aetna us healthcare

[Beth]

Has anyone who has Aetna won an appeal reagarding therepy? My son was denied further therepy because his benefits have expired and i am doing everything I can before I submit my appeal. Just wondering if I am wasting my time or if they may actually give me an extention. Thanks in advance for any info
Beth

[francine]

Beth - I know a few people who have gotten extensions...keep on fighting for this. We are entering a huge fight for Maia's aquatic therapy with a non participating provider.

good luck,
francine

[francine]

Beth - read Tina's reply on the post Insurance and Health Club Benefits...

[TNT1999]

Beth, I don't have experience with appeals with Aetna, but I do have experience with an appeal with another former HMO that we had. It wasn't regarding therapy, but rather, surgery at TCH. It took a lot of work, but we were eventually successful for the most part. I attribute a huge part of that to the help / involvement from the asst. attorney general. I suggest that you contact the individual in your AG's office who deals with insurance issues. Sometimes just knowing the AG's office is involved puts the insurance co. "on alert" and makes them nervous and more agreeable to you. Remember that insurance co's aren't getting great press these days. Also, I would never think it would be a waste of time and would always recommend going through the appeal process. I'm tired so I hope what I wrote made sense. -Tina