RunAround Aetna!!!!!!

madelaine M.
on 9/28/06 9:22 pm - coral springs, FL
Can they do this?  My boss just had open enrollment with Aetna HMO once again and now they have an exclusion that do not cover WLS., i have invested so much money the insurance he did have prior was also Aetna HMO and it covered WLS with a multidisciplinary regiman (PCP,Nutriionist, Psych,)., this changed effective September 1,2006.When i confirmed with Aetna back in March of 06 with the old policy they did cover this procedure i have 5 months of nutrionist., 3 PCP, 3Psych., 1 month short to turn in all paperwork., i have contact our insurance broker he stated Aetna did not cover this...but  Aetna shows me calling in March and August 2006., they have it noted..My HR person at work try to add a Dual Option on our policy and Aetna would not allow them to do this...they stated Aetna no longer covers this procedure effective January 1, 2006.. I am ready to fight and not give up....Please what do you suggest is it worth my while.???I know it will be...my BMI 51.6., and I have a medically necessary letter from my doctor with my co-morbidities.....please help????what can I do to appeal ., i know i am going to be denied i wanna be ready for this///////
walter A.
on 10/26/06 7:44 pm - lafayette, NJ
take it up with your boss who just lowered your rate of compensation, ask him for a raise, fat chance there.    Verizon just did the same thing to all the NON UNION employees, cancelled key health care benefits and raised the the weekly cost.   Fortunately that wont be a issue for us, until the end of 2008,  Perhaps you might want to consider organizing a union where you work.     
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