QUICK QUESTION ABOUT AETNA

A close friend of mine is considering gastric bypass surgery, and I've told her that the most trouble you'll get out of the surgery is trying to get insurance approval. I looked up her insurer on the site but haven't read really great things. Anyone have AETNA, and have problems? Are there any major qualifications she'll have to have? Thanks for the help.

I have Aetna Open Choice. My primary care doctor had to send my records and a letter of necessity along with the letter from the surgeon. I was turned down once because they wanted the records from my doctor. Then it was turned down again and the surgeon called. She hounded them relentlessly for a week and they finally gave their approval. Took a little over a month to get approval. They were great. The only qualifications I had to have was that mentioned above then of course the doctor had me to do the consultations with the dietician, exercise and the psych evaluation. Aetna paid their 85% on everything and if they were in my approved list all I paid was my co-pay and they paid everything else. Tell her to document everyone she talks to Aetna. I wrote every name down when I called to see the status and what they told me. Good luck! Glenn Gay Springdale lap RNY 5/26/04

Aetna has a strict guidline for this surgery. Either 6 months under primary care doc with nutritionists and workout program ...or 3 months supervision under the surgeon doing the procedure with the same guidlines right before surgery. Lots of hoops....I'm worn out from jumping them myself, still no answer from them.

Thanks, guys! My friend appreciates the feedback. If you have any more info, let us know! Brandy

Hi there, I hope your friend does not have a group policy with Aetna through Entergy. Entergy has a written exclusion to any Bariatic procedure.