Anyone have Aetna ASA PPO?

Has anyone had this particular type of insurance & been approved for surgery?  My agent says they cover any medically neccessary surgery but you have to jump through hoops.  Anyone know what the hoops might be?

Hello,

I have Aetna PPO and myself and all three of my kids were approved for surgery.  Yes, there are hoops to go through but not much different than any other insurance.  If you go to Aetna.com and in their search engine type in 0157 it will bring up their clinical bulletin of the reqirements needed to qualify for bariatric surgery. 

Basically, you need to do a 6 month physician supervised diet or a 3 month multidisciplinary program (one or the other).  Three of us did the 3 mo MD program and my one sone did the 6 month plan.  YOu have to prove being morbidly obese for the past 2 years (meaning a BMI of .40 with no co-morbidies, or a BMI of >35 with at least 2 documented co-morbidies)

If you meet the requirements and are going to pursue, let me know and i can send you some stuff on how to go about doint the 3 month program as I have shared it with others on this site.  Like I said, myself and all three of my kids have had surgery.  Two of us were denied at first and I needed to appeal, but won the appeal so I have a lot of experience and knowledge of what type of documentation is needed for approval by Aetna.

Hope this helps.

Nan