Business Profile

Insurance Companies

Aetna Inc.

Headquarters

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Complaints

This profile includes complaints for Aetna Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

1,344 total complaints in the last 3 years.
492 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:01/22/2025
Type:Sales and Advertising Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
TO WHOM IT MAY CONCERN: I AM ******* *****. AETNA INSURANCE COMPANY *** ********** ****** ******** *********** IS TRYING TO FORCE ME TO BE A CUSTOMER. MAIL FROM THEM IS COMMUNICATING THAT I AM A CUSTOMER AND THAT I OWE THEM MONEY. THOSE ARE LIES. AETNA IS INTERFERING WITH MY DENTAL APPOINTMENTS. I WANT ALL OF THIS TO STOP. I MAY CALL POLICE AT ******** IF THIS CONTINUES. SINCERELY, ******* *****
Business Response
Date: 01/29/2025
**** *** ******* **********

Please see our response to complaint #******** for ******* ***** that was received by us January 22, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of your request, we immediately reached out internally to have Mr. *****’s concerns reviewed. Based on the review it has been confirmed that Mr. ***** was enrolled in the Aetna plan Gold S from March 01, 2024, through January 21, 2025. The agent that enrolled Mr. ***** has a recording of him agreeing to the plan’s enrollment with the effective date of March 01, 2024. It has been confirmed through the member’s call history that he was given the information to call the Marketplace to cancel the policy.

A renewal notice for the 2025 benefit year was sent to the member on October 22, 2024, to the address on file. If the member did not want to continue his enrollment for 2025, he would have needed call the Marketplace at ###-###-#### or went to the website ************** to cancel his coverage by December 15, 2024.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. *****’s concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive Resolution Team
Initial Complaint
Date:01/21/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Hello, My name is ********* *****. I am a ********** ** ************ student enrolled in Aetna's **** Student Insurance Plan for the academic year 2024-2025. I suffer from rosacea and use three kinds of medicine a day to treat it. I knew I had rosacea before I enrolled in the **** Student Insurance Program and was excited to seek care through Aetna. Due to a rosacea flare-up, on October 4, 2024, I saw *** ******** **** **********, an in-network provider. I scheduled the appointment using MyChart via my****Medicine. Per my insurance plan, I expected a $35.00 copay. I did not see anything about the necessity of a referral on MyChat. If I had, I would have happily gotten a referral from my doctor. Instead of the $35.00 copay advertised on Aetna's Summary of Benefits and Coverage, I received a bill of $345.00. I was shocked. When I called Aetna the first time, I spoke to a manager. She gave me explicit instructions to attain a retroactive referral and guaranteed me that, once received, Aetna would reprocess the claim. I went to my doctor and was issued a retroactive referral on 11/5/2024. Per the message I received on MyChart notifying me of the retroactive referral, I called Aetna and asked for a reprocessing of claims. The claim was not reprocessed and I received the same bill. I called again on 11/29/2024 and spoke with a manager who said he reprocessed the claim while I was on the phone. But, I received the same bill again. So, I reached out to the support team at MyChat and asked for their help correcting the bill. But, they responded that my responsibility was $345.00. Today, 1/19/2025, I received a bill for, again, $345.00. I am a student. I do not have $345.00 to spend. For me, that's nearly two months of groceries. IN addition, I have a chronic condition. I relied on Aetna to seek covered care. I am asking Aetna to do what two of its managers said it would: reprocess the claim to $35.00. Please send me the correct bill. Thank you. ********* *****
Business Response
Date: 01/24/2025
**** *** ******* **********

Please see our response to complaint #******** for ********* ***** that was received by us on January 21, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of your request, we immediately reached out internally to have Ms. *****’s concerns reviewed. Based on the review it has been confirmed that claim from the date of service October 04, 2024, was reprocessed with the referral on file. The member’s responsibility for the claim is $345.00 which applied to the $400.00 in-network deductible.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms. *****’s concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive Resolution Team
Initial Complaint
Date:01/21/2025
Type:Product Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On multiple occasions, claims submitted by me for reimbursement to a provider I have a Network Deficiency Coverage approval for are not processed properly. Most often than not, they are processed as Out of Network. This causes me to have to reach back out to Aetna to dispute and have the claim reprocessed. It already takes long enough to get a claim processed and reimbursement sent. There have been instances where it still doesn't get processed correctly. This makes receiving reimbursement that much longer and puts me in a financial strain adding additional interest to the credit card the charge was placed on.
Business Response
Date: 01/22/2025
Dear ******* *********:
Please see our response to complaint # ******** for ******* ****** that was received by us on January 21, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.
Upon receipt of your request, we immediately reached out internally to further research the concerns. After further review it was determined that the notes in the system were not updated with the approved through date. Based on this the claim was sent back for reprocessing on January 21, 2025, the notes have since been updated reflecting the most recent approved through date of July 11, 2025. The claim was processed and allowed in full under claim number ***********.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. ******** concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at ********************************
Sincerely,
ShaCarra B.
Executive Analyst, Executive Resolution Team
Customer Answer
Date: 01/22/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

******* ******
Initial Complaint
Date:01/21/2025
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
YOUR COMPLAINT I have $200 OTC benefit with Aetna/*** that is supposed to be available January 1 to purchase groceries, gas, etc. I have not received a card even though it was supposedly sent out December 6, 2024. I tried to use my old card on January 5 which did not work. When I called Aetna/*** I was told a new card had been sent out and it takes 30 days. On January 15th I called back to say I had not received my card. The rep offered to cancel the original card they sent out and order me a new card which would take 2 weeks to a month to receive. I explained, and the rep understood that would be a problem. She transferred me to a *** customer service rep who was supposed to be able to help me. The *** rep again offered to cancel the card and send me a new one which would arrive after the month of January, effectively removing my OTC benefit for the month. I called back the Aetna number and was told there is a one-time emergency where *** can send me the $200 cash. I was transferred to *** who said they might be able to reimburse me but I would have to spend the money out of pocket. I requested a supervisor; none was available but she would have them call me within 48 hours. It's been 3 days and no supervisor has called. Aetna/*** has an OTC benefit that I am not receiving and seemingly no way to correct this situation nor do they seem to care.
Business Response
Date: 01/29/2025
**** *** ******* **********

Please see our response to complaint # ******** for *** **** ***** that was received by us on January 21, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.

Upon receipt of the complaint, we reached out internally to view the member’s concerns. A representative from the Extra Benefits’ Department contacted the member. A new card will be sent to the confirmed address on file. Please allow 14 days to receive.

The member was advised how to use the card online or on the app. The member was also guided on how to register online. As a one-time courtesy, we are requesting the $200 that the member was not able to use in January be rolled over to February.

Calls will be reviewed, and coachings will be sent where needed. The member will receive a detailed Medicare Resolution Letter within 7-10 business days.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** *****’s concerns.

Sincerely,
Cindi D
Analyst
Medicare Executive Resolutions
Initial Complaint
Date:01/21/2025
Type:Billing Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Aetna messed up the effective date of my insurance which let my insurance company withdraw the payment, and now, we’re receiving bills from everywhere! Hospital bills and collection bills! I have been calling them at least 30 thirty times, now, they’re still not correct my daughter’s coverage effective date! I have my company send over the correction documents so many times! I’m so frustrated and helpless, I don’t know who can help me, their representatives are pushing around the issue between departments. I don’t even have a timeline! It is a such simple issue, they just need to correct the effective date, and they other insurance company will process the payment, but they don’t, they let the issue sitting there, and we can’t do anything about it ! Please help me !
Business Response
Date: 01/22/2025
**** *** ******* **********
Please see our response to complaint #******** for ***** *** that was received by us January 21, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of your request, we immediately reached out internally to have *** ***** concerns reviewed. Based on the review they confirmed that *** ***** daughter’s enrollment has been updated to reflect the effective date of June 25, 2022, and the termination date of July 13, 2024. *** *** will need to allow thirty business days for all the claims to be reprocessed.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ***** concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 01/22/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

***** ***
Initial Complaint
Date:01/20/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On September 30, 2024, I received medical care at the office of ******* ******** ** at her office located at **** **** **** ***** ***** *** in **** ***** **. Interestingly enough, I found her medical office at aetna**** in their provider directory. Please take note of this fact. Before booking the appointment, I verified that the office participates with Aetna. Despite my many safeguards, Aetna processed the claim as out of network, saying that I should pay the entire fee. More astounding than this, I have called Aetna at least five times. The first time I called, I was told it would be fixed and taken care of. From here, with each further call, Aetna laid out yet another new roadblock and gave entirely new reasons. Furthermore Aetna has given contradictory information in each call. The first rep told me that I cannot request a claim appeal verbally over the phone. Yet the rep that called me most recently told me that she could address my issue if I merely filed a verbal appeal! Aetna has said- the provider changed their tax id number, the provider might have used another address in the past. Not sure what that has to do with me. I am absolutely shocked that we live in a world where I have health insurance, pay a lot for it, and yet they try to unethically get out of paying. I found that provider in their directory and they have the nerve to say it is out of network? *********** I found this provider in their online directory, they need to process this as in network.
Business Response
Date: 01/31/2025
**** ******* **********

Please see our response to complaint #******** for ******** ***** that was received by us on January 21, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of the member’s concerns we immediately reached out to investigate. We found that *** ******** is a contracted provider with Aetna. He has been participating in a different office location in ************** since 2021, but he added the Tax Identification Number and the **** **** location billed on this claim in October of 2024, subsequent to the Date of Service. The provider was listed as participating on our website, but in ************** and not Oxon Hill. At this time the claim is processed correctly and cannot be paid in network.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******* concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *****************.

Sincerely,

William B.
Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 02/03/2025

Complaint: ********

I am rejecting this response because: The provider was listed at the **** **** address in the provider directory at Aetna**** before I made the appointment. Furthermore, the provider told me they participated with Aetna when I made the appointment. It appears that Aetna has not fully read my complaint. It appears that Aetna has not called the provider. Again I say for the millionth time- this provider at the **** ***** ** address was in the provider directory when I made the appointment. Also this doctor is not a he, it is a she. Aetna clearly has not read any of the facts or listened.

Sincerely,

******** *****
Business Response
Date: 02/03/2025
Dear Mr. Stewart Henderson:

Please see our response to complaint #******** for ******** ***** that was received by us February 03, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of your request, we immediately reached out internally to have *** ******* concerns reviewed. Based on our review it has been confirmed that Dr. Kehinde Folawewo became a participating provider at the **** **** address in October of 2024, which was after the claim's date of service. With this information, we are not able to reprocess this claim, as it was processed correctly per the member’s out-of-network benefits.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******* concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Marshell H.
Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 02/03/2025

Complaint: ********

I am rejecting this response because:
I found this doctor on Aetna**** in September before my appointment, the address, name and everything matched including the suite number. Perhaps Aetna could explain how this provider was on their website as a participating provider. Furthermore, the provider told me they were participating in September. Also, I contacted Aetna three times- Aetna never disputed that I found the provider on their website in September- this is the first time Aetna has said this. Although yes, Aetna gave a litanty of untrue reasons why the claim was not properly processed. Aetna has bended the truth to suit their needs.

Sincerely,

******** *****
Business Response
Date: 02/11/2025
**** ******* *********:
Please see our response to complaint #******** for ******** ***** that was received by us on February 4, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.

Upon receipt of the complaint, we immediately reached out internally to further research the member’s concerns. We reviewed the member’s call history and were unable to locate any calls made prior to September 30, 2024, regarding the rendering provider. However, the member did call after the claim was correctly processed at the out-of-network benefit level. No call feedback was required. Please know, the provider was not participating with Aetna under the billed tax identification number and service location until October 18, 2024, which is after the date of service. Unfortunately, there is no way for us to recreate what Mr. ***** saw on the Aetna website. However, we can advise that if a provider is out-of-network with Aetna, their information will not reflect on our DocFind website as in-network. In addition, we cannot control what the provider advises their members. Therefore, the information received from their office was not a valid reason to rework the claim. As a one-time courtesy exception, the plan has agreed to reprocess *** ******* claim at the in-network benefit level. Please know, the claim was reprocessed on February 10, 2025, and the member is responsible for a $35 copay. Mr. ***** should receive an updated Explanation of Benefits (EOB) within 7-10 business days.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******* concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.

Sincerely,

Shay G.
Analyst, Executive Resolution
Executive Resolution Team
Initial Complaint
Date:01/19/2025
Type:Customer Service Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Hi, I am writing to express my deep concern and frustration over the fact that my critical medications have been withheld for the past three months without any clear explanation. This delay in providing essential prescriptions is not only unacceptable but poses a severe risk to my health. It is appalling that a healthcare provider would fail to fulfill its obligation to ensure timely access to life-sustaining medications. I am extremely worried about how many other patients might be suffering the same neglect, possibly with devastating consequences. Despite countless attempts to seek resolution through ***/Aetna, my prescriptions remain on hold, and my condition continues to worsen. This situation has left me feeling helpless and frightened for my well-being. I urgently request that you impose strict penalties on the responsible parties and conduct a thorough investigation into their operations. Please assess how many individuals have potentially lost their lives or faced grave health complications due to this alarming delay. This issue must be taken seriously, and immediate measures should be implemented to prevent any further harm. Thank you for your prompt attention to this critical matter. I trust you will treat my case with the urgency it deserves.
Business Response
Date: 01/31/2025
**** ******* **********

Please see our response to complaint #******** for ******* ****** that was received by us on January 21, 2025. Our Executive Resolution Team researched your concerns, and I would like to share the results of the review with you.

Upon receipt of the member’s concerns we immediately reached out to investigate. The member did not specify what medication(s) he is concerned about. We found that the member has a number of prescriptions that match his statements.

The member’s requests for authorizations and/or denied prescription fills are mainly denied as the member is requesting a non-formulary drug without meeting criteria for approval. Generally, to obtain approval for non-formulary drugs, the member must attempt to use approved formulary alternatives. If the alternatives are attempted and failed to produce the expected results, or there is some medical reason that an attempt would be inappropriate for the patient, then the member may request approval for the non-formulary medication. The non-formulary medications that the member is requesting have not been approved as there is no evidence that the member has attempted alternatives or that they would be contraindicated.

In addition to the non-formulary medications, the member has submitted mail order requests for supplies that are denied. This is because the orders are for a 30 day supply, and the member’s plan indicates that mail order deliveries can only be filled for requests of 31 days or higher. A request that meets this criteria could be covered if it meets all other plan criteria.

The member may contact our customer service team to obtain additional information on specific drugs and the relevant criteria. The member may also refer to the plan documents, which contain more information on the requirements of his policy. At this time, Aetna will not be compensating *** ****** as he requested. Claims and authorizations have been handled correctly based on the plan criteria disclosed in the plan documents.

We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Mr. Tiwari’s concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *****************.

Sincerely,

William B.
Analyst, Executive Resolution
Executive Resolution Team
Customer Answer
Date: 02/07/2025
THEY HAVE NOT CONTACTED ME
Initial Complaint
Date:01/17/2025
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Aetna Medicare Advantage plan charged me after my policy was cancelled as of January 1, 2025. I was told I cannot have 2 policies at the same time and Aetna was cancelled. After speaking to a representative, I was told they do not have to reimburse me and I would need to file a complaint. I was told my policy will be cancelled as of January 19th instead of January 1st.
Business Response
Date: 01/22/2025
Dear *** ******* *********,
We are writing to follow up on complaint #******** for Ms. ******* ******, which was received by us on January 17, 2025. After speaking with the member on January 21, 2025, she confirmed that her concerns with Aetna have been resolved and she is no longer in need of assistance with this issue.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address *** ******** concern.

Sincerely,
Jennifer
Analyst
Medicare Executive Resolutions
Initial Complaint
Date:01/14/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have had the Atena Plan D Prescription Drug policy for the past two years and this is my 3rd year starting in 2025. My rates have gone from $5.20 per month the past two years without a deductible to $40.20 per month in 2025, an astounding 8x the premium. I paid $0 for my tier one prescriptions in 2024 and $2.00 per prescription for a 30 day supply in 2023. Not only have the premiums increased 8x but there is now a $500+ deductible, For example, I went to refill my ********* for 90 days yesterday and the out of pocket cost was $98.17 for 3 months supply which goes towards my deductible. This seems a bit steep of an increase from 2024 to 2025 and wondered if this is legal and legit.
Business Response
Date: 01/15/2025
***** ******* ********** *** ********* **********
We understand that our member Mr. ********** concern is in regard to his monthly premium increase and also a having a deductible of $590, which he did not have last year. *** ******** is also concerned if this is a legitimate increase in his premium and deductible. We understand how frustrating this can be and we take our members complaints very seriously.

*** ********'s premium may have increase based on multiple factors including the service area, and he can refer to the Annual Notice of Change (ANOC) during our Annual Enrollment Period.

Annual Notice of Changes for 2024:
*** ******** is currently enrolled as a member of the SilverScript Choice (PDP) prescription drug plan. Next year, there will be changes to the plan’s costs and benefits. Please see page 4 for a Summary of Important Costs for 2025, including Premium.

This document tells *** ******** about the changes to his plan. To get more information about costs, benefits, or rules please review the Evidence of Coverage, which is located on our website at Aetna-PDP. *** ******** may also call Customer Care to ask us to email him an Evidence of Coverage.

This Annual Notice of Change (ANOC) was emailed to *** ******** on September 1, 2024. The document is emailed yearly in September so our members can better plan financially for the upcoming year. *** ********'s premium cost and deductible changes are listed below that were emailed to him previously.

2024 (previous year premium) $5.20
2025 (current year premium) $40.20

Upon review of the deductible, per the previous 2024 plan year there is a deductible in the amount of $280.00 for (Tiers 2 - 5) drugs. The drugs that you are prescribed currently for 2024 plan year were Tier 1 drugs. Therefore, you did not go into the 2024 deductible phase due to the drug being listed as Tier 1. If you had utilized any Tier 2 - 5 drugs per your Annual Notice of Change you would have went into the $280 deductible phase for this drug. This is a legitimate increase to your premium and deductible for the 2025 plan year.

2024 (previous year deductible) Deductible: $280.00 for (Tiers 2 - 5)
2025 (current year deductible) Deductible: $590.00

Per *** ********'s Medicare and You Book, the Annual Enrollment Period (AEP) runs from October 15, thru December 7, every year to review and make any changes to his plan for the upcoming year.

The inflation reduction act made many enhancements to Part D coverages such as $0 cost-sharing during the catastrophic phase, elimination of the coverage gap and limiting the Rx OOP threshold to $2,000. These enhancements to the basic Part D plan will benefit many if not most Medicare beneficiaries but reduces the ability to design products with meaningful differentiation. Consequently, a decision was made to consolidate SmartSaver and Plus with our Choice PDP.

If *** ******** needs financial assistance, he can apply for Extra Help.

*** ******** can apply for Extra Help using one of these options:

1. Fill out the online application at www.ssa.gov/medicare/part-d-extra-help on the internet.
2. Receive and complete another copy of the application by mail.
3. Call ****** ******** at <###-###-####, 8 a.m. to 7 p.m. Local Time, Monday-Friday>.

· TTY users should call <###-###-####>.
· If you need assistance later, please call SilverScript MED D Customer Care toll-free at <###-###-####, 24 hours a day, 7 days a week>.
· TTY users should call <***>.

Refer to www.ssa.gov/medicare/part-d-extra-help.

******* **** ***** ***** ******** ***** ****** ********* ********** ******* ******
Call: ###-###-####
Website: ****************

We would like to extend our apologies to you for any inconvenience *** ******** may have encountered. We place special importance in making our member’s experience trouble free. Silverscript expects that our members are given accurate information in a professional, friendly, and timely manner and treated with the dignity and respect they deserve. Thank you for your time and feedback in this matter.
Initial Complaint
Date:01/14/2025
Type:Customer Service Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
1/12/25. Contacted customer service. I received an email about my HRA rewards. All I wanted was the contact number to the rewards dept. Representative gave me the wrong number three times. When I asked for a supervisor. She then gave me another number that was wrong. When I spoke to the supervisor. He said he never gave her a number to give me. So she just lying? Why? Supervisor said she gave me the right number. When I called the number he changed his story to I cannot have the number. What? I cannot have the number to the rewards center? Why? He said he just cannot give it out. Asked him for his name he said Joseph N. He cannot give me his last name? I dont understand why not, dont you know my name? This billion dollar corporation and I still dont have ONE PHONE NUMBER! What is the number AETNA? This company definitely need better representation
Business Response
Date: 01/16/2025
Dear ******* *********:
Please see our response to complaint # ******** for ****** ****** that was received by us on January 14, 2025. Our Executive Resolution Team researched the concerns, and I would like to share the results of the review with you.
Upon receipt of your request, we immediately reached out internally to further research the concerns. After further review it was determined that the member must complete their incentives and earn rewards through the A*********** ********** ****) and that telephone number is ###-###-####. ************ will then send the incentive earnings report to the HRA vendor, the HRA vendor is Via ******* ********, that telephone number is ###-###-####. This number has been confirmed, although the customer service representatives in member services has the access to see this information, the number had not been updated which is why the customer service representative gave the incorrect telephone number previously. The call from January 13, 2025, was reviewed and the member was given the incorrect telephone number. The proper feedback and coaching were given to the customer service representative as well as the supervisor.
We take customer complaints very seriously and appreciate you taking the time to contact us and giving us the opportunity to address Ms. ******** concerns. If there are any additional questions regarding this particular matter, please contact the Executive Resolution Team at *******************************.
Sincerely,
ShaCarra B.
Executive Analyst, Executive Resolution Team
Customer Answer
Date: 01/19/2025

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

Sincerely,

****** ******

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Aetna Inc. is NOT a BBB Accredited Business.