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Aetna Settles Lawsuit – Agrees to Pay Millions to Insured and Doctors

Published date: January 22, 2014 | Modified date:
by Dr Stephen Wangen

The United State District Court; District of New Jersey has issued a notice of proposed settlement in a case involving Aetna, Inc. and its subsidiaries and affiliates (not including Coventry Health Care, Inc.). The suit claimed that Aetna failed to provide adequate reimbursement to subscribers and providers for “out of network” care.

If you had Aetna insurance between March 1, 2001 and August 30, 2013 and ever had any medical care from an out-of-network provider, you probably qualify. It doesn’t matter if the provider “took” your insurance, or if you paid the provider and later made your claim to Aetna. If you saw a doctor or other provider that was not “in-network”, you probably qualify for additional reimbursement.

Details are online at

The total to be distributed under the proposed settlement is well over $100 Million Dollars. That is a lot of under-reimbursement.

Just as a reminder – The IBS Treatment Center is always out-of-network, but most patients get reimbursment for care provided at the IBS Treatment Center. After this huge settlement one might expect fewer problems with getting proper reimbursement.