My experience with Aetna has been absolutely unacceptable.

Before my scheduled surgery, Aetna issued written authorization specifically stating: **"Pay at Highest in Network Benefit – Network Deficiency."** I relied on that written authorization when proceeding with my surgery.

Despite having this written authorization, Aetna subsequently processed the claims using out-of-network benefits, leaving me responsible for thousands of dollars in medical expenses.

When I challenged this decision, Aetna's first-level appeal determination stated that there was "no record of a precertification request."

How can a company issue written authorization and then turn around and claim there is no record of that authorization?

This has dragged on for MONTHS.

I have submitted documentation, made countless phone calls, explained the situation repeatedly, and gone through the formal appeals process. I am now at the second-level appeal stage, still trying to get Aetna to honor its own written authorization.

There have also been discrepancies involving my deductible and out-of-pocket accumulations, creating additional problems with other medical bills. One related medical bill has even gone to collections while this matter remains unresolved.

And just when I thought the process could not become more frustrating, I contacted Aetna to request an update on my second-level appeal. Instead of receiving an actual status update or information about the current appeal, Aetna sent me the original determination from months ago.

Think about that. I am months into an appeal process, at the SECOND level of review, and when I ask for an update, I am sent the same old decision I have already received and disputed.

This is not customer service. This is not accountability. And this is certainly not how a health insurance company should treat its members.

People purchase health insurance so they can have some assurance that when they need medical care, their coverage will be there. I followed the authorization process, obtained written approval, and proceeded with medical care based on what Aetna told me. Now I am left fighting to have the company honor its own documentation.

The financial burden, time, stress, and endless effort required to get a legitimate issue addressed have been exhausting.

**I am asking Aetna to honor the written authorization it issued, correctly process my claims according to that authorization, and correct the resulting financial discrepancies.**

Aetna needs to take responsibility, conduct a meaningful review of this matter, and provide an actual resolution instead of continuing to recycle old denial letters.

I would strongly encourage anyone considering Aetna to look beyond the promises of coverage and consider what happens when something goes wrong. Getting a problem resolved should not require months of appeals and an extraordinary amount of persistence from the very person paying for the insurance.