Aetna Insurance ??????

Question, what, where, and who can I talk to or read about finding out something about insurance companies? I have heard that an insurance company cannot ask you to do something to meet their criteria for WLS, if they do not cover it under their policy? Such as you need to see a nutritionist and then not pay for you to see one. Is this true? If so where can I find it? I have been to obesitylaw.com but can not find such.

I work for Aetna - there are a few dieticians and nutritionists that are covered, but most are just discounted through aetna. They deny 95% of people on their first attempt for approval - just play their stupid game and you will get approved. Belive me they have a TEAM of lawyers they know what they are doing. They suck to work for cause I know all their dirty little tricks. -Sherrie

Sherrie, I were deny because of the 6-months supervised diet. I am in the process of getting a lawyer. So you think these is a good idea? I have Aetna. Barbara Smith

Hello Sherrie, My name is Monica Cole, and I wanted to ask you a couple of questions about aetna since you said you work for them. I had wls about 2 yrs ago with approval from Humana. Now we have switched to Aetna due to lower premiums and am in need of a desperate Tummy tuck. I have gone to my pcp and he reffered me to a plastic surgeon which I have seen already. He took lots of pictures and wrote a letter of recommendation for the TT. He told me it could take up to a month for any type of respnse from Aetna. It has only been a few days but, I am realistic and just have a feeling Aetna will turn me down. Do you have any feed back on Aetna's track record on this matter? I am ready to write an appeal letter now even though I havn't gotten an answer yet. Do you know of anyone who has been approved for a TT? Thanks in advance for any info. that might be helpful. P.S. I have Aetna hmo. Monica Cole [email protected]

Hi, Monica I'm still doing the preop 6 month pcp thing. But the subject came up at group last night. They said that you have to apply for "reconstructive surgery" not tummy tuck or plastic surgery. It's all in the words. Good Luck Joanne