Aetna Medical
Well Child Visit Denied Because Policy Allows One Per Calendar Year

I have an Aetna Co-payment health insurance policy through my employer. My policy begins January 1st and ends December 31st, each year. When I signed up for this policy, I get a pamphlet from my employer which gives an overview of each plan, and what is covered. According to the pamphlet, my child may receive a well child visit, which there is no co-payment for. My child received hers on 9/3. I recently received a collection letter from my child's doctor for this visit. I went online to my Aetna account and looked through the claims. The status of the well child visit was not approved. I called Aetna regarding this. They told me that she already had a well child visit on 9/5, and she is only eligible to have one per calendar year. This was not on the pamphlet I received from my employer when I signed up for the plan. I understand that this pamphlet is a published by my employer. I also checked the booklet that I received in January after enrolling in my insurance policy. It did not mention that my child was only eligible for one well child visits per calendar year as well. It was only until I questioned Aetna regarding the non-approval that I was told of this. Since children in this country must pass a physical before attending school, and most health insurance plans run January 1st through December 31st, I believe Aetna was intentionally deceiving their customers. One policy should not have anything to do with the previous years policies, especially since these companies are extorting higher and higher premiums for less service every year.

Company: Aetna Medical
Country: USA
State: Texas
City: El Paso
Address: P.O. BOX 981106

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