Met OOP in March, except now I haven’t?

Went to pick up an RX yesterday. I met my OOP in March, so I was expecting a $0 copay.

Turns out I have a $100 copay, which doesn’t even begin to line up with what my preferred generic (or even preferred name brand) copay should be. When I called Aetna, the first person said they retroactively removed payment for a hospital stay in August (what hospital stay?). They sent me to someone else who told me they’d retroactively removed payment for all of my insulin and insulin pump supplies for the year. Neither of these make sense. No hospital stay in August, and the difference in my OOP wouldn’t align with what they’re saying I still owe on my OOP (random number near $900). They do not require preauthorization for anything I’m on, and everything I’m on still shows as being preferred brand or preferred generic on their formulary as of today.

I also can no longer view any of my EOBs online – I get a 0 byte PDF.

Anyone been through this with Aetna? Any advice? I do plan to file a complaint with the state department of insurance, but multiple calls just keep getting met with them saying they either removed payment for insulin or removed payment for a hospital visit that never happened.

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