Persistence Pays Off When Dealing With Insurance Company

When a Johnston County man could not cut through it during a dealing with his insurance company, he called 5 On Your Side's Monica Laliberte for help.

Insurance is great, but sometimes even when you and the company agree that something is covered, it still takes countless phone calls and paperwork to get a situation taken care of.

"I need something that has a solid frame on it, because I jump off a lot of curbs and that's hard on the frames and stuff," said Alan Brackett of his need to replace his wheelchair.

Brackett's new chair is made of aircraft aluminum. The Quickie XTR is solid, lightweight and even comes with a shock absorber.

"I was glad that it was finally here," he said.

When you look at his 6-year-old wheelchair, you can understand why Brackett is so happy to get a new one. Posts stick through the back upholstery, the frame is taped and parts of the wheelchair are glued together.

"It was a good chair. It's just that I've had it so long, it's just worn out," he said.

Brackett is very active. He hunts, fishes and gardens -- hobbies he could do in his old chair. That is why he wanted to replace it with a similar model. In April, he called his insurance company, Aetna, to find out what he needed to do.

"They told me I needed to get a prescription from my doctor and take it to the medical supplier and then they could order the chair," he said.

Brackett followed those directions, but when a medical store employee called Aetna, Brackett was told that was not enough. He was told that his doctor needed to call Aetna for pre-approval.

"When they called in, they were told that they had to send a letter in. So my doctor sent a letter in," said Brackett.

Brackett waited, called, wrote letters and waited some more. He says Aetna kept needing something else and would not give the go-ahead to get the chair.

"I was just getting where I wasn't getting any results from them. It was like I was running into a brick wall. So I decided to see if you guys could help me out," he said.

5 On Your Side called Aetna. A representative claimed Brackett's approval took so long because the company needed more information from him and the medical supplier. Within a couple of days of the call, Aetna approved delivery of the new chair.

Brackett is happy the ordeal is over.

"I was glad I had a new chair and it would be something that would hold up good. It's even better than the old one," he said.

As Brackett learned, most insurance issues require a lot of persistence and having your paperwork in order. From the beginning, make sure you find out exactly what the company needs and get it to them quickly, then follow up frequently. That way if there is a problem, you can get right on it.