Provider Confused by Insurance with Aetna PPO

I have insurance that I purchased that comes with access to the Aetna PPO network. When I purchased the plan, I was told my coverage is through Aetna. I have an insurance card with an Aetna ID and Group number.

I’ve had this plan for three years, and pay my monthly premium. I’ve thankfully never had to use it until last week I wound up needing to go to urgent care. As I was being checked in, the receptionist ran my card and could not validate me in Aetna’s system. They had me sign self-pay paperwork so I could be seen.

The receptionist then came over to me and told me they got Aetna on the phone and confirmed I have coverage, am active, etc. Great. I tried going into the Aetna website with my ID. Couldn’t. Now the urgent care provider’s billing department is having trouble tracking down my insurance again.

Fast forward to today. I called the broker that sold me the insurance, very confused by what’s going on. He told me that I don’t actually have Aetna coverage; rather, I have access to the Aetna network, but his company pays claims, not Aetna.

All of this is confusing to me and wasn’t how it was explained when I was sold the plan. Does this make any sense?

submitted by /u/vandalayimports
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