I’m going to lose my mind. I feel like I’m going to have a panic attack. I have Aetna, yet I still owe $6000 on an er visit after I had complications with my gallbladder surgery. I haven’t even gotten the bill for my surgery yet. I literally cannot afford this. Insurance is through my work and I didn’t have a choice. My deductible is 6000 and yeah I’ve MET that now, but I still can’t afford $6000!!! Why is health insurance in the us so bad. I’m literally going to cry Is there ANYTHING I can do to lower my bill? I called the hospital and they couldn’t do anything to help

My dad just went through open enrollment and he opted out of employer Medical insurance since he is starting Medicare as of today (he used to have the Medical insurance but the increase in price made Medicare a better choice). He only signed up for dental and vision. I called his insurance company (aetna) just to double check and they say that it shows he has all three: medical, dental, and vision. I told them we didn't sign up for it so they told me to contact our employer so they can update the information. My dad spoke to someone in HR who says that there might be a delay since today is the first of the month and the first day of the insurance taking place after open enrollment. Does this sound correct? Should i give it time? Just trying to make sure everything gets updated correctly especially since my dad signed up for Medicare B with special enrollment (qualifying life event of losing employer insurance so that he doesn't pay a penalty for signing up after 65).

My wife was in Seattle late last year and needed an ambulance ride to the hospital for an emergency. AMR, the provider is billing me $900+ for the amount that Aetna didn't cover at the in Network benefit. AMR shows as in network on Aetna but AMR is claiming they are out of network. Aetna says the tax identification number that AMR used is different than the in network number they have. Aetna said this in a message but doesn't seem to make sense: "If the provider bills you for an additional amount, please send a copy of this Explanation of Benefits and the bill from the provider." Anyone ever had an issue like this and who can I contact to resolve? Also we live in Illinois and get our insurance in Illinois.

I had a pre-op call with my hospital today prior to my bilateral salpingectomy (preventative birth control) procedure next week. I have a new Aetna plan with a $2k deductible, so it didn’t seem crazy when the hospital said I owed $2k. But now I’m hearing that my procedure should be free under the ACA. I was told I’ll get my receipt for the charge at my pre-op appt on Friday. Any chance of me getting this money back if I dispute? Can I do a chargeback on my card?

I have Aetna DMO, and I am constantly being overcharged for things. It started with the dentist recommending a deep cleaning even when I knew for sure that I didn't need it. I still paid because I thought it was better than letting my teeth worsen. Then the dentist tells me I need 2 inlays. The insurance says they should cost $115, but the dentist's very rude receptionist mentions that they use Emax only, which is a $750 upgrade. It makes no sense to be paying so much for these treatments, and for all I know, I may not even be needing them. What is a good solution for me at this point? Just go to a well-reviewed dentist and pay them cash for this? Or can I maybe get external insurance myself? But I doubt any external insurance will be as good as what my employer is already offering. (Aetna DMO)

I need advice on how to negotiate a bill that I received from my insurance. I had a neck and upper shoulder pain for more than a week and I went to a specialist. He did some routine range of motion checks and just advised to avoid the gym and use a heat pack. Now I see I've got a bill where Aetna was billed $1155 for the office visit and my bill is $375.76 which is around 30%. This seems like a very high charge for a 10 minute routine appointment. Is there any way I can either ask for a reduction on what Aetna was billed or what they charged me? The latter seems less likely since I haven't hit my deductible yet Edit: This is NY state and the appointment was at NYU Langone

I have Aetna with acupuncture coverage. I had seen a provider 6 times, 3 times in 2023 and 3 times in 2024. All of the visits were coded CPT Code 97811 and CPT Code 97810. In 2024, I saw the provider in January, June, and July. For some reason, the visit in June was denied and Aetna said it was experimental. But the provider billed using the exact same code as before and after June 2024. All other claims had been paid. I'm at a stage of appealing this decision. But I'm wondering if anyone has any insights into why a claim would randomly be deemed experimental when it was paid as normal otherwise?

i went to urgent care to get HIV PEP pills. Which must be taken within 72 hours of a potential exposure. i payed my $10 copay and They prescribed me the medicine where I was able to get my medication at the pharmacy that was covered by Aetna. But when I checked they fully denied my visit when I called she said the visit was not urgent. i told her I want to do an appeal. But im Absolutely disgusted by Aetna im already traumatized. i feel this needs to reported but I don't know which agency I would need to reach out too.

Hi all, I'm running into a pretty frustrating issue. I have called like 50 clinics in the Austin area and even though they appear on the list of clinics that take my insurance, they don't. Is the only option to pay out of pocket? My son is 3 and has a delay that was diagnosed at 2. We had speech therapy for a while and he is doing a lot better, but I am having issues getting it covered. I have an Aetna plan that is self-funded through my employer. If I could find a clinic, they would cover the sessions at 100%. My son is 3 and I have called the school district, but they said it would be next school year before they could assess and set him up, if his delay is even serious enough. He does not have autism, he has no other markers for it besides the speech delay.

I hope the flair is correct. So I have Aetna POS II through my employer and my prescriptions are handled through OptumRX. I previously had Cigna health insurance for 2024 and was forced to Aetna cause plans changed and this was the cheapest one (even though it’s not cheap) I had an auth for Zepbound valid until 3/16/25 that was initiated in September 2024. Well my provider submitted a new auth and it was denied. Optum is telling me it’s my health insurances problem. Then Aetna tells me they have no control, contact Optum. My provider is supposed to submit an appeal but I’m feeling really confused. Who has control over the prescriptions then? How have I gotten two refills since January even with my health insurance changing? (Optum rx has not changed and I had them in 2024 too) Can anyone help me understand?