Complaint / review text:
I am disabled and have both part A and B of Medicare and used Silverscript as my prescription plan. Three weeks ago I wanted to switch prescription plans because Silverscript keeps dropping medications I am on off their formulary. A representative with E-Health named Morgan talked me into a combined Aetna HMO/Prescription plan saying it would save me a lot of money but that I would need a Primary Care Physician listed. What he didn't explain is that you have to have a PCP in their network and that PCP has to refer you to specialist in the network for anything outside of normal doctor care. I am a disabled Chronic Pain Patient and don't have a Primary Care Physician as I see a Rheumatologist and a Pain Specialist for care and pain management only. This representative picked out a PCP in my area from the Aetna network and we proceeded to get me onto this plan. He told me to go see this doctor so I would be covered.
Three weeks later I get all the paperwork only to discover this PCP has to refer me to the Specialists I see now or nothing gets covered. I have doctor appoints with my Rheumatologist and Pain doctor in about a month.in a panic I called this PCP he gave me and they haven't been in practice for 3 years! I called at least 4 other PCP's in their network and most are not taking new patients and some won't see me because I am a Chronic Pain Patient (which I don’t understand because they wouldn't be treating me for Chronic Pain, just giving the referral). I spent hours on the phone with Medicare having to switch back to Silverscript. I do not recommend switching to Aetna at all if you are on Medicare A&B. Beware. Especially if you are a Chronic Pain Patient.