Aetna in MD

Anyone have Aetna insurance? I am having ZERO luck with them, and the state laws do not cover me since my husband's company has less than 50 people. Thanks, Vicky vicky @enchantmentportal.com

Gosh Vicky you sure have been through a lot in the past year or so. But it sounds like all is well now and that's great. Now moving on to your issue, I guess I would first say don't give up. But be very clear as to why you are being denied and who is denying you. I don't think the state laws are the reason for your denial, your husbands company insurance POLICY is. I know people constantly put out ther that generalized statement about being employed by a company with or less than 50 people, but the state mandate does not follow that rule. Insurance companies in general don't follow that rule, they are mandated to follow the state mandate, which again, says nothing about 50 employees. However, some insurance companies use the Maryland Insurance Commission rule to get around the state mandate and they have created policies that they sell to SOME small employers excluding WLS coverage. The up side to this is that they have to offer both types of policies to small employers and most companies are not charged more money for the policy that includes WLS coverage. So the key here is getting confirmation from YOUR insurance company as to which policy you are covered under. I personally am employed by a company with less than 50 people and I was approved for WLS. I personally know people with Aetna who are also employed by company's with less than 50 people and a couple of them were approved. So there is hope there. If you havn't already done so, contact your insurance company via mail or e-mail. Specifically give the customer service rep at Aetna YOUR policy and/or member ID and ask "what are the exclusions for weight loss surgery, if any?" Get their written response and hopefully it will clear up their coverage. If coverage is available, they might also quote you their requirements for surgery, take that information to your surgeon and hopefully you have already met most of them. Good luck and don't give up no matter what anyone says about your insurance. Every situation is different and no one knows your POLICY better than you and your insurance company.