Aetna Experience?
Hey everyone!
I'm going to be calling Aetna tomorrow to discuss all their various requirements, but I wanted to check with those of you who had the surgery already and have aetna
...did you run in to any problems with various members of the surgical team being considered "out of network"?
For example, did you have to MAKE SURE your anesthesiologist (spelling!?) was in-network or was that a non-issue if the facility is considered in-network?
Were the labs an issue/person performing them had to be in-network?
Thanks!!
C
I'm going to be calling Aetna tomorrow to discuss all their various requirements, but I wanted to check with those of you who had the surgery already and have aetna
...did you run in to any problems with various members of the surgical team being considered "out of network"?
For example, did you have to MAKE SURE your anesthesiologist (spelling!?) was in-network or was that a non-issue if the facility is considered in-network?
Were the labs an issue/person performing them had to be in-network?
Thanks!!
C
I have Aetna and had the DS in November. (Aetna is one of the few that covers it without a bunch of hoops to jump through. Have you considered it?) I just made sure my surgeon and the hospital were in network. I didn't worry about any of the others and all was well. My surgery total was about $70k and I've had to pay about $750.
Congrats on your success!!
I will have paid about $850 by the time I have the surgery--between nutritionist requirements, physical therapy requirements and "program" requirements...plus the co-pay.
I'm just terrified of getting hit with a few hundred or thousand dollars in bills not covered by aetna. I'm scared because we had to file bankruptcy over medical bills and "balance billing" from my previous insurance (Blue Cross in Idaho) and no one in our city being "in-network"--so every thing was balance-billed, including medical emergencies and surgeries.
"...seriously a nightmare.
So I'm, obviously, just scared of repeating that nightmare now that we have finally emerged from it. :)
Thanks! What hospital did you have it at?
I will have paid about $850 by the time I have the surgery--between nutritionist requirements, physical therapy requirements and "program" requirements...plus the co-pay.
I'm just terrified of getting hit with a few hundred or thousand dollars in bills not covered by aetna. I'm scared because we had to file bankruptcy over medical bills and "balance billing" from my previous insurance (Blue Cross in Idaho) and no one in our city being "in-network"--so every thing was balance-billed, including medical emergencies and surgeries.
"...seriously a nightmare.
So I'm, obviously, just scared of repeating that nightmare now that we have finally emerged from it. :)
Thanks! What hospital did you have it at?
Maybe this will help someone else out there...
OK, so here is what i've learned this week about my Aetna plan....I have a QPOS
It will cost $250/day at the hospital. Last year when I spoke with them it was going to cost me $150 total for surgery and hospital stay...the $250 includes the surgery (I was told on the phone...)
Fair Oaks is in-network--sort of. Radiology at Fair Oaks isn't considered in-network bc they are sub-contractors and the labs aren't in-network because they are sent out for analysis...so...I have to have my pre-op ultrasound and xrays with an in-network place AND have to have my labs drawn at a Quest Diagnostics place...Can't have either at Fair Oaks even though the hospital is considered "in-network"
The labs are OK to be ordered by the surgeon--but--the pre-surgery consults with a GI and Pulmonary specialist MUST be ordered by the primary care physician or they wont be honored by Aetna...even though Aetna has approved the surgery and the surgeon is in-network.
...I just wish there was a form somewhere that explained all of this craziness...so I hope my experience can be helpful for someone else going through this to at least know what questions to be asking Aetna and providers.
OK, so here is what i've learned this week about my Aetna plan....I have a QPOS
It will cost $250/day at the hospital. Last year when I spoke with them it was going to cost me $150 total for surgery and hospital stay...the $250 includes the surgery (I was told on the phone...)
Fair Oaks is in-network--sort of. Radiology at Fair Oaks isn't considered in-network bc they are sub-contractors and the labs aren't in-network because they are sent out for analysis...so...I have to have my pre-op ultrasound and xrays with an in-network place AND have to have my labs drawn at a Quest Diagnostics place...Can't have either at Fair Oaks even though the hospital is considered "in-network"
The labs are OK to be ordered by the surgeon--but--the pre-surgery consults with a GI and Pulmonary specialist MUST be ordered by the primary care physician or they wont be honored by Aetna...even though Aetna has approved the surgery and the surgeon is in-network.
...I just wish there was a form somewhere that explained all of this craziness...so I hope my experience can be helpful for someone else going through this to at least know what questions to be asking Aetna and providers.
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