Aetna is not being good.

by marjorieingall on April 13, 2010

Look! Look! This is Steven. Steven has cancer.

Look! Look! This is a letter from Aetna, Steven’s insurance company.

Aetna does not want to pay for Steven’s chemotherapy, despite having already authorized Steven’s chemotherapy. Isn’t that silly?

Here is what will happen. Aetna will ultimately pay for Steven’s chemotherapy. Did you know they send letters like this all the time? It’s true! They hope people will be scared by the mean words in the letter and pay for the services themselves. They hope people will not follow up. But here is another funny thing! Steven is an oncologist! An oncologist is a cancer doctor! That means Steven knows how to deal with an insurance company that reflexively denies pre-approved coverage. But many Americans do not know what to do when they get letters like this. That is why it is good to have health-insurance reform. That is why it is good to shame Aetna. (It is not only Aetna who does this. Many insurance companies send mean letters saying NO NO NO, we will not do the job insurance companies are supposed to do, even though we are an insurance company. Some people call letters like this “nastygrams.”) We hope this kind of bad corporate behavior will stop. Aetna needs to sit in the time-out corner and think about what it has done.

Does this story make you sad? Maybe a picture of Steven with his kitty, Jelly Bean, will make you happy.

Are you happy now? No? Even though Jelly Bean is a very good-looking kitty? Then read more about Steven’s fight with cancer and with his insurance company on his blog. Steven explains the letter here. What would you do if you were Steven? (Guess what? You are!)

{ 2 comments… read them below or add one }

steven weinreb April 13, 2010 at 1:28 pm

Hey Marjorie

Thanks for the shout out

I gotta have better pictures than this. I look insane. I keep telling Judith I don’t want to be a drama queen ( I do, but that’s for another blog) As Judith and you point out, It’s not my problem, it’s our problem. It’s the problem of anyone who has parents or grandparents who will agonize when this casually cruel letter comes. Nastygram: is that my term or is it universal? I thought I held copywrite on it ( of course you may use it)

keep bloggin!

love

steven

Robin Aronson April 14, 2010 at 11:17 am

A while back I had Aetna insurance and I had to have exploratory surgery. It would be the only way to get a diagnosis for a disease I just might have had. I was pre-approved for the surgery. I had all the paperwork in order and everything. So I had the surgery, and it turned out that I didn’t have the thing they were exploring for. Guess what? Since I didn’t have the disease, Aetna wouldn’t pay for the surgery. We got the bill for $17,000. Of course, if the hospital had been billing an insurance company and not a person, the surgery would have cost a whole lot less, but that’s another argument. In any case, in the end, after many letters and appeals we had a very important lawyer we were very lucky to know write a very strong letter on very important letterhead and suddenly our pre-approved but post-rejected surgery was covered.

I hope Steve is doing well.

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