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Posts for February, 2010

Aetna demostrates insurance industry callousness about the medical needs of their “members”

This commentary is a personal rant from the author and may not necessarily reflect the opinion of other authors at Box Turtle Bulletin. Additionally, it is not directly within the realm of what this site normally covers. I wrote it anyway. I make no claim that this is representative of anyone else's story, but it's mine.

Timothy Kincaid

February 2nd, 2010

AetnaIn 2004 Aetna Insurance Company adopted the slogan, “We want you to know.” However, I really, really, truly, very much wish I knew nothing about Aetna.

As I wrote last Friday, Aetna, my HMO insurer, decided as of January 1, 2010 to move a medication that I require off of their preferred list. They do allow one other alternate medication, but I have an allergic reaction to that medication which results in redness and eye irritation and my ophthalmologist will not prescribe it.

In my update last Friday, I told you that it looked like a tier override might be possible. It is now clear that this was a misunderstanding. As I do not reside in New Jersey, such an option is not available.

During this process I discovered something interesting. Aetna has in place procedures to ensure that those who decide the pricing are shielded from all contact with those who suffer the consequences of their decisions. Even the intermediaries who speak with doctors are not allowed to talk to these decision makers, instead having all interaction be by means of forms and email.

Aetna wishes to make certain that those who deny coverage are not swayed by emotional appeal or the circumstances of any individual members. Were they to be made aware of the difficulties that they cause, they might be inclined to prioritize ethical practice ahead of gasp-worthy profits ($1.4 billion in 2008) and exorbitant executive salaries (which increased 625% between 2005 and 2008).

So Aetna wins. By taking my drug off the preference list, they will shift $25 per month from their bottom line to mine. And I have no recourse at all other than, of course, informing you, my Congressman, my Senators, my state legislators and the CA Insurance Commissioner of the practices of this corporation.