AETNA Insurance......

Hi, I have AETNA PPO and I have recently been approved for surgery and have a date of 11/26. I have seen several posts regarding the concerns about wls coverage in 2005. My cousin is also in the process of getting approved for wls and we decided to call AETNA and find out about coverage in 2005. Well the reps were really nice and explained that wls will not be part of the general coverage policy but that if ones employer wants to 1. keep it as part of the covered benefits or 2. add it as a rider they can. So in short the ones ultimately deciding whether wls is covered or not is our employers. Luckily our mother company is The Washington Post and we have a large enough group that is really is not expensive to keep wls as a covered benefit. We just started our open enrollment period for 2005 and it has been confirmed that our coverage will not change at all. My advice is check with your employer to find out exactly what they are deciding to include in the benefits package they choose with the insurance company. I hope this helps. Gesell

I also have Aetna and they covered my surgery. I had a great case worker who took real good care of me. Just because someone does have the rider in 2005 does not mean that they don't have to meet the same criteria as today.

I agree the rider does not guarantee approval, but the rider at least tells you that there is the possibility of approval IF you meet the criteria. gesell

Alot of large companies actually have self-funded insurance, the companies like Blue Cross, and United and Aetna only handle the claims for them. So alot of times it is not the insurance company, it is your employer who is including or excluding WLS. If you are having problems go to your human resource insurance person. They should know the policy and have copies of it for you.

I have United Healthcare and I was told by human resources that our policy which started this fiscal year Oct 1st was the same as we had last year. I found out after I started the proceedings that wls is now an exclusion as of Oct 1st. Boy was I lied to. But I should have known because when I got hurt at work this human resources benefit person lied about all of that also. I guess I'm just stuck being overweight. Pray for me in my efforts to shed 110 lbs. Thanks, Betty