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Aetna Denies Hepatitis B Immunization for Health Care Worker
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Aetna Denies Hepatitis B Immunization for Health Care Worker

I am entering graduate school this Fall to become a speech-language pathologist. Because we do clinical rotations as part of our master's program, my university requires that all students receive a Hepatitis B immunization. Aetna is refusing to pay my doctor for the immunization, stating that they do not cover routine immunizations for adults.

I contacted customer service to let them know that I am undergoing the immunization because I am in health care and it is required by my university, and I offered to submit documentation to support my need for the immunization. I also pointed out that Aetna Clinical Policy Bulletin 0410 states that "Aetna considers hepatitis B vaccine a medically necessary preventive service for..." adults who are health care workers. http://www.aetna.com/cpb/medical/data/400_499/0410.html

The customer care rep responded that the bulletin does not apply to the PPO insurance plan I have because of some decision my employer made. Her explanation was very unclear to me.

I filed an appeal using the Aetna online appeal form yesterday. Although I provided my email address, I received no confirmation of submission of any sort. I do not feel confident that I will receive a reply.

Does anyone out there have any suggestions on how to resolve this? Any help would be greatly appreciated.
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