent, unethical and corrupt insurance experience I’ve ever had.
I’ve waisted literally hours and gotten no where.
Customer Answer
Date: 03/25/2025
I’d like to withdraw my complaint. Aetna is now trying to assist with my claim.

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