Aetna (must I say anything else?) Help appreciated!

TLDR at the bottom

In the beginning of January, the new doctor I started seeing suggested a Genesight test in order to help me navigate SSRI selection. She did the cheek swab at the appointment, but later called to tell me that she cancelled the test. She had originally done it thinking I had Medicaid, but realized soon after that I didn’t and she wanted to make sure my insurance covered it before I got it done (the test costs like $330 without coverage). She told me to call Aetna, see if it’s covered, then come back in anytime to get the swab done. On January 10th, that’s exactly what I did. I called Aetna, and the representative told me that the test was completely covered. I shit you not, I made her clarify this THREE times. Nothing out of pocket for me. No fees or copays. Immediately, I drive to the doctors office, get the test done, and I’m told that I can expect results in 6 weeks or less. About 8 weeks go by- still no results. So I was excited to see a letter in the mail from Genesight. When I saw it was a bill for $330 and not my results, I was livid. I sent an appeal into Aetna after speaking with one of their reps, and it went nowhere. It’s now almost May- still no results, but I’ve gotten two more notices for a bill from this test that I wouldn’t have gotten done had I not been explicitly told that it was 100% covered. I spoke with Genesight today, who told me that they sent my results to my doctor in January (doctor told me she never received them, and I also never received them at my residence like I was told I would) and the Genesight rep also told me that Aetna completely denied the claim. I just spoke with Aetna again, and finally the rep sent in a request to pull and review the call (I knew exactly when I called). If they explicitly told me that it would be covered on the call, are they required to honor that? Am I gonna be stuck footing this bill?

TLDR; if Aetna denies a claim and it’s on a recorded call that I was previously told it would be “100% covered” with nothing out of pocket for me, do they have to honor their mistake?

submitted by /u/TheFummestChum
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