Aetna & IVF Meds - WTF?
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Anonymous
| Aetna only authorized and sent me half of the amount of one of my IVF meds that my doctor ordered. Obviously because of this, I needed more of that med during treatment. When I called to get more, they said I needed an authorization for a REFILL for the meds which can take up to two weeks to get. How can it be a refill when they never filled it in the first place? Also, how can they authorize only half of what my doctor ordered and when I need more, tell me that I need an authorization for a refill which can take more days to get than the usual entire injection period. Is this even legal????? When I explained that I needed the meds the following day, they basically said I have to get it from a local pharmacy and pay cash price (which they will not reimburse). My doctor's office called and it made no difference. It's been three days since I needed the meds and I still have not gotten the refill. Has anyone experienced this and what did you do to get the meds? |
Anonymous
| Yep, that sounds about right for Aetna. I used them for 3 cycles and had to deal with *&%*&^% like this every single time. My favorite was when they were out of the trigger med but would not authorize me to get it anywhere else. They horrible and in my opinion should not be allowed to charge double to cost of the meds! |
Anonymous
| PP here. I never got my refills from Aetna. They basically said that the medication that my RE ordered, which they approved but sent only half of the amount ordered, was medically unnecessary. If it was medically unnecessary, why was it approved the first time (even if only half of the amount was approved). Also, what makes Aetna think that they know more about what med i need for fertility treatment than my own RE. |
jindc
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Wow - this is insane. Perhaps there should be a letter written to OPM signed by all those who had issues? OPM should not be part of an insurance scheme that intentionally screws people over, which Aetna does (I haven't used them for fertility - switching to MD IPA). I also think the "three attempt limit" is crap. Perhaps the cost should shift, but there should still be coverage. |
Anonymous
| PP I agree. Something needs to be done. Charging double for meds should not be allowed! Not to mention all the other problems! |
Anonymous
| With aetna, I can't get a clear answer on what is covered. God is good I hope for the best. |
Anonymous
God may be good, but Aetna is not. Hope for what you want, but be prepared to pay what you would have paid if you had no insurance coverage at all. |
Anonymous
If you go this route (out of pocket) I would recommend: www.goodrx.com Lets you compare cash prices of drugs at pharmacies. |
Anonymous
|
So I had to use Aetna Specialty pharmacy to get my meds and here's what they charged me. I have Aetna HMO fed which is suppose to cover infertility drugs. They claim they cover 50% meds but look at what I had to pay.
This was my price with the 50% Aetna coverage: Gonal F 1050 iu (per vial) $839.22 HCG $74.43 Menopur 75 iu (per vial) $49.45 Freedom pharmacy charges the following for cash price (with rebates) Gonal F 1050 (per vial) $868 HCG $67 Menopur (per vial) $71.99 So the price I paid is not 50% off. I only saved $28.78 (3%) per vial on Gonal F and $22.54 (31%) per vial on Menopur. I actually paid more for HCG at Aetna than if I paid cash at Freedom. So when Aetna says they cover 50% of your meds, think again. When I asked about the price of Gonal F they said without my 50% copay the price is $1678.44 per vial. WTF!!!! |
Anonymous
| IF you read through all the old posts you will see Aetna's 50% off is a big rip off. They double the price of the drugs then say they are 50% off. Should be illegal. |
Anonymous
| I used the plan to cover my monitoring, ER, and transfer but used Grubbs to buy drugs out of pocket. Maybe I paid a touch more but not much and Grubbs will deliver day of, to your office, and has amazing customer service. I sometimes ordered several times a week to keep from paying for drugs I wouldn't need and they made it work. |
Anonymous
| Any lawyers out there? Is this legal? |
jindc
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| Our clinic told us they recommend to Aetna clients to pay out of pocket for drugs and look for rebates. You can come out ahead. We were just talking about ow horrible they are. MD IPa gave us crap, too - didn't cover lupron because I didnt have prostate cancer! |
Anonymous
+1 I have to come up with 4 grand on my own for meds. Wish these complainers would just STFU! |
Anonymous
Well, we had to come up with $6,000 on our own for meds WITH Aetna insurance so we beat you and you should not complain. It actually was cheaper to do it without calling Aetna at all. If you read the posts carefully pp, you will see that the point of this post was to warn other women that this "insurance" was actually a huge rip off and that this company is taking advantage of women by claiming they pay 50% when they are really just running a shell game. Those of us with this so-called "insurance" paid the same amount as those of you without any insurance AND we had to pay monthly Aetna premiums for the pleasure. I'm pretty sure it's fair to say we got a raw deal and that other women should think carefully before going this route. Maybe you should take that nasty attitude and language to another board. |