Aetna insurance questions

Hello all..

I'm a long term DoD employee working overseas, and have Aetna "NAP" insurance through my workplace. In 30 years of working there, I have never used my insurance, since healthcare is relatively cheap in my area, and I've never even met the deductible.

I recently was diagnosed with a rare blood cancer. Caught early, not curable, but treatable.

Initially, I went to the hospital for diagnosis, and paid out of pocket. That hospital then referred me to another that accepted my US based insurance to do the treatments.

I filed the paperwork online from the first hospital, and all went through. Met my deductible, and added a few hundred to my out of pocket expenses (around $900).

My new hospital arranged a "Guarantee of Payment" (GoP) with Aetna, and treatments began. Aetna did eventually pay their 80%, and I the 20% (The hospital system is set up to have you pay at the very end of the process. There is no "I'll pay you later"). Mine was paid upfront, and Aetna's payment maybe 3 weeks later.

I once again filed that paperwork and the appropriate receipts. Every week from that point on, I have treatments to the sum of around $2,000 per week (my 20%), and Aetna averages $10,000.

For two months now, I keep receiving notices that they need receipts and proof of payments for every claim I've filed, even though they have been filed and labeled as such. I've mailed them directly, and they request receipts for the 80% that Aetna is supposed to pay. One claim in 10 went through in the last two months, and just recently the amount disappeared form the out of pocket graph on the app.

Multiple phone calls to reps end in frustration and confusion, as all my paperwork seem to be in order, and they have no answers, except to send my claims to "urgent claims" where I never hear anything, and call.. only to find the claim is somehow "pending" again.

I'm currently $20,000 out of pocket and getting deeper.. taking a hardship withdrawal out of my 401k just to keep treatments going.

Currently waiting on a supervisor call back, but not holding my breath.

Appreciate any help.

submitted by /u/AcademicBeautiful118
[comments]