Aetna Student Health finally returned my call about the $500 in medical bills they haven’t paid. Now I’m getting a completely different answer (I think I’ve been given about four different explanations so far). The most recent customer service representative said that I met the maximum benefit level for this medical service. I explained that the last person I talked to said these doctor visits were counted differently, under the three doctor visits per accident or sickness. She said that the case notes were not showing that he said that and if he did, he was wrong. She was a bit curt and not at all sympathetic. Seeing as I’ve been given so many different answers by customer service reps, I’m going to give myself a few days to calm down, review my notes and the policy’s brochure, and call back to see if I get a different answer from the next person I talk to. I might decide to submit a written appeal. Maybe if Aetna has to reject my bills with a written explanation, I’ll get a definitive answer.
As an aside, I was re-reading my Aetna Student Health policy and I read a few things that struck me as odd. The policy lists 50 exclusions that the plan will not cover, including medical bills from committing a felony and medical bills from participating in a riot. But you are allowed to defend yourself in a riot and have your resulting medical bills paid, as long as you’re not defending yourself against “persons who are trying to restore law and order.” I don’t know why they would single out those two types of activities as ones that they won’t cover. What about all of those college students committing misdemeanors or getting hurt at political demonstrations? I guess they’re covered.
Jen Ramirez