Health Insurance Rant

My husband pays Aetna $201.50 per month for family coverage for health insurance. Why? Yes thats the major question on my mind lately. Last month I took my twins to the doctor for their nine month well check. Two weeks later I get a bill in the mail for $125 for EACH baby and it said the well visit was not covered. So I look at the total due of $250 and think.."what the hell?" So I call Aetna.

Aetna: "Hi this is ****, how can I help you today?"

Me: "Hi I am calling about a claim that was not paid and I need to know why?"

Aetna: "yes maam, may I have your group ID number?"

Me: ********

Aetna: "aaahhh yes maam, this is a non covered visit."

Me: thinking {no crap, thats why I am calling to figure out why its a non covered visit} , "Ok, I see that and I need to know WHY it is a non covered visit."

Aetna: "Well we only cover six well visits in the first year of life for babies and this was the seventh well visit so we do not cover this one."

Me: "Ok, and obviously you will not be covering their twelve month visit either, then huh?"
Aetna: "thats correct maam"

Me: "Did you know that the American Academy of Pediatrics recommends at least eight well visits in the first year of life?"

Aetna: "yes maam we are aware of that however we do not think eight is necessary so we only cover six"

Me: "so aetna is now comprised of doctors from the AAP?"

Aetna: {she now sounds frustrated with me} "no maam"

Me: "can you explain why a person on welfare or state assistance has better health insurance coverage than me? We pay over $200 per month for coverage plus $20 copays and we STILL have to pay for a full visit out of pocket. We also have had to pay a lot of money when my twins were born as a lot of things were not covered from their hospital stay. So can you tell me why my husband pays a ton of federal taxes out of his paycheck to the government for these state assistance programs that have better health insurance than we do????" {now I am fuming mad}.

Aetna: "all I can say is contact your HR dept maam."

Me: great. thank you for all the "help" you have provided me today.

hang up.

Can you believe this? We pay all this money for coverage yet we do not actually have "coverage?"

This is so very frustrating.