#fuck aetna

[tj-crochets]

Hey y’all! Aetna (the worst health insurance company I’ve dealt with) denied my doctor’s Prior Authorization Requests for my inhalers, so I could use some help.  What do you know about appealing health insurance coverage decisions in the US? I think there’s something about asking who made the determination and if there were doctors involved, but I can’t remember the details.  Additionally, do you know how to determine when your open enrollment period is? I am at this point wanting to get away from Aetna as quickly as possible, but apparently even if I am paying the premiums myself out of pocket I can’t get blue shield until it’s an open enrollment period??? I don’t really understand that because I know I’ve seen forms asking like “which of your multiple health insurances are you using for this” so I thought you could have multiple forms of health insurance if you wanted. Health insurance makes no sense and I deeply resent everything about this. Especially Aetna. Resenting the fuck out of Aetna tbh

[timewasjustadream]

I hate the US health insurance system, particularly Aetna. They are the worst.

For the past 3-4 weeks, I've had sudden, new symptoms in lower back that I haven't felt since I had back surgery 5 years ago. Tingling in the feet. Sciatica. Pain near the spine. Back muscles feeling like they are working harder than they should. Can only sit on the edge of a seat because sitting normally hurts.

I saw my doctor. Got a steroid pack to try to pull down the inflammation. I'm seeing a physical therapist for a leg muscle pull and they are concerned about the sudden change in my back given my history. They wanted me to see a spine specialist. I should note that I can't go back to my surgeon because he doesn't practice anymore.

I contacted a new spine center. They won't see me without an MRI because of my surgical history. I went back to my primary care doctor, who ordered the MRI. I got it scheduled for about a week later. I checked the patient portal last night (appointment is tomorrow) and the appointment is gone.

Turns out, Aetna denied the MRI so the radiology place canceled my appointment without telling me. I'm still scheduled to see the spine doc on Tuesday (6 days from now).

So I got the MRI rescheduled to today and I paid $867 out of pocket to have an MRI that my insurance should have covered if I had suffered for 2 more weeks and gone back to my doctor after.

Yep. Aetna requires 6 weeks of "treatment" and a follow up visit to my primary care before they will pay for an MRI. Mind you, had they covered it, I would have paid $100 and they would have paid $400. $400!! And they would have paid 6 weeks of PT (probably going to happen anyway) and the follow up visit to my doc.

I called Aetna and asked about the denial. They told me the above but also told me the other MRI policies. 15 days for pre-authorization, which I didn't successfully get past. If the doctor marks it as "urgent", they can do the pre-authorization in 72 hours.

How do they define "urgent" you may ask.

To Aetna, "urgent" = can wait 3 days = "imminent loss of life, imminent loss of limb, or condition will worsen"

3 days if you might not be alive soon?! 3 days if you might lose an arm?! 3 fucking days! AND that's if the doctor marks it as urgent and they may still need to call Aetna and talk with someone to actually get it taken seriously.

I hate Aetna.

[thedyke]

i feel like i’ve grown so much recently. like i’m on a year and a half of fully supporting myself and not living with family, i’m finally trying to make decisions that help me in the future, i’m staying on top of my med refills… 24 will be a good year!!!

[truthwithlight]

hey fellow cripples if you can DO NOT USE AETNA FOR YOUR INSURANCE... [pt: do not use Aetna for your insurance]

this is a load of fucking horse shit. i've been fighting with my insurance for FIVE WHOLE MONTHS [pt: five whole months] to get my AS medication approved. they keep canceling my prior auth. yeah. canceling. not denying! just straight up deleting it and not telling anyone

they tell us we don't have specialty pharmacy coverage, so we talk to our insurance guy and he tells us yes we do it's in our plan! then they tell us cvs isn't a pharmacy in their network! THE INSURANCE IS LITERALLY AETNA CVS [pt: the insurance is literally Aetna CVS]???

they keep directly lying straight to my rheumatologist's medical assistant's face about how the PA process works when half her job is getting PA requests done! i've been living off of sample injectors for the last five months, my doctor is almost out of samples, and the manufacturer has informed them that they're not making samples anymore. the insurance is well aware of this and (before april when they stopped covering that as well) kept telling me to just take humira. i cannot take humira! i get severe injection site reactions! they also know this! it's in my notes!!!

we've sent in appeals, we've gotten both every pa submitted and the appeals expedited, and there's absolutely no word from aetna. just a silently canceled document or "yeah the higher ups aren't budging, sorry, here's [number you've called like 5 times that gets you nowhere]" we get a different story from every single person we talk to

i'm sick of this, my mom is sick of this, my DOCTOR [pt: doctor] is even sick of this, and i just want to be treated like an actual fucking human being and not a case number no one at aetna wants to deal with.

i've been holding myself back from making this post because surely it'll get resolved, right? surely i'm just being bitchy, right?

well my last straw is today when they sent me yet another message saying cvs isn't in their pharmacy network (bullshit) and told me it had to be filled by a local pharmacy i'd never heard of. we call said local pharmacy and they inform us that they're a family owned compounding pharmacy and cannot fill expensive specialty prescriptions like this without LITERALLY GOING BANKRUPT [pt: literally going bankrupt]

the medical assistant we keep having to talk to says that in all her years of having to work through stubborn insurance, she's never had an experience this bad. no patient has ever had this much trouble getting a relatively common prescription filled.

literally the worst experience of my life, it's beyond degrading to be treated like you're the problem because some executive somewhere is deciding that it's better for you to be crippled and in bed all day than approve a single prescription

[subversivecynic]

Today in "things that should radicalize you"

Retrieved Mom from LTC and she came home. They gave her 10 days worth of the meds and said good luck, just tell ss that you discharged and you will receive payments again starting October.

One of the 12 meds she is on one is $1800, another is $1500, and a third is $600. I don't know what the rest are because they haven't processed them yet, but 3 of those are name branded.

The facility, upon discharge, did not offer transition to home or help restarting her insurances.

So to tldr, they sent her home to us with zero money, zero coverage, and a bill that's about 1 month income for her kids to continue to have access to her heart meds, insulin, and dementia meds.

[the-voice-of-night-vale]

I'm a medical biller, and Not only does UHC deny care based on an absolutely dogshit AI model, but they also basically reject every single office visit above level three (office visits are split into 4 levels based on time and/or complexity(99212-99215)) and force you to resend them because they don't believe that you should actually be billing "that high" (any office visit in which you discuss a prescription is automatically eligible for at LEAST 99213, oftentimes it's 99214) (and then a lot of the time they reject it again for "duplicate" :))))

Unfortunately most insurance companies are dog shit in general, and a lot of the time those of us who are covered by our empoloyers don't have a choice (and marketplace plans are EXTREMELY expensive) but if you have the choice, yeah. try not to go with them (of course, change healthcare also happens to own a ton of insurance carriers besides uhc)

UnitedHealthcare, the largest health insurance company in the US, is allegedly using a deeply flawed AI algorithm to override doctors' judgments and wrongfully deny critical health coverage to elderly patients. This has resulted in patients being kicked out of rehabilitation programs and care facilities far too early, forcing them to drain their life savings to obtain needed care that should be covered under their government-funded Medicare Advantage Plan.

It's not just flawed, it's flawed in UnitedHealthcare's favor.

That's not a flaw... that's fraud.

[unicornbeck]

Welp. Our insurance now charges us more than 5 times our last year’s copay for being seen in Immediate Care.

It was $15. Now it’s $80.

Our insurance company’s name starts with “A” and rhymes with Etna. Fuck them and fuck the American Health Care System.

[tj-crochets]

I am once again in insurance hell, so let me reiterate: Aetna is the worst health insurance company I’ve ever had to deal with. Avoid it if you can. 

[frasermints]

because they drug test upon offer of employment and with reasonable suspicion. as much as i love costco they're still fucking cops. if issaquah and company can't get with the program, don't expect your local warehouses to.

costco should sell weed i want to smoke kirkland signature strain

[strinak]

oklahoma is fucking with the state version of medicaid (soonercare) and making it a managed care system (??) and it's stressing me out bc only one of the three choices has "we cover this but not this" brochure and re: the brochure they don't cover shit? but also all three are "contracted to provide the same level of care"

[crookedheir]

The juxtaposition between how well my MCAS symptoms are managed on medication and how awful my symptoms are as/after it wears off is wild. For like 3 weeks a month I’m lulled into a false sense of security and then WHAM, I’m in hell.

[lagerwhat]

Fuuuuuuuuuuck Aetna. Lowest possible cost. Pfft. If they can afford to take management to Disney and hire John Legend for a concert, they can spring for Concerta.

Kiss all my ass.

[deadpanwalking]

[minthe-lover]

most of chapter 241 is like... pretty boring. It's alot of set up and very little pay off with just.. some really shitty art. Like damn they did Aetna dirty, some panels she just glows, other that look really interesting when she's glitching a bit.. and some she's just... a normal nympth? Did the assistance's not like share their work to have some level of consistent with the effect?

It's sad cause Aetna is one of the few character with a design that is more then just.. nymph + colour.

Also... it's so funny how much hades freaks out over the smallest shit possible. Demeter mentions wanting persephone to come home and he freaks the fuck out so much that he drops his tea.... Persephone mentions that she's still busy with something and he's acting like she just admitting to stealing a baby. Like hades buddy.. she hasn't really done anything yet for you to be worried.

Lastly I just... I need to talk about how fucking boring these shots of persephone and hades are. Like they feel so stilted, and just dull. Theirs barely any emotions are their face, hades mainly looks bored and Persephone look tired. Persephone isn't even naked???? This isn't interesting, and it's the same problem with the wedding episode....

I mean christ rs you've done better shit then this in THIS comic with psyche and Eros. You have the switch from full colour to black and white to give the scene more emphasis, we don't see as much but it's still more dynamic and just interesting. Also because the panels are more stylized with get a sense that they are doing more then we are physically seeing.

[raedshadowlegends]

Which LO Characters are Antivaxxers?

Omg hi all. It's been a while since I made an LO thing!!

And in honor (or rather dishonor) of the comic's return tomorrow, I thought I'd make this.

So here's a run down of which characters I think are antivaxxers, pro vaccine, or other.

ANTIVAXXERS

Persephone and Hades: They're both so fucking stupid, of course they'd be antivax.

Daphne: She's a sociaI media infIuencer. She'd use crystals to feel better.

Hera: She's conservative.

Kronos, Hermes, Aphrodite and Eros: They just have the vibes. Also Aphrodite and Eros would be essential oil bitches.

Artemis: She'd think her immune system would be too strong she she wouldn't feeI the need.

PRO VACCINE

Heph, Aetna, and Athena: I feeI Iike they'd aII be smart enough to know vaccines are good. Maybe that's wishfuI thinking. Aetna is an AI so she wouId be very adament about that position.

Zeus: I just feeI Iike he wouId be.

Demeter: She's the onIy smart one in this comic.

Leuce and Thanatos: They'd have very shaky opinions. But one Instagram infographic wouId be enough to sway them otherwise.

Hecate: She had common sense at one point.

Psyche: She's smart, I feeI.

Hebe: Zeus had her vaccinated behind Hera's back. She's aIso probabIy be swayed by an infographic and/or peer reviewed paper.

Amphitrite: Vibes.

Arion: I think it'd be funny if the horse was pro-vax

Ares: I aIso think it'd be funny if Ares was very adament about vaccination and Aphrodite was against it. But aIso vibes. He'd secretly get his kids vaccinated because he's a loving father and RS can't convince me otherwise.

OTHER

Dionysus: Victim of anti-vaxx "parents".

Thetis and Eris: They'd be antivax just to make peopIe mad. They're indifferent otherwise.

Minthe: Indifferent but she wouId vaccinate a kid if she had one.

Hestia: Hestia's opinion wouId change with the wind depending on who she's with.

Poseidon: He has no opinions at aII and trusts Amphitrite to deaI with the immunizations of their kids.

Chiron: Pro vaccine in pubIc, antivaxx in private. I feeI Iike she's super conservative but she hides it. I don't Iike Chiron.

Apollo: His opinion aIso changes depending on who he's with. OnIy this time it's extra malicious.

Thanks for reading this. I just think it's funny :]

[windowsandfeelings]

FUCK. AETNA.