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Aetna steps in it

This is the case that may change health care. The way I see it Aetna is trapped. If they "are" making medical decisions based on medicine, why the need for middle man doctors? Concurrently if they aren't making medical decisions they are making financial ones which does not play well in Peoria. Either way this case will have huge impact on the industry. Time for insurers to insure and doctors to doctor.

Interesting . . . . .

We were just forced to switch to Aetna due to a school board decision.

We started in November trying to find out how much our cost of my wife's medication would be. We needed this information to help decide which policy level would make the most sense for her. We never got the information.

She had to delay a treatment due to their nightmare approval process. She would get approval (even a letter) but then was told it was not approved.

Fortunately, she had a day off due to a snowstorm and spent the entire day on the phone dealing with three different Aetna entities, two different departments in the hospital where she gets he treatments, and the doctor's office that wrote the prescription.

Even with all of that, it was three weeks later before she actually got the medicine and was able to get the treatment. She has a serious disease. This medicine is essential.

I kept thinking "How can we do this when we are older and not as able to advocate for ourselves?"

BTW, the retail cost of the medicine is somewhere above $1,000 per week. She will be on it or something similar all of her life.

One mistake in getting the proper approval would cost us as much as $10,000 for one treatment.

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