I have Aetna health insurance. I may as well say I have NO insurance. Same difference in my case.
I obtained insurance, through the company I am employed with, on May 1. After being without insurance for nearly 2 years. Being uninsured for 2 years was horrible. I had health issues come up that I could not seek medical attention for, so I had to suffer and wait it out.
I was excited about being able to finally see a real doctor about my thyroid, since I have been suffering many symptoms associated with hypothyroidism, and had not been able to afford to see a doctor regularly without health insurance.
Once insured, I have been getting medical attention for hypothyroidism with a multinodular goiter. I've recently had blood tests, an ultrasound, and even a biopsy to determine what is going on with my thyroid. (and to rule out cancer) At this time, I have not gotten the results from my doctor, about my biopsy. So I'm in hopes that the news is good.
I noticed in the last month or so, that all my claims through my insurance company are still PENDING.
I have sent Aetna a few unfriendly emails, because they STILL haven't paid any claims to date.
Today (JUNE 20) I received a letter in the mail... And what they are claiming is preposterous!
I am quoting this from my letter -
"Because your medical plan does not cover pre-existing conditions, we need to determine if any medical conditions are considered pre-existing under this plan.
A medical condition is considered to be pre-existing if the member did not have prior health insurance or did not have health insurance within 90 days of enrolling in this plan."
Are you kidding me???
So, if I didn't have insurance before... ANY medical condition I may suffer from would automatically be considered pre-existing!
Since when is being covered by previous insurance considered part of what defines a pre-existing condition? What does insurance have to do with the condition???
Then why did I bother obtaining this insurance at all???
I pay $90.00 every 2 weeks for absolutely nothing. I am paying for a plastic card that I can carry in my purse, that has no value whatsoever. It's bad enough that I have to pay a $40 copay every time I see a specialist, but give me a break!
The best part is, I can't make any changes to my insurance policy at work, unless I can prove I am covered by health insurance elsewhere. I cannot cancel it either. I can only make changes at the beginning of each calendar year, or it cancels if I terminate employment. That's right. They get their premiums, I get no coverage. That makes no sense at all.
Besides this ridiculous explanation of pre-existing conditions. I was never given anything in writing, nor is there anything on Aetna's web page, explaining their policies about pre-existing conditions.
What happened to the laws about informing the consumer???
I'm flaming mad. I'm going to be calling on Aetna to provide proof of this 'clause'. Then I want to see where I signed in agreement to it. Because I know I have signed nothing. If I have not signed anything, then I'm going to insist they pay the claims or I want all of my premium payments be refunded in full. This is an out and out FRAUD!!!
Also I think it's interesting that my company doesn't offer employees health insurance until we have been employed for 90 days. (90 day clause) In fact, our insurance did not take effect until the 1st day of the month FOLLOWING our 90 days of employment.
Other than the few souls out there that can afford the cobra payments to continue their previous insurance (if they even had any coverage previously)... Which most of us cannot. Then it looks like quite a few people are NOT going to be getting any claims paid, although they are technically insured. What a joke. No, what a rip off!
What a shame!
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