Thanks to Aetna, considering self-pay

donnaz
on 1/17/05 1:05 pm - Dallas, TX
I know this is a quetion I should probably ask Aetna but I just don't trust them. Aetna messed up my paperwork and showed me still on the HMO plan that our office was on prior to our renewal. I was approved under that plan...but then our office bookkeeper caught a billing error. Aetna had been double billing for my insurance, charging me for both the HMO and the new PPO plan. It never showed up in the billing paperwork because Aetna had that messed up in many ways. When the error was corrected, Aetna recinded the approval because the PPO plan didn't cover the surgery. I am looking at doing a self-pay because I have no other options and I am not willing to go out of the country. My question is...if I have the surgery and, say, a couple months down the road there is a problem that requires medical intervention, can Aetna say, "We didn't cover the surgery, so we are not going to cover any issues related to it." Am I SOL for the rest of my days because I paid for something that was medically necessary but the insurance wouldn't cover? Thanks for any insight you can give me. Donna
Kristey G.
on 1/17/05 3:18 pm - Boston-ish, MA
Yes Donna, they CAN deny you for future problems with WLS they did/would not cover! Be careful! Can you switch back to HMO? Kristey
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