So last summer, I broke my ankle pretty bad, displaced fracture and at the time I had limited insurance. They claimed to pay up to 1k in ER visit, 250 for anaestesia, 2k in doctor visits, and up to 20,000 for secondary care. This happened last august and they JUST paid the ER 1000 dollars after I had to file some paperwork. This company is a subsidiary of Aetna, and instead of denying claims they just ignore them. At the time I was out of work for 4 and a half months because my job involved me walking and my car was a manual transmission. Usually they auto deducted my payments out of my paycheck every week but I had to pay them by credit card while I was not working. I have a receipt for my payments all the way to 11/9. They sent me a partial denial of my doctors bill on 11/16/07 because I was not up to date with my insurance and could no longer afford insurance as I just got a job back. My questions are how do I get them to pay and is physical therapy considered secondary care?
Additional Details
The company is SRC, its quoted on the back of the card "SRC, an Aetna Company", I did everything the policy told me to do, I went to their website and used the approved doctors on their website, Your right on the 'limit'ed part but still they have to pay for what I bought into, I went to the physicans that were on their webpage, I went to the Physical Therapist on their web page, The only thing that wasnt there was the aneasthsia but its in the policy that I purchased for 250 dollars they cover. (which is definitely limited.) The thing is they havent denied the claims, they are just ignoring them. I have denied claim letters from after my insurance ran out for treatment after 11/9 but nothing before that. It took the hospital ER calling me and me calling them 10xs in 7 months for them to even get that payment out