I have never had a problem before but now find myself very upset with Aetna and believing the other chatter that they must look for loopholes as to not pay. We own a mid sized emplyment company in New York. We started utilizing Aetna as our provider for our family as well as our employees.

My son has been having problem with his feet while doing sports. He is very active and kept complaining that his heel hurt. Our pediatrician referred us to a foot doctor. Upon reading the x-ray he said that he was flat footed and that he was having growth plate issues in his heel. He recommended orthotics be made and put in his shoes and cleats. I was told this would be costly (several hundred a foot). We agreed that we should get approval from Aetna prior to making them. The office did that for me and was told verbally by two different reps (all documented) that we had a zero co-pay and were totally covered. After I picked up the orthotics the office and I were told we were not covered for any of it. They said they have it documented also from the reps that we were covered however, they do not stand by any verbal assurances. We should have read the manual as it says they are not covererd in the fine print.

We are on our second appeal however, I cannot believe that these reps are authorized or even utilized to speak with the insured, give erroneous approval and then rescind upon their discretion. How many businesses do you know that practice this kind of false advice and do not stand behind their word.

I am extremely surprised and suggested to them that they tell people upon calling not to believe what they are told. Had i been told to refer to my manual I sure would not be in this mess. How many of you run your businesses this way? I'm sure not many for if you did you would certainly be out of business. Something is just not right with this practice...any advice???