Aetna PPO?

troopersma
on 10/9/06 11:06 am
From looking at the plan information I believe that our insurance will cover WLS (after of course the deductible).  I contacted the insurance company but haven't heard back from them.  So thought maybe I'd post here and see if anyone has any experience.  I'm in Arizona (if that matters).  I did see that they require a precert for the POS and HMO programs.  When I called the surgeon's office they said it depended on the plan but in general Aetna requires a 3 month wait (I'm assuming this is when I'd be doing all the testing and such).    Anyone with Aetna???? Jane
ninatina_2006
on 10/10/06 1:37 am - Louisville, KY

Hi...I have Aetna insurance as well and I have been told that they require a 6 month medically supervise diet before they will pay for the surgery. I am in a delima of my own because they also require a 5 year medical history proving that you have been overweight for at least 5 years. I just got insurance a couple of years ago and knock on wood, I have had no need to go to the Dr for anything. I have no medical history to provide them with. The only documented proof of my weight would have been from when I joined weigh****cher at least 5 times but they wouldn't provide me with any documentation that I was a member and I do not have my weigh in books anymore. I am really worried that one little thing is going to keep them from paying.

Consultation with surgeon scheduled for October 9. Getting closer.....


Julie V.
on 10/10/06 12:34 pm - Lake Mary, FL
I have Aetna POS & THEY STINK...at least for me.  I have been denied because my BMI dropped below 40 Three years ago. So because I havent had a 40 BMI for 5 years they denied me. You can have a 35 or higher BMI with there 3 listed co morbs (hyperternsion, sleep apnea,cornary heart dis.) I believe are the 3 they will accept.  I dont have any of those.  I am going thru an external appeal right now, but things don't look good for me getting approval They denied me 3 times.
myspace.com/julielynnvon      (add me :0)

~ 11-22-06 ~   259
~ Today ~        135
~  Goal  ~         140
 
 
 
AllisonW
on 10/11/06 12:05 am - Versailles, KY
I have Aetna PPO (Kentucky) and i was approved. I did have to do three months medically supervised dieting, but after that they approved me and i had my surgery two weeks later. The only problem was after the surgery...Aetna "forgot" that they pre-approved me and sent all the bills back to the doctors. I now have two that were sent to collection agency. Aetna admitted it was their fault and started paying everything again...after 6 months of fighting with them and phone calls daily. But i think everything is getting straighten out now.
annephillips
on 10/20/06 10:27 am
What exactly is a medically supervised diet?
suchaclassylady
on 10/13/06 3:07 am - Midwest
I have Aetna PPO and I have to do a 6 month supervised diet.  My plan doesn't have an exclusion for wls.  good luck



...and NOTHING tastes as good as this feels!

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