Battling Aetna

Aetna has something within our prescription program they call Maintenance Choice.  It’s a misnomer.  Essentially, if a member of your household is on a “maintenance” drug, you get a slip of paper in the mail stating that you need to get it in 90 day chunks from CVS, or through the mail – I didn’t even pay attention to who that goes through.  If you don’t use one of these two options, you will pay full price for the medication.  Some choice.

We’ve run up against this before with my thyroid medication, but it was a non-issue. I asked my pharmacy and it turned out I was already paying full price so it wouldn’t change anything and I kept my own pharmacy.

Now my daughter is on a blood pressure medication to help with her exercise induced PVCs.  She may or may not be on this medication beyond June.  Our current pharmacy has taken care of at least 95% of our children’s prescriptions.  There’s been an occasional free antibiotic from elsewhere, or a really late night need which only one place in town could fill at that hour.

Two of the pharmacists know me by name, one of whom has greeted my elsewhere in the store before I saw her.  The point is: they know my family’s history and nearly everything we’ve taken (for 17 years).  I want to continue to use the pharmacy which knows my family, but with this medication our cost will increase $20 a month if I continue with them.

I called Aetna and asked to be elevated as high I could go right away.  The person I spoke with was respectful and professional.  After about a week, the decision makers came back with “no exceptions”.  They sent along the message that there is a CVS within four miles of me.  I responded with the fact of that being beside the point.  It is on the complete opposite end of town from everything else I do, but location was not the deal breaker.  Thank you for listening, Aetna Powers That Be.

Apparently, I am now at a dead end with Aetna.

That said, I still have a voice.  I can still post my story and share it with whosoever wishes to know more about Aetna.  They are a cold company which does not care about anyone’s health.

Aetna is quick to tell me that my children haven’t received flu shots or the HPV vaccine.

When my son was two, his pediatrician prescribed the use of a nebulizer (sp?).  The word asthma was never spoken or written, yet Aetna so thoughtfully sent us literature on asthma control.

We’ve received other unsought advice from Aetna.  If they haven’t noticed, we do go to the doctor when needed, and the kids have had every recommended well check and all other vaccines.  We are intelligent people who can make decisions based on conversations with our doctors, and research of our own.

Aetna is very quick to poke their nose in our business, yet really don’t care to hear anything back.

Conversations don’t show up on the spreadsheets.

Education doesn’t tally up on the balance sheet.

Knowing what the doctor’s plans and possible treatment plans ahead don’t help make the line move further into the black.

A pharmacist who has a seventeen year history with a family doesn’t make a blip on an executive’s radar screen.

I understand that Aetna is a company who wishes to make a profit. I just ask that common sense not be thrown out the window as a sacrifice to the balance sheet.  Do Aetna executives have to live by the same rules?  Probably not.



About homereferee

I'm a stay at home mom who sometimes feels more like a tape recorder yelling, "Get apart!".
This entry was posted in Aetna, children, family, insurance, kids, maintenance choice, pharmacy, prescriptions, Uncategorized. Bookmark the permalink.

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