Action 9: Woman says Aetna wouldn't cover some of her baby's checkups

by: Don Griffin Updated:

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CHARLOTTE, N.C. —

A new mother said her insurance company wouldn't cover some of her baby's checkups, and when she called the company for help she said she couldn't get a straight answer.

Dustin Morris has her hands full with 4-month-old Rebecca and 2-year-old Jack, but she is also fighting with her insurer over paying nearly $1,400 for Rebecca's wellness checkups.

"I am really frustrated. I have wanted to rip my hair out a couple of times because I call and I get shuffled through their automated system and it is hard to talk to somebody," said Morris.

Morris said Aetna Insurance refused to pay the claims saying she failed to enroll Rebecca with a primary physician, but Morris showed Action 9 paperwork where she signed Rebecca up 12 days after she was born -- well before Aetna's 30-day deadline.

"It's got her name and her primary care physician's name," said Morris, "And that is what they are telling us they do not have."

After Morris filed an appeal, Aetna agreed to pay for Rebecca's future doctor visits, but not past bills. It then sent two new insurance cards, just like the old ones.

"It's got her name, the same doctor's name, nothing has changed," said Morris.

Aetna insisted that no primary care physician was selected until three months after Rebecca was born and it said earlier claims were denied because the care was deemed out of network.

After Action 9's contact, it paid two claims totaling more than $1,100.

Morris is happy, but this just underscores how important it is to understand your health benefits.