BCBS & Aetna Question

Good Afternoon Everyone!!! I'm sitting at home today on Veteran's Day looking outside as it's raining ...overcast skies...gloomy...looks like what I feel like I have been researching the surgery, reading posts, reading the Q&A Library for the past 2 years. I met with a surgeon over a year ago to begin the process of having this surgery...put it off..put it off...and now I sit here with 1 1/2 months left until the end of the year in which BCBS will no longer cover this surgery. Yes I feel it was completely in my control to have done this sooner and I just didn't. But I want this surgery...I need this surgery. The one answer I can't find anywhere and I was hoping someone out there could answer for me was this: Is Aetna also not covering the surgery as of 1/1/05? Right now I have BCBS but as of 1/1/05 I will have Aetna. I have most of the requirements to be covered under BCBS but I'm not sure if I have enougth time. Any help would be appreciate!!! -Jenn

Hi! I am new to the board, and was just browsing to gather more info on the surgery and saw your post. I have not tried to get Aetna approval as of yet since my insurance is also changing to Aetna as of 1/1/05, but I have not heard that they are not covering it. As a matter of fact, I went to their website about a week ago and found that they had just updated their Clinical Policy about obesity surgery at the end of October. I printed it out so I could bring it with me to my PCPs office when I actually go, so they can help me in ensuring it gets approved the first time. Good luck!! Lillian

Jenn... Is your BCBS possibly State Employees PPO or Federal? I ask because those are 2 policies I know that are not going exempt after the first of the year.

Hi - Thank you for replying - No it's netiher of those. I work for a bank.

Jenn- Have you spoken with your insurance carrier. If you have completed all the requirements isnt possible to get approval and have the surgery before the end of the year. Come on -- don't think "I only have 1 1/2 months to do this" think "I've got a whole month and half to do this." And even if you can not complete the surgery before the end of the year -- but can get the approval--there may a continuity of care clause in the new policy.

I've heard that there are actually several carriers that won't carry the surgery in January, and Aetna is among them, but I don't know if that means most policies or what. Good luck! Jan

I am dealing with Aetna right now. They are changing their policy as of 1/5/05 to not cover the procedure unless your employer pays an extra premium. In my case, however, they will cover it until 6/05, as that is when our renewal date is. Good luck!