Back in October, my health insurance switched from BCBS to Aetna without my knowledge, as I am under my father’s insurance plan. I was seeing a psychiatrist & therapist at the time. They are not in Aetna’s network. I was not informed by my psychiatrist that my visits were not being covered by my health insurance until late November.
I called my dad and asked him what was going on, and he told me that we had switched providers. I was, of course, very upset that I had not been kept in the loop.
I contacted Aetna and after an entire day on the phone with them, I was directed to fill out a Transition of Coverage form, found here. I was told that this would cover an out-of-network doctor for up to 90 days. I completed the form, and my psychiatrist/therapist filled out the necessary fields, and we faxed it over to Aetna. I continued seeing my therapist until the New Year, as that was presumably still protected under the 90 day period.
I didn’t hear anything for MONTHS – from either Aetna or my psychiatrist. My dad switches us back to BCBS in March (or some time around Spring).
I receive an email from my psychiatrist office in late May that I am responsible for paying for my Oct/Nov/Dec visits and that I owe $3000+ and that I need to set up a payment plan. They were informed by Aetna that my visits will not be covered.
I called Aetna two weeks ago, and I was told that they were reprocessing my forms.
I received an email from my former psychiatry office urging me to start a payment plan.
I called Aetna again today, who said I’m not being covered because I need “pre-certification” or “certification” or something like that. I expressed that I was confused and that I didn’t know what that was. I asked for a definition, but they were unable to provide me with one and then the call dropped when I was on hold.
I’m on hold again with someone who is already much more helpful, but I thought I would turn here for any additional advice or insight you have to offer! Thank you in advance 🙂
submitted by /u/Chillephant
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Back in October, my health insurance switched from BCBS to Aetna without my knowledge, as I am under my father’s insurance plan. I was seeing a psychiatrist & therapist at the time. They are not in Aetna’s network. I was not informed by my psychiatrist that my visits were not being covered by my health insurance until late November. I called my dad and asked him what was going on, and he told me that we had switched providers. I was, of course, very upset that I had not been kept in the loop. I contacted Aetna and after an entire day on the phone with them, I was directed to fill out a Transition of Coverage form, found here. I was told that this would cover an out-of-network doctor for up to 90 days. I completed the form, and my psychiatrist/therapist filled out the necessary fields, and we faxed it over to Aetna. I continued seeing my therapist until the New Year, as that was presumably still protected under the 90 day period. I didn’t hear anything for MONTHS – from either Aetna or my psychiatrist. My dad switches us back to BCBS in March (or some time around Spring). I receive an email from my psychiatrist office in late May that I am responsible for paying for my Oct/Nov/Dec visits and that I owe $3000+ and that I need to set up a payment plan. They were informed by Aetna that my visits will not be covered. I called Aetna two weeks ago, and I was told that they were reprocessing my forms. I received an email from my former psychiatry office urging me to start a payment plan. I called Aetna again today, who said I’m not being covered because I need “pre-certification” or “certification” or something like that. I expressed that I was confused and that I didn’t know what that was. I asked for a definition, but they were unable to provide me with one and then the call dropped when I was on hold. I’m on hold again with someone who is already much more helpful, but I thought I would turn here for any additional advice or insight you have to offer! Thank you in advance 🙂
submitted by /u/Chillephant [link] [comments]Read Morer/HealthInsurance