Complaint / review text:
I have an Aetna Select health insurance policy through Cobra. This spring my primary care physician dropped out of the Aetna network. Aetna did not advise me or any other insured members who used him as a primary care physician. When I learned quite by accident that I no longer had a primary care physician, I called a physician in the network and asked that he be my primary care physician. I needed a physical exam at the time. He, of course, wanted to meet me before agreeing to be my physical. I met with him. He agreed to be my physician and offered to do a routine a physical at that time.
Rather than making an appointment to come back, when I was already there, I got the physical and he submitted the paperwork, showing himself as my primary care physician. I have since received a new insurance card listing him as my "PCP". However, since he was not shown on Aetna's records as my "PCP" at the time of the physical, they won't pay for it. I will pay the doctor for the physical, but I will argue with Aetna until I run out of breath! This is typical behavior of a greedy for-profit company. Aetna is relying on a technicality to deny coverage for a normally covered routine physical conducted by an approved doctor in the Aetna system simply to save money. I can afford to pay the doctor. But how many other small claims are denied by this company for no good reason other than to make more money? My claim is small and is under $200.00. But when they deny a few thousand small claims because of technicalities, they make a lot of money and many who submit those claims suffer because they cannot afford to pay for the services themselves.