Advice Needed - Insurance Company & Medications

I need some advice because I do not honestly know what to do. My apologies for the long story.

I currently have Aetna and pay additional $$ per paycheck for the buy-up plan. This plan includes coverage for IUIs and for fertility medications. All fertility medications need to be filled through Aetna Specialty Pharmacy.

I went through 1 IUI cycle end of September - mid October. My REs office would fax paperwork and with some phone calls from me and from them we were able to get my medications.

I started a new cycle and saw my RE on October 28 for CD5 bloodwork. That day, the REs office faxed prescription and request for authorizations to Aetna.

I called Aetna Specialty Pharmacy to check status of my prescriptions and authorization on 11/4. Aetna had not received any faxes. I called RE immediately and they resent faxes that same day. I called Aetna Specialty Pharmacy again on 11/7 and they still have not received faxes.

My RE office called Aetna Specialty Pharmacy today and found out that Aetna still does not have faxes.

I have been waiting 2 weeks for medications and authorization so that I can begin my IUI cycle.

RE is faxing information for a THIRD time today. They confirmed fax number is the same and was used for all the faxes.

Is there someone I can speak to about this situation? I feel like the insurance company is jeopardizing my medical care but I do not know who can help me. Do I contact Aetna and speak to a manager? Or NYS Insurance Department to file a complaint?

Thanks!

Advice Needed - Insurance Company & Medications

What about your nurse case manager of your insurance company? Or have you called the pharmacy to speak to a supervisor and raise hell? Is there an email address someone can scan the prescriptions and email them?

Re: Advice Needed - Insurance Company & Medications

Advice Needed - Insurance Company & Medications

Does your RE have meds to donate to you while you wait for ins co? Call your nurse case manager at your insurance company and tell them if they are not willing to fix this RIGHT AWAY you will take all of the copies of the faxes and confirmations and file a complaint with the state maybe? You speak to a supervisor at the specialty pharmacy? Maybe call and threaten to file a complaint against them? I'm so sorry, I cam imagine your frustration :(

Advice Needed - Insurance Company & Medications

I would call and speak with a manager/supervisor, then tell them that you are speaking with your HR representative to inform them that Aetna is jeopardizing your care.

Re: Advice Needed - Insurance Company & Medications