ABOUT AETNA! PLEASE READ

HI, THIS WAS POSTED ON THE MAIN BOARD EARLIER I work for Aetna and am currently waiting for approval for my surgery- this morning, there was a article on the employee website that beginning January 1, 2005 Aetna standard plans will not cover Bariatric Surgery !!! The employers will have to opt to cover the service in order for it to be eligible under Aetna. Sooooo, if you are waiting for surgery, or thinking about surgery- push, push , push to get it approved and done before 12-31-04. HELLO, DOES ANYONE ELSE HAVE AETNA ALSO ON THIS BOARD? I'M SO WORRIED THAT I WON'T MAKE THEIR DEADLINE, BECAUSE MY 6 MONTH SUPERVISE DIET DON'T END TILL NOVEMBER 6, 2004. ALSO, I HAVE TO GET A PSYH EVALUATION, AND MEDICAL TESTING DONE... PLEASE RESPOND AND TELL ME WHAT I SHOULD DO. THANKS LORRIE

Lorrie, What a shame, I am so glad I opted to not stay with Aetna this past enrollment period. I didnt have any problems with my approval with my new insurance company but I knew several who had problems with approval with Aetna last year so I bailed. Is it possible for your PCP to prescribe some of the testing for you now? That way you would have some tests out of the way by the time you finish your six month diet. My surgeon took some test results as far back as a year and others only as far back as six months. Maybe you could get bloodwork, cardio clearance, sleep study done before hand (of course this is based on what your surgeon requires). Also, the psych eval is often not covered by insurance anyway, so that could be cared for too unless your surgeon requires you see someone in particular. Just a thought... Good luck, Amy

I heard that Blue Cross Blue Shield of Florida made this same announcement and that is was expected that several other carriers would be following suite. I have Cigna, and even though they have not made a formal announcement, I expect that they will do the same.

Lorrie, I have Aetna HMO and I just can't worry about this. Whatever happens will happen and I just have to have faith that things will work out one way or another. I haven't tried for approval yet, which will be in early August after my next PCP appointment. I have all other pre-op testing done. I don't see why you can't get your psych eval and medical testing done now, to get it out of the way. Good luck!!

Hi Lorrie, I have Aetna and was denied last July due to not having the 6 month diet thing. I had my psych eval and nutritionist eval even before I started the 6 month diet. My diet ended in Jan 2004 and my paperwork was submitted in February and it too****il April 2nd for me to be approved and I had my surgery on April 28th. Just to let you know you do NOT have to wait to submit paperwor****il the diet is completed...you can be preapproved so long as your surgery date is after the 6 month time frame. This is stated on their website. So if your doctor will give you a surgery date sometime after the 6 month mark you can have him submit the paperwork in like Sept or Oct so hopefully you will be approved by Nov. Just a thought. Good Luck...God Bless!!

Lorrie, Hello! I have Aetna POS and just had surgery on 7/15. I had some documentation of a diet I had done about 4 years ago that they actually accepted and then I just had to diet for 3 months with the surgeon. Apparently the rule right before this was you had to diet for 6 months so you may want to double check. I got approval within 3 weeks so I'm praying the same goes for you. Good luck !!