Aetna Specialty Pharmacy sucks

[Anonymous]

After 2 failed IUI cycles, I was so excited to find out Aetna covered 50% of my IVF and meds. I was told I had to use their specialty pharmacy, and thought it would be similar to Freedom Fertility Pharmacy (which I used for IUIs and was awesome).

I recived my IVF meds on time, and was happy. Originally, we thought my egg retrieval would be tomorrow or Wednesday, but now we're probably looking at Friday so some of the smaller follicles can play catch up. I will need more meds to cover these extra days.

Easy, I thought. I'll just call and get them refilled, since my meds even state I have 2 refills left.

Alas, I need an authorization - for refills. Considering how long it took to get my initial authorization for meds, I'm not holding my breathe that it will be done in time for me to get my meds to take tomorrow evening.

Why oh why would you have this policy for fertility patients? Everyone knows dosage can change unexpectedly, and the cycle can take longer than expected. I am really peeved, and I don't need this stress when I'm so hormonal.

At this point, I'm guessing I'll have to go to a different pharmacy and pay out of pocket. Hoping the SGFC nurse covering for my regualr nurse (who's out today) can get it done today. Maybe I'll go through good old Freedom Fertility.

I hate Aetna now.

[Anonymous]

Sorry this is happening to you. Other people have reported this problem here, and it's the reason no one should choose Aetna for IVF. MDIPA is much better (meds are 100% covered).

If I were you, I'd get the meds from Freedom out of pocket.

[Anonymous]

You may also want to check with your nurse to see if they have any samples on hand that could tide you over for a couple days.

[Anonymous]

Aetna sucks. I have been on the phone with them all day for the exact same situation. I started my IVF cycle 4 days ago and need a gonal F refill for tomorrow morning and so I had to do the authorization, Dr.s office did that, then they said well you need the ultrasounds also the nurse denied the med. Then someone called me from Aetna precert to tell me that the meds had been authorized, I had 4 refills left and I could have gotten them when I first picked up my meds. So when I called the pharmacy they said its still needing precert. So again I spoke with the precert dept, after waiting on hold for 20 minutes and I had 2 people on the line and they said it should go through, it's been authorized that the reason it didn't go thru was they were only trying 1 when it was authorized for 4, doesn't make sense that you can't get 1 but 4 is ok. So tried again with the pharmacy, and not even 4 is authorized of course it says needs precert. So called Aetna Specialty Pharmacy to see if they could fill it, as I am not forced to fill with them, and even though in their notes they see that it's approved for the 4 refills not even they can fill it, still says needs precert. So I am on hold with them now waiting to find out what's going on. They say maybe a glich in the system, but really come on Aetna, this is so stressful! Already I am worried about failing this IVF and I have to worry about being able to continue with it because of having meds. Plus stress is the last thing to add to an already stressful situation and don't they say stress can affect a cycle. ARg

[Anonymous]

They really do exceed at the sucking. I am convinced they give mixed messages and refuse to answer questions and find reasons to deny services that should be covered so that customers get so frustrated they simply give up. Aetna gets paid by the Feds (or whatever company) to insure the employee and then tries their hardest not to provide. I am also guessing they would rather drive infertility patients to different companies as we end up costing them more than we bring in.

[Anonymous]

There is another thread on here about Aetna and meds. Check it out- I can't believe anyone would use them. They are beyond horrible besides marking up there meds to double the price so your 50% copayment is full price anywhere else. It's open season so I'd switch to MDIPA as it is much better for IVF.

[jindc]

So, I'm getting from DCUM that if I ever go with Aetna, I should just buy my own meds out of pocket - the cost will be about the same, but there will be significantly less aggravation!

I think if you have issues, you really should send feedback to OPM - they deserve to know what is happening with the plans they offer. They might not know, and can put pressure on Aetna (maybe just in theory??) to do better.