Anyone have Aetna insurance?

[catwoman]

My employer is switching from United Health Care to Aetna starting Jan. 1, 2008.

Am interested in anyone here who has Aetna and what their experience has been with home testing coverage. Of course, I know, not all policy coverage is identical with the same insurance company.

We have informational meetings starting 7/13/07. I'll be drilling the reps, but would also be interested in personal experience from others doing home testing.

 

[Lisa in Katy]

I have Aetna and will be finding this out soon. I go to the cardio later this month and will be initiating the paperwork. I read where effective earlier this year (April, I think), they do cover the machine, but I'm not sure at what level. I will let you know what I find out, although you may know before I do.

 

[catwoman]

Lisa:

I'll find out today the co-pay on DME and if they do cover home INR machines. Will also ask about testing supplies.

The code for testing supplies (can't remember it) is different from DME (I think that's E1399), so United Health Care would not cover that -- even though it does cover diabetic testing supplies. My company's policy only covers home testing for diabetics, not for people indefinitely on warfarin.

 

[johnbart]

I have had Aetna insurance since my surgery 4 years ago. I have had no trouble at all getting my machine or ordering supplies. I have found them easy to deal with.

 

[MyBloodRunnethOrange]

I have AETNA and was told last week they would not cover the Coagucheck XS "because it was available over the counter". Huh??? I then asked what machines they would cover and was told that was a broad question. HUH?????

The lady then said she had never heard on the INRatio, and it was not even on her list. LOL

I hung up and will call back this week to speak with someone else. Needless to say, this lady was less than helpful and very unfriendly.

By the way, what kind of machine are you using that is being covered by AETNA for those that have recieved them?

 

[catwoman]

Ansley:

Bet you got an Aetna employee who mistook a CoaguChek, an anticoagulation monitoring machine, for an AccuChek, a glucometer, (same company, name of both machines ends in Chek). That would also explain her comment that it was a "broad question."

Try again, and explain what the machine is used for. Most insurance companies will refer you to a vendor who distributes that type of DME.

 

[Computec]

Aetna and INRatio

Aetna and INRatio

I have had Aetna for years and have had no luck whatsoever getting them to go for a home tester. The policy says that they will but there's a lot of small print to allow them to avoid it. I have a PPO policy which should be top of the line but it seems to make no difference.

I've had the vendor wrestling with them since April of last year and still no luck. Short I've arriving at Aetna's office and bleeding on them I'm about out of options.

If you get anywhere with them please let me know.

Thanks

 

[briansmom]

My understanding is that it is really not the insurance company that approves or doesn't; it is your doctor's group. If you are on an HMO then your medical group gets a set amount of money from the insurance company monthly for your care. I think they get more money for specialists but I'm not sure. In my case, the insurance company said that sure they would pay if my medical group approved the home test unit. The medical group DID NOT approve the equipment for my son. There is an appeals process, etc. We went ahead and bought the unit on our own as I am VERY sick and tired of fighting and dealing with doctors and it was not a financial hardship for us.

 

[Computec]

Aetna

Aetna

I'm looking forward to a new battle with Aetna.

My previous request for "predetermination" was denied in August of last year. QAS attempted follow through on the appeal but appears to have missed the deadlines. Aetna's response at this time is that the claim is closed unless QAS can prove with correspondence that they were following through.

Needless to say, Aetna has been very determined not to pay for the tester.

My next way to deal with Aetna will be opening a NEW claim based on two things. Aetna's new guidelines (April 2007) and the fact that I'll buy the device myself and submit for reimbursement.

I'll let you know how it goes.

Jerry

 

[catwoman]

My next way to deal with Aetna will be opening a NEW claim based on two things. Aetna's new guidelines (April 2007) and the fact that I'll buy the device myself and submit for reimbursement.

I'll let you know how it goes.

Jerry

What are Aetna's new guidelines (April 2007)???

 

[Computec]

Aetna's Guidlines (April 2007)

Aetna's Guidlines (April 2007)

http://www.aetna.com/cpb/medical/data/100_199/0173.html

Hope this helps.

Jerry

 

[catwoman]

Jerry:

Thanks a bunch!