Which Aetna Plan?

Im might be starting a job at a new company and they offer these aetna plans:

Aetna HealthFundT
Aetna Choice POS II
Aetna Choice POS II Plus
Aetna OOA Aetna Select
Kaiser HMO

Which have people had success with for bariatric surgury?

I've read the aetna guidelines, and I think I'll be ok cause I visited a surgeon last year and have recoded weight from then till now.

Or should I just ask my HR rep? Or would that be the wrong move to do?

I have the Aetna Choise POS II and have just submitted all the documents for approval. The insurance lady at the surgeon's office was very positive about Aetna. She said they were one of the easier to work with. She said they issue their approval/denial in about two weeks. Keep your fingers crossed for me :)

Thanks for the info, yeah I just contacted my surgeon to find out what they know but Aetna seems to be good with WLS>

www.aetna.com/cpb/medical/data/100_199/0157.html


I have Aetna PPO. They are great for the RNY. You get a 50/50 chance for the sleeve. I'm trying to get the sleeve but have been denied.

I think I will end up with Aetna PPO but want to talk to my HR person privately first. I've read all of Aetna's info. I just emailed my surgeon to ask the question, can the DS be done as a 2 part surgury, and my surgeons website says that it can be. The DS is a VSG and then some re-routing of your small intestine. I don't want to move any organs around but do want the sleeve (1st part of the DS) so I want to talk to my surgeon to ask if we can CALL the surgury a DS for insurance sake and do it in 2 parts. First the sleeve, then 6 months to a yr later (if needed) I would do the switch. We'll see what he says, but I think he'd be open to this type of wording for insurance sake. Of course if in 6 months I hadn't lost substantial weight, then I would do the switch part.

We'll see what he says.

I can't vouch for any of the other plans but my company offered (and I have) Aetna POS II.  There is a $15,000 lifetime cap on weight loss surgeries.  Here's what it says:    

In Network (or Special Network) Lifetime Bariatric Surgery Maximum:  $ 15,000.00

Good luck (I am just starting to do my research).

I have Aetna POS II and ther is no lifetime max for tha plan that I carry.  WLS is very expensive another co-worker just got the breakdown from the hosp. and her bill for just the hosp. stay was 42K.  We have an out of pocket max for $1200 in a year so I reall think it's just a little different with each company.  You do have to go step by step with the clinical policy bulletin though or they will say NO.  This is my 2nd time trying and I should know by the end of the week if there are going to approve me this time.

Good luck!