GOOD NEWS

My Hardship Medical Check was approved through my 401K plan and will arrive next Monday. Then it’s off to Dr. Schwartz office to pay for this medical procedure. I should be able to schedule my surgery date next week and then proceed to make an appointment with Lisa Benson at St. Joseph Hospital for my medical work-up.   

I am disappointed that Aetna will not fund this surgery even though they will cover RNY. I am sure that once I have this surgery Aetna will get on board and cover future Lap Band surgeries after the recent in the news about weight surgery and diabetes.  “This will just be my luck”… HMO’s really suck when it comes to the patients dealing with them. Even my family doctor can’t stand them. He told me that he spends a great deal of time arguing with HMO’s for his patients. I am lucky in having the same family doctor even though I have changed HMO’s a number of times in the last 20 years.

 

 

I find that often insurance companies deny the first time around just to deny, even though the checks on the way...I hope you faught them as much as you could.  Either way, I am so happy that these doors opened up for you.  Let us know when you get your surgery date!

lynsmyster

Aetna will not cover LB, plain and simple… Aetna views LB as experimental surgery and will NOT cover even though they know of the benefits of being less invasive, less time in the hospital, and the rewards are nearly the same as RNY that they will cover. I felt that RNY was not for me even though LB take’s longer to achieve the results in weight loss but with much less issues then those with RNY.

When I looked into WLS last year and went through the headaches of dealing with Aetna for nearly 3 months I dropped the idea. Then a co-worker just recently thought she had Aetna on her side for LB then Aetna drop the ball on her. Seems these bureaucratic jerks are willing to pay for you to be in ICU for weeks but a simple surgery as LB and they turn and run.

If and when you locate the PDF file on Aetna ’s website containing the information on WLS it’s very clear that they will not cover LB.

I am very happy with my decision to dip into my 401K funds. At least I know the money went to a great cause in furthering my life so that I can enjoy the 401K funds later in life.

 

 

 

 

 

 

 

 

 

 

Way to go Keith!  Glad you found a way to live a healthier life style. This will be over before you know it and you will be a much better person for it. Gena