I had a labral tear in my right hip, and I needed an MRI with contrast to diagnose it. Aetna wouldn’t cover the MRI until I’d done 6 weeks of physical therapy. I ended up paying out of pocket for the physical therapy because it was an $80/session co-pay vs their self-pay rate of $70/session. Then once I’d finished therapy there was about 6 weeks of waiting until I could get in for the MRI, because Aetna wouldn’t let me get an MRI at the local hospital, I had to go to an outpatient imaging center and they were booked up. And when I got the results - what do you know, near complete detachment! Something that physical therapy would never help with. After that, I consulted with a surgeon (6 week wait), and his waitlist for surgery was 4 months. (Granted, I went to one of the top surgeons in my area - I was OK with waiting for that.) So it ended up being 10 months from noticing the hip pain in May 2023 to finally getting the surgery in March 2024, and a lot of that delay was because Aetna was being obstructive.
I suspect they want people to get fed up with the roadblocks and just give up on pursuing medical care.
In my case, Physical Therapy needed the MRI to confirm the nature and extent of the damage before they would even touch me. The 1 month delay caused by Aetna made everything worse.
I had a labral tear in my right hip, and I needed an MRI with contrast to diagnose it. Aetna wouldn’t cover the MRI until I’d done 6 weeks of physical therapy. I ended up paying out of pocket for the physical therapy because it was an $80/session co-pay vs their self-pay rate of $70/session. Then once I’d finished therapy there was about 6 weeks of waiting until I could get in for the MRI, because Aetna wouldn’t let me get an MRI at the local hospital, I had to go to an outpatient imaging center and they were booked up. And when I got the results - what do you know, near complete detachment! Something that physical therapy would never help with. After that, I consulted with a surgeon (6 week wait), and his waitlist for surgery was 4 months. (Granted, I went to one of the top surgeons in my area - I was OK with waiting for that.) So it ended up being 10 months from noticing the hip pain in May 2023 to finally getting the surgery in March 2024, and a lot of that delay was because Aetna was being obstructive.
I suspect they want people to get fed up with the roadblocks and just give up on pursuing medical care.
In my case, Physical Therapy needed the MRI to confirm the nature and extent of the damage before they would even touch me. The 1 month delay caused by Aetna made everything worse.
How frustrating!!